General Post-Operative Instructions

Please read these instructions carefully.

Sometimes the after-effects of oral surgery are quite minimal, so all these instructions may not apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office anytime for clarification.

Bleeding Control

• If given a gauze pack, keep in place for approximately 2 hours with constant, firm biting pressure.
• If bleeding persists and gauze was given, fold the gauze and place over the bleeding area exerting firm pressure by biting your teeth together for an additional 2 hours. You may use a moistened tea bag as an alternative. Repeat as needed until bleeding has stopped. Most bleeding slows down and stops on the first day or early on the second day. After the bleeding stops or there is minimal bleeding, gauze is no longer needed. If bleeding has not stopped by the end of the second day, please call our office.
• Some oozing and discoloration of saliva are normal.
• Do not suck or spit excessively for 48 hours after surgery.

Swelling

• If told to use ice, place the ice bag on your face near the surgical site for 20 minutes on and 20 minutes off for the first 48 hours. The ice may be placed in a plastic bag and covered with a thin towel before applying to the face. Keep your head elevated for the next 48 hours, including at bedtime, to minimize your post-operative swelling. The more elevated, the less swelling you will have.

Medications

• Take the medications prescribed by Dr. Rayher as directed.
• For Mild to Moderate Pain:
  Take ibuprofen (Advil or Motrin), 600 mg about every 6 hours, 4 times a day, for the next 3-4 days to minimize swelling and mild to moderate discomfort.
• For More Severe Pain:
  Take Hydrocodone (Vicodin), 1-2 tablets every 4 hours as needed for pain that is not managed by the ibuprofen. You should not drive or operate machinery while taking medications.
• Antibiotics: Take all of the medication according to the instructions on the label. Typically, you should take 1 tablet about every 8 hours. You may take the antibiotics at the same time as the ibuprofen, as long as they are taken with some food. Otherwise, stagger them at least 1 hour apart or you may experience nausea.

Oral Hygiene

• Do not use a mouth rinse or saltwater rinse for 24 hours. After 24 hours, you should rinse gently with salt water (1/2 teaspoonful of salt in a glass of warm water). Use 5-6 times daily, after eating and between meals, for the next week until we see you at your post-op check.
• If given Peridex mouth rinse, begin rinsing after 48 hours 2 times daily until instructed by Dr. Rayher to stop. Do not use commercial mouth rinses, such as Listerine or Scope, for 2 weeks, as this may impair healing. You should resume brushing your teeth 24 hours after surgery; however, you will need to be careful to avoid the area of surgery for 2-3 days.

Diet

• For the next 24 hours, stay on a clear liquid diet (broth, Jell-O, juice without pulp, etc.). As healing progresses over the next 2 days, follow a non-chewing diet (yogurt, soups, ice cream, protein shakes). Until wounds are healed (up to 6 weeks) soft diet is important (eggs, fish, pasta, mashed potatoes). Well-balanced meals are important for predictable healing.

Rest

• Avoid over-exerting yourself. Go to bed early at night and get adequate rest during the day. If you were sedated or given a general anesthetic by the administration of medications into your vein, you should go home and rest quietly with your head elevated. Remain inactive for 24 hours and do not operate machinery or drive an automobile.
• No strenuous exercise for 1 week. Do not swim until wounds are healed.

Sutures

• Sutures are usually placed. Although you may feel them with your tongue, it is best to leave them alone. If dissolvable sutures are used, sutures will usually dissolve within 2-5 days. If non-dissolvable suture materials are used, we may remove them at your next visit.

Bruising

• Do not be alarmed if a yellowish blue-black discoloration appears on your face after surgery. It will take a week or more to fade away.

Possible Complications

Following any oral surgical procedure, particularly the removal of impacted lower wisdom teeth, several undesirable effects may occur.

• You may have pain that becomes worse after a few days and does not respond to the medication you are using. It may be necessary for you to call the office and arrange to come in for a sedative dressing.
• Other teeth on the same side may ache temporarily.
• You may have a sore throat or an earache for a few days.
• If the medication you are taking does not make you comfortable or if you develop a fever, call the office.
• Numbness of the lower lip may persist on the same side as the surgery. Mention this at your post-operative appointment.
• There may be a “hole” in your gum after surgery. This is the tooth socket and will fill in.
• The blood clot, which forms in the extraction socket, is very important to allow for proper healing. Be very careful not to rinse out the blood clot.

Post-Op Visits

You should return to the office for your post-operative visits at the suggested time. However, feel free to call if you are having any problems.