On your first day immediately after your surgery:

1. Remove the gauze and throw it away.

2. Eat. Any soft nourishing food that can be taken with comfort (i.e. Eggs, Mashed Potatoes, Pasta, Pancakes, Ice Cream, Cottage Cheese).  AVOID CLEAR FLUIDS, CLEAR SOUPS OR JELLO as they are not substantial enough and will not protect your stomach from becoming upset.  Avoid extremely hot or spicy foods.   DO NOT USE A STRAW FOR THE FIRST FEW DAYS AFTER SURGERY.  It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. It is important not to skip meals!  If you are a diabetic, maintain your normal eating habits or follow instructions given by your medical doctor.

3. Take your Motrin / Ibuprofen. .  It is important that you take the first pill before the anesthetic has worn off. Generally, Dr. Harris prefers you take Motrin / ibuprofen even if there is no pain; it works in two ways; pain control and swelling reduction. Take the narcotic in addition to the Motrin, only as needed.  If Dr. Harris has prescribed an antibiotic, you should take it as directed.

4. Place new pieces of gauze at each surgical site. Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in place.  DO NOT SPIT!  Do not change them for the first hour unless the gauze is saturated.  The packs may be gently removed after one hour.  If active bleeding persists, place new gauze over the surgical site and bit down gently for another 60 minutes.  The gauze may then be changed as necessary (typically every 45 – 60 minutes). 

DO NOT DISTURB THE SURGICAL AREA TODAY.

PLEASE DO NOT SMOKE for as long as possible, since this is very detrimental to healing and may cause a dry socket.
DO NOT rinse vigorously today or probe the area with any objects.  You may brush your teeth gently. 

OOZING:  Intermittent bleeding or oozing for as much as 24 hours is quite normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 45-60 minutes at a time.  Consider placing a towel over your pillow before going to bed the first night.  This will prevent the staining of your bedding should you drool a small amount of saliva and blood while sleeping.

PERSISTENT BLEEDING:  Bleeding should never be severe.  If so, it usually means that the gauze packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the gauze packs.  If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in hot water and squeeze until damp/dry) for 20 or 30 minutes.  If bleeding remains uncontrolled, please call our office.

SWELLING:  Swelling is often associated with oral surgery.  It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area.  This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery.  The swelling will reach its maximum at approximately 48 hours after the surgery.

PAIN:  Unfortunately most oral surgery is accompanied by some degree of discomfort.  You will generally have a prescription for pain medication.  Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a large amount of food, the chances of nausea will be reduced.  The effects of pain medications vary widely among individuals. A few patients may even require two of the pain pills at one time.  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  Dr. Harris will likely want to examine the surgical site to ensure there are no complications.   

NAUSEA:  Nausea is not uncommon after surgery.  Generally, pain medications are the cause.  Nausea can be reduced by preceding each pain pill with a large amount of soft food and taking the pill with a large volume of fluid.  Should the nausea persist, try to keep drinking and eating and minimize the use of pain medications.  
Call us if you do not feel better. Cola’s/ Ginger Ale may help with nausea.

 ALWAYS ENSURE YOU HAVE A FULL STOMACH BEFORE TAKING PAIN MEDICATIONS WITH CODEINE (PERCOCET, VICODIN, TYLENOL #3)

NEVER USE TOPICAL ANESTHETICS (SUCH AS ANBESOL) ON HEALING SURGICAL SITES!

PLEASE NOTE:  Dr. Harris will not renew narcotic prescriptions over the phone.  If your pain remains uncontrolled, a follow up office visit will be required to ensure there are no post-operative complications.

INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES:  Avoid rinsing during the first 24 hours. Keeping your mouth clean after surgery is essential.  Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.  Repeat as often as you like, but at least two or three times daily. 
DO NOT USE MOUTHWASHES or HARSH CHEMICALS (Scope, Listerine, Bleaching agents, Anbesol…) for the initial healing period.

BRUSHING:  Begin your normal oral hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of your comfort.

HEALING:  Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be a gradual, steady improvement.  If you don’t see continued improvement, please call our office.  During the initial healing period, avoid heavy exercise as it may lead to increased pain.

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call the office.  Dr. Harris is available 24 hours a day for emergencies.  Calling during office hours will afford a faster response to your question or concern. 

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Send me an e-mail: dr.harris@highdesertoralsurgery.com