Care of Your Mouth Following Oral Surgery

Special consideration must be given to the mouth following surgery.
Proper home care is very important.
Please do not hesitate to contact this office, if any doubt arises as to your progress and recovery.

General Instructions

Important

Upon leaving, if there is gauze in your mouth, wait 20 minutes before removing it. Replace it with fresh gauze and bite down firmly, changing the gauze not more than about every 20 minutes, until bleeding has stopped.

Bleeding

A certain amount of bleeding is natural and desirable. Mild oozing may be expected for 24 - 36 hours following surgery, and your saliva may become discolored from the blood clot. This is normal and should not cause alarm. If your bleeding is heavy, place a dry, sterile gauze, wrapped around a tea bag, moistened in cold water, directly over the bleeding area. Bite down on the bag with firm pressure for 30 minutes. Sit upright, stay quiet, and do not spit or talk while biting on this pack. Continue to replace the gauze, as needed. If this does not considerably slow excessive bleeding, please call our office. Because a properly formed blood clot is essential for healing, it is important that you not disturb the area around the surgical site for the first 48 hours following your surgery. Creating suction by drinking through a straw, spitting, and exploring the wound with your tongue or finger must be avoided.

Pain

A certain amount of discomfort following oral surgery is expected. For mild discomfort, you can take medications like Motrin or Tylenol. For more severe pain, take your prescribed medication with food or juice. Crush tablets, if they are hard to swallow.

Antibiotics

If an antibiotic has been prescribed for you, it is very important to take it exactly as instructed. If you develop a rash from any of the medications prescribed, stop all medications and call the doctor.

Swelling

Some swelling is expected, especially after difficult impactions, extractions, and other oral surgeries. This swelling may be minimized by the immediate use of ice packs. Place the ice pack on your face for 20 minutes, and then remove it for five minutes, for the first four to six hours following your surgery. Do not use cold after the first day, unless specifically instructed to do so. Swelling usually peaks around the second to third day, and then gradually recedes.

Rinsing

Do not rinse or brush for 24 hours following surgery, as this may disturb the clotting process. Beginning the day after surgery, start rinsing gently with a solution of one teaspoon of salt in a glass of warm water. This promotes healing, as well as cleansing the mouth. Do this with three to five glasses per day, until the soreness is gone. Begin brushing your teeth the day following surgery, using caution in the area surrounding the surgical site. If you have received a bone graft, do not rinse; it disrupts the graft. Gently squirt the area with Peridex twice a day.

Diet

If you have received an intravenous anesthetic, have only cool, clear liquids, such as apple or cranberry juice, 7-up, lemonade, etc. for the first six hours following surgery. This helps prevent nausea. Do not use a straw for five days following your surgery. If your stomach is not upset, or if you have had nitrous exide (laughing gas) or just local anesthesia, you may progress to soft foods (e.g., frozen yogurt, applesauce, soft bread, scrambled eggs, mashed potatoes) about an hour after surgery, if so desired. Be sure your food is room temperature or cooler for the first 24 hours; hot foods and liquids may cause bleeding to increase or resume.

Activity

There should be minimal physical activity the day of your surgery. Rest or sleep after arriving home, as movement encourages both bleeding and nausea. If you are unsteady following intravenous anesthesia, seek help getting up to use the bathroom. Do not shower or bathe until all unsteadiness is gone.

Smoking

Do not smoke for at least 72 hours after surgery.

Again, if pain or swelling occur after the area seems to have healed, or if any doubt arises as to your progress and recovery, please do not hesitate to contact us.

Impacted Teeth

Removal of impacted (buried) teeth is quite different from the removal of erupted teeth.
The following conditions may occur, and are considered normal:

The operated area may swell, and facial swelling may be noticeable, but should start to diminish on the third to fourth day following surgery.
Tightness of the muscles may make it difficult to open your mouth.
Numbness of the tongue or lower lip may occur on the side from which a lower tooth was removed. This is not disfiguring, although it is annoying, and usually is temporary. It may remain from a few days to possibly many months, as discussed in your consultation, and normally resolves with time.
The corners of your mouth may become dry and cracked from being stretched. Keep them moist with Vaseline.

Other Conditions

The following post-operative conditions may occur during the normal progression of the healing process

Small fragments of bone may loosen and work through the gum. If this is annoying, call the office for a return appointment, so they can be removed.
A cavity or depression remains after the removal of a tooth. This should be kept as clean as possible by rinsing and using your irrigating syringe, if one was given to you. Occassionally, healing occurs in such a manner that a dressing may have to be placed to provide comfort.
You may develop black and blue or yellow skin areas. These are not bruises, but are the result of bleeding into tissues, and usually disappear in seven to 10 days.
Your other teeth may ache temporarily. This is called "sympathetic" pain, and will resolve.
A sore throat and/or earache may occur.
Slight temperature elevation may occur for 24 - 48 hours. If it persists, notify our office.
Nausea may occur and last for several days, if left untreated. This usually is due to swallowed blood or drainage, or sometimes as a reaction to medications. Treat this by drinking only small sips of cool, clear liquids, or by taking Dramamine. If nausea persists or vomiting occurs, notify Dr. Strahs.
After intravenous sedation, drowsiness may persist for several hours. This should cause no undue concern. Bed rest is the best cure. Do not drive for 24 hours following your intravenous anesthesia.

Soft Food Diet Instructions

Although we give food suggestions above, some patients have asked for a longer list of foods, which are presented below.

Remember, foods must be mouth temperature or cooler, and you must not use a straw. Try to direct foods away from the side operated on. If you have had wisdom teeth removed, try to chew food toward the front of your mouth.

Scrambled eggs
Very soft pastas
Mashed potatoes
Pudding or custard
Oatmeal or cooked cereal
Yogurt or frozen yogurt
Soft bread or muffins
Smoothies (no straws!)
Soup (tepid / room temperature)

The day after your surgery, once bleeding has stopped, foods can be warmer. You however should continue to avoid the surgical side until it has healed.