Post-operative Instructions

• You and your escort will be given post-op instructions prior to your dismissal.
• Ice packs should be used intermittently in 15 min. increments for the first 24 hrs. to minimize swelling. Ice cubes/snow cones held in the mouth in the region of the surgery may also be beneficial. After 48hrs, the use of moist heat will assist in resolution of swelling.
• The gauze may be removed after 1 hour. If bleeding should persist, replace with a fresh damp gauze for an additional hour.
• Avoid dehydration by drinking plenty of water or Gatorade. The gauze may be removed while drinking and then replace thereafter.
• If sutures were placed, they may be removed at your post-op appointment or may fall out by themselves.
• The day following surgery, rinse your mouth 4 times a day (after each meal) with CloSys or 1 cup of warm water containing 1 tsp. of salt. Use the provided LivFresh or AO gel/rinse afterwards.
• Following surgery, take pain medication with water or milk. Take your pain medication as directed especially the first 5 days.
• Please ensure that you do not chew on your cheek or lip while they are still numb.
• Do not play with surgical site with your tongue, fingers, or objects (toothbrush, pencils, etc.)
• Do not consume hot liquids or foods for 48hrs.
• Avoid vigorous rinsing, spitting, smoking, snuff, and using a straw.
• Do not blow your nose! If you need to sneeze, sneeze with your mouth open.
• Avoid strenuous work or exercise.
• If you are taking a birth control pill, please use additional birth control while taking prescribed medications and for 30 days after.

If Sedation was used for Surgery:

• You are under the influence and should act and be treated as such.
• Under no circumstance drive an automobile, operate machinery, or make business decisions for at least 24hrs.
• You will require observation for at least 24hrs.
• Please do not take a major trip immediately after procedure.
• If you become dizzy while standing or sitting, please lie down. You will need assistance with walking until this resolves.

Symptoms That May Occur:

• Swelling and elevated temperature occurs to some extent with any procedure. It does not always mean you have an infection. After removal of teeth or re-contouring of bone, swelling may be quite severe and will peak at 48-72 hours after surgery.
• Black and blue marks (bruising) may appear and are a result of bleeding internally into the cheeks or chin. This will resolve within approx. 1-2 weeks. Moist heat compresses applied to the face will assist with disappearance.
• Stiffness in the jaw may occur and typically take a week to resolve. Temporary or permanent numbness of lips, tongue, or chin may occur as explained. Please inform us if numbness is still present after 72 hours post-surgery.
• If IV medications were administered, slight redness and tenderness may occur in the region of injection. Apply a warm, moist towel and elevate arm. Contact our office if it does not improve after 24 hours.
• Your symptoms should improve daily after the 3^rd – 5^th Please contact us if your temperature elevates to 100 or greater or condition seems to worsen after day 6.

Please avoid the following foods the first 7 days after surgery:

Spicy Foods

Crunchy foods or foods that are difficult to chew (raw vegetables included)

Popcorn, Chips, Nuts, and Seeds (avoid for a month)

French bread loaves and Baguettes

Grapefruit and most citrus fruits with 8 oz. of pineapple juice per day being the only exception.

Alcoholic Beverages

Carbonated Drinks

Tomatoes or Tomato Sauce

On the day of surgery, begin with clear fluids (juice, broth, tea, Jell-O, protein shakes) and progress slowly to more substantial foods. Remember, it is important to maintain nutrition for optimal healing to occur.

Be sure to rest and take it easy for the first few days; rent a few movies and have a relaxing recovery!

If there are any serious problems or questions which need our doctor’s immediate attention, we are available 24 hours at High Plains Periodontics PLLC Phone Number (806) 686-1262.

Pain. Some discomfort is normal after a procedure. 600-800 mg every 6-8 hours of ibuprofen (Advil, Motrin or generic) with 1000 mg Tylenol is usually an excellent choice – IF you are not allergic or intolerant to non-steroidal anti-inflammatory drugs. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past. In the very rare instance that narcotic pain reliever was prescribed for you, alternately taking the ibuprofen and narcotic when needed will improve your pain control. Some liquid/food in your stomach before taking pain medicine is usually a good idea in preventing nausea. Remember, pain medicines that contain a narcotic can impair judgment and reflexes and cause constipation. Avoid driving or doing anything potentially dangerous while taking these medications.

Bleeding and Gauze Pads. Gauze should be placed over the surgery site(s) with gentle pressure applied when you bite down; proper placement helps you avoid swallowing blood, which can make you more nauseated. The gauze should be replaced every 45 – 60 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. Any heavy bleeding should slow within 3 to 4 hours. A small amount of blood is common up to 24-48 hours after your surgery and occasionally during sleep the first night. AVOID touching the area with fingers or your tongue. You may have been provided a plastic syringe with a solution that aids in stopping bleeding.

Rinsing. Do not rinse your mouth on the day of surgery, it may prolong your bleeding. Begin CloSys or salt-water rises the day after surgery and continue for one week. If using salt water rinses, use 6 to 8 times each day, with approximately 1/2 teaspoon dissolved in a glass of warm water (a pre-made bottle each morning will lessen the amount of work!). Do not use full-strength mouthwashes (except for CloSys) of any kind during the first week (mouthwashes contain alcohol which will hinder healing).

Swelling. Swelling is a normal occurrence after oral surgery and is a major cause of discomfort. Swelling normally reaches its peak by the 3rd day and then starts to resolve; it can be reduced using an ice pack (or bag of frozen peas) over the affected area. Follow the 15 ON/15 OFF rule. Apply the ice pack for 15 minutes, making sure to avoid heavy pressure, then remove or transfer it to a different area for 15 minutes. Do not freeze the skin. Apply the ice continuously, as much as possible, for the first 24 hours. Ice packs are useful for the first 24 hours only. Also, keep your head elevated above the level of your heart on 2 pillows for 4 days. These measures won’t eliminate swelling but help immensely to reduce its severity.

Diet. Do not eat for 2 hours after surgery (to allow blood clotting to begin undisturbed) then start with clear liquids, such as apple juice, tea or broth. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours. If you were sedated for surgery, avoid fatty, creamy, or oily foods to minimize nausea. You should eat only soft food for the first few days. For example: soups, juices, mashed potatoes, rice, protein shakes, and meatloaf are fine. For 2 weeks, avoid any hard, chewy, sticky foods such as European breads, pizza crust, steak or jerky, and nuts or popcorn. To help prevent dry socket after an extraction or pulling out stitches or graft material, do not use a straw for the first 7 days after surgery. 8 ounces of pineapple juice a day will also speed up the healing. Any more than 8 oz. however can become detrimental and slow down the healing process.

Oral Hygiene. Begin brushing your teeth the day after surgery. It is important to brush all your teeth, even if the teeth and gums are sensitive. It is important to proper healing that plaque and food are not allowed to accumulate near the surgical site. Smoking is strongly discouraged for at least a week. As with the use of straws, suction causes increased bleeding AND the nicotine and tar can cause delayed healing and loss of blood clot. Warm salt water rinses (1/2 teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, especially after meals.

Activity. Unless told otherwise, do no vigorous physical activity for three days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may increase your activity, such as jogging or tennis, 7-14 days after your surgery.  As new blood vessels are growing, activity will raise your blood pressure and may cause these new vessels to burst. If you feel thumping or your heartbeat in the surgical area, you are overdoing it and may delay healing significantly.