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by Dr. Jeffrey Dorfman, Director of The Center for Special Dentistry.

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Post Operative Instructions after Oral Surgery

 

Bleeding - A few drops of blood in you mouth will turn your saliva red.  Don't panic!  What you might see in your mouth is red saliva not real bleeding.  It is ok if you swallow your own blood; it's part of you!  The best thing to prevent bleeding is pressure, e.g. biting on the cotton we gave you or Kleenex.  Caffeinated tea bags like Lipton or Tetley contain Tannic Acid that is a good blood clotting agent. You could wrap a moistened tea bag in cotton or tissue and gently bite on it.  Never spit!  This is the worst thing you can do because it will create a vacuum in your mouth that will make you bleed!  If you must get rid of the red saliva in you mouth you may occasionally wipe your mouth with tissue.

When you brush your teeth for the first few days post operatively, avoid the wound and instead of spitting out the toothpaste let it gently (and gracefully) fall out of your mouth.  You might want to use an old pillowcase and sheets for the first few nights because you might drool a little red saliva at night.

Smokers should refrain from smoking during healing because this does delay healing, but if you must smoke don't inhale!  This was good enough for President Clinton and more importantly, inhaling will create a vacuum in your mouth (like spitting) and might make you bleed.

ICE - Use it for the first couple of days.  Ten minutes on then off, as much as possible while watching t.v.  Ice will help minimize swelling if it does occur.

DRUGS- Take them if necessary!  Two types:  antibiotics and pain relievers.

1.  Antibiotics - For example, Penicillin, Erythromycin or Tetracycline may be prescribed following certain surgical procedures four times a day for the week following surgery.    You will be informed following your surgery if antibiotics will be necessary for you.  Ladies taking birth control pills should inform their Ob/Gyn who might recommend additional birth control procedures during that cycle because some antibiotics decrease the effectiveness of The Pill.  The antibiotic may be used to ensure that the surgical site does not become infected.  It is a precaution worth taking.  Be sure you have made us aware if you have any antibiotic allergies!

2.  Pain relievers - Two types; an anti-inflammatory pain reliever, e.g. Advil or Motrin and a narcotic, e.g. Percocet.

1. Anti-inflammatory (ibuprofen) pain relievers like Advil or Motrin (Not Tylenol!) inhibit prostaglandin synthesis that is an early event in your body's pain response to surgery.  Take Advil or Motrin immediately after surgery.  Then take one or two tablets every six hours up to the daily maximum listed on the bottle for the next several days.  Take this recommended dosage even if you don't have pain because this will significantly help prevent you from feeling pain in the first place!  If you wait to first feel the pain you have lost the anti-inflammatory advantage.  Although these products do not contain aspirin some cross-reactions may occur in aspirin sensitive patients!  If you are sensitive to aspirin you should take Tylenol instead but you give up the anti-inflammatory benefit Advil or Motrin provide.  You should not drink alcohol with these drugs because in combination they can be highly toxic to your liver!

 

2. Narcotic pain relievers - Typically this will be Percocet that is similar to Percodan but it does not contain aspirin.  Take one tablet every four to six hours for pain, if your Advil or Motrin are not providing you with an adequate amount of pain relief.  Percocet may be taken along with these non-narcotic pain relievers.  Do not drink alcohol, take other medications without approval, and perform activities that require eye-hand coordination or drive a motor vehicle when taking this narcotic.

 Drug Dosage - The antibiotics, anti-inflammatory pain relievers and narcotics can be taken together but some people might find they get a sensitive stomach.  Drugs are easier to handle with food in your stomach.  Some patients might vomit around their second postoperative day; this is almost always from the medication and rarely from the surgery itself.  If this happens spread out your pill taking to give your stomach a break.  Eat smaller meals to stay nourished and avoid taking all of your pills at the same time.  If you do vomit, you could reduce your drug dosages a little, e.g. take only two or three antibiotic pills a day or take a little less Advil or Percocet.

 Drug Warnings - Don't drive your car!  Avoid alcohol!  Patients who take other medications, have drug allergies, or who have other medical conditions should speak with me directly for special info!

 Swelling And Skin Discoloration - This may occur following any surgery.  You might even notice the glands under your neck becoming a little enlarged as they drain from the surgical site.  Mild swelling is normal.  If you think your swelling might be excessive, or it is still increasing after several days, call!  Your skin might discolor black and blue or sometimes purple, green or yellow.  Wear all white or all black clothing so you don't clash!

 Nourishment - Eat numerous small meals to stay nourished, tons of ice cream if you want-hooray!  Drink plenty of liquids to stay hydrated.  If you become dehydrated and undernourished you will not feel nearly as well.

 Mouth Washing - For the first week post operatively you may rinse with 50% Hydrogen Peroxide and 50% water several times a day.  Afterwards you should rinse with just plain water to get rid of the peroxide taste.  Remember not to spit - just let the mouthwash fall out of your mouth.  (I only recommend peroxide rinses following surgery not as a routine mouthwash).

 Your Tongue And Lips - They are your friends!  Be careful not to bite them until you have regained full sensation from the Novocaine.

 Your Nose - If you have had surgery on your upper jaw try to avoid blowing your nose for the first few weeks after surgery.  Hard nose blowing could disturb the newly forming blood clot and make you bleed.

 Stitches - You may, or may not, receive stitches (sutures) following oral surgery.  If you do receive stitches we usually use a type that resorbs (dissolves) over two to three weeks without intervention.  Sometimes these stitches will begin to hang loosely around the wound and you may feel more comfortable if you return to the office for their removal; this should only take a few minutes and is painless.  Please be sure to confirm the type of stitches we use after your specific oral surgery.  Thanks, RS!

 Questions???? - Call!  Get some rest.