After All Procedures

Following:

• Wisdom Teeth Removal
• Tooth Extraction
• Implants
• Bone or Soft Tissue Grafting
• Other Oral Surgery

POST OPERATIVE INSTRUCTIONS

Any surgical procedure in the mouth is followed by some oozing, swelling and discomfort.  In order to avert complications, these instructions should be followed unless different instructions have been given by the doctor or clinical staff.

BLEEDING
The gauze pack in your mouth should remain in place with slight biting pressure for at least 1 hour after you leave the office.  The area should be covered with a clean gauze pad and firm biting pressure applied for 20-30 minutes.  Repeat as necessary for the day or evening.  If some bleeding persists, you may also consider applying a warm, moist tea bag to the surgery site for 30-60 minutes.  Please call the office or Dr. Boghossian’s cell phone (listed on the cover) if these measures do not control your bleeding.

SWELLING
To minimize swelling, apply an ice bag to the operated side of the face as soon as you arrive home.  Apply cold for 10 minutes, then off for 10 minutes.  Continue for one to two days when awake.  In some cases, a 3 day course of steroid is prescribed by doctor to minimize swelling.

SUTURES
You may notice sutures in your mouth.  In most cases these are the dissolving kind which will fall out by themselves, from the day of surgery until your postoperative appointment. 

CARE OF MOUTH
Do not rinse your mouth the day of surgery and avoid using straws.  This may dislodge the blood clot and interrupt the normal course of healing.  After 24 hours you may rinse gently with warm water and hydrogen peroxide (mixture), one ounce of each: swish and spit 2-3 times per day for 2 weeks.  You may brush your teeth, but stay at least 2 teeth away from the wound for 7-10 days.  In some instances, a prescription mouthwash will be ordered for you at the pharmacy to be used for 7-10 days. 

AFTER IMPLANT PLACEMENT
Do not wear denture or false tooth until approved by Dr. Boghossian.

PAIN
Discomfort (or severe pain after difficult or prolonged surgery) should be expected.  Medication is given or prescribed to alleviate this (take as instructed on the bottle).  Take medication prior to discomfort and no driving when taking narcotic pain medication.  Sleeping on 2 or 3 pillows may lessen the pain and the swelling.  Most pain should decrease after 2-3 days; you need to report/call the office if your pain increases or does not improve after 2-3 days. 

ANTIBIOTICS
Antibiotics are to be taken until finished and as instructed on the bottle.  They may cause diarrhea or stomach upset.  All female patients utilizing birth control pills, use an alternative form of birth control during this time period. 

DIET
Drink cold or warm liquids the day of surgery (jell-o, puddings, yogurt, etc.).  You may advance to soft foods the following day.  Avoid Chewing on the surgery side for at least 7-10 days. 

NAUSEA
Nausea may accompany the discomfort during the initial postoperative period and/or as a side effect of pain medication or antibiotics.  Small sips of tea, 7-up, or ginger ale may help.  If nausea persists, telephone the doctor at the numbers provided on the cover of this pamphlet. 

IMMEDIATE DENTURE
If a denture was placed in your mouth after surgery, it will serve as a surgical bandage and needs to be in place for the first 24 hours.  After 24 hours, remove as needed to clean and rinse.  Keep it off at night to allow for healing.

POST IV ANESTHESIA
The major effects of IV drugs will have worn off before you are allowed to leave our office.  However, there can be residual effects lasting 6-12 hours and sometimes longer.  During which time your reflex time and judgment may be altered.  You are advised not to drive an automobile or operate machinery for 24 hours.  This is also recommended while taking narcotic pain medication.  During this period you may also experience lightheadedness, dizziness, etc.  Do not walk without assistance to avoid falls.
The following postoperative conditions may occur in some patients while healing is progressing normally:

FEVER: Your temperature may be elevated for 24-48 hours after the operation.

SORENESS: If the corners of the mouth are dry and cracked, cream or ointment may help.

NUMBNESS: You may experience numbness around the corner of the mouth.  This may remain for a few days or few weeks.

MUSCLE STIFFNESS: Tightness of the muscles (trismus) may cause difficulty in the opening of the mouth.

DRY SOCKET: This may occur 3-5 days after surgery (wisdom teeth).  It is characterized by an earache due to the loss of the blood clot in the tooth socket.  Call us so that we may schedule you for a check up visit.

BRUISING: The skin may become discolored a few days after the operation with bruising.  It may last up to 10-14 days.

SMOKING: Do not smoke during the first 72 hours after surgery as it will increase pain and result in poor healing.  The longer you refrain from smoking the less chance you have of post operative complications.

SHARP BONY EDGES: small pieces of bone may work out of the surgical areas as long as 5 to 6 weeks after surgery.  They will either resolve on their own or we will remove with a simple process.

ACTIVITY: Avoid physical exertion and fatigue during the immediate post operative period.  Light activity is preferable for 7-10 days post operatively.  Obtain adequate sleep.  No weight lifting.

Download these instructions by clicking on the following link: After All Procedures