Post operative instructions After SURGERY (Wisdom teeth, extractions, implants, & bone or soft tissue grafting)

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.


A damp gauze pad will be placed in your mouth at the end of the procedure.  It should remain in place with slight biting pressure for at least 1 hour after you leave the office.  The area treated should be covered with a clean and damp 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 (given to you in the office) if these measures do not control your bleeding. 


Swelling is a normal occurrence after surgery. To minimize swelling apply an ice bag to the outside (cheek) of the treated side of your mouth as soon as you arrive home.  Apply cold ice bag on cheek for 10 minutes, then off for 10 minutes.   Continue for 1 to 2 days when awake.  Dr. Boghossian will also prescribe a 3 day course of steroids to minimize swelling.  If you experience residual swelling or soreness after the second day, you may use warm compresses as needed.   


You may notice sutures in your mouth.  In most cases, they will resorb.  They usually fall out by themselves starting the day after surgery until the day of your post operative appointment approximately a week later.


Good oral hygiene is essential to good healing.  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.  

Wearing your Prosthesis after implant placement

If you had an implant (s) placed, do not wear partial dentures, flippers, or full dentures, until approved by Dr. Boghossian. 


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. 


You will be instructed to start taking pain medication before discomfort sets in.  Discomfort (or severe pain after difficult or prolonged surgery) should be expected.  Medication is given or prescribed to alleviate this as instructed on the bottles.  You should not drive when taking narcotic pain medication.  Sleeping with your head elevated with 2 or 3 pillows may lessen the pain and the swelling.  Most pain should decrease after 2-3 days.  Please call the office if your pain increases or does not improve after 2-3 days. 


Be sure to take the prescribed antibiotics as directed to help prevent infection.  They should be taken until finished and as instructed on the bottle.  They may cause diarrhea or stomach upset.  All female patients utilizing birth controls pills, need to use an alternative form of birth control during this time period. 


Drink plenty of fluids.  Drink or eat cold or up to room temperature liquids and foods the day of surgery (Jell-O, puddings, yogurt, etc.).  You may advance to more substantial soft foods (pasta, scrambled eggs, mashed potatoes, etc.) the following day.  Avoid chewing on the surgery side for at least 7 – 10 days. 


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 Dr. Boghossian at the numbers provided to you by the office. 


The major effects of IV drugs (if your case was an IV case) 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 to 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 if you have had wisdom teeth surgery.  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.