Post Op Instructions Extractions Bone Graft Day 1

We wanted to drop you a note with some post-op instructions for the extraction and bone graft we performed today. Please call us if you have any questions.

Antibiotic: — If an antibiotic has been prescribed, start taking it the first day (unless directed otherwise) and use it to completion. You can reduce stomach upset by taking it with food and/or plenty of liquid.

Ibuprofen: — If we prescribed ibuprofen, start taking it the day of the bone graft surgery and continue for 2 days. After that, you can still take it as needed for pain. Do not use ibuprofen for more than one week.

Pain pills: — Take one pain pill as soon as you can after surgery. It will usually work better if taken before the numbness wears off. After that, take only as needed. Take any narcotic pain pills with food and/or plenty of liquid. Do not drive after taking any narcotic pain pill and do not take them with sleeping pills or alcohol.

Ice bag: — Use a cold pack (a plastic bag of frozen peas works well) to the face over the area where the procedure was done for 10 minutes at a time, twice an hour, for the first 6 hours. You can periodically use an ice bag the rest of the day of surgery and the next day. If you use the ice bag as directed, you should have less swelling than you would have otherwise. Less swelling = less pain. Do not use hot packs or a hot water bottle.

Sleep somewhat inclined: — For the first 2 nights after the procedure, sleep in a recliner chair or with your head propped up with some pillows. A recliner is better. If you keep your head above your heart level for the first 2 days, it will significantly cut down on post-op swelling. Less swelling = less pain.

Swelling: — Most people get some swelling and, if they do, it usually happens about 48-72 hours after the surgery. Using the ice bag and sleeping inclined as directed above will help a great deal with keeping it to a minimum.

Liquid in the brown jar: — (if necessary) is chlorhexidine (Peridex®), a topical antiseptic. Use a Q-tip to apply it. The ear cleaning Q-tips work best, as they are very absorbent and hold a good size drop of liquid. Apply about 3 times/day for 4 weeks to the surgical site by dabbing the chlorhexidine soaked Q-tip to the surgical area. Do not scrub it in. During the 1st 4 weeks, whenever you do start any tooth brushing in the surgical site, dip the toothbrush in the chlorhexidine, as well. If you run out, call us to pick up more. Once this liquid is applied, do not eat, drink, or rinse out for 30 minutes.

Oral hygiene: — Do not use a water-pick or an electric toothbrush around the surgical area for 6 weeks after the procedure. After that, it should be OK. Do not floss around the tooth/teeth worked on for 1 week, so you don’t accidentally take out any of the stitches. After 4 weeks, there should be no oral hygiene restrictions, except for water-picks & electric toothbrushes as noted above.

Stitches and “Barrier membrane”: — The stitches and barrier membrane over the extraction site are usually non-dissolvable and will need to be removed about 3 to 4 weeks later.

Salt-water rinses: — Rinse your mouth out (don’t swish) with warm salt water (1/2-tsp. salt in an 8-ounce glass of warm water). Hold this in the mouth for 30 seconds and spit out. Repeat. Do this 4-5 times per day for 7 days. Start the day after the procedure.

Exercise: — Avoid strenuous exercise for the first 7 days. Strenuous physical activity may increase postoperative pain or cause post-operative bleeding and swelling. Less activity equals less pain.

Touching the surgical site: — It is important that the surgical site remains untouched during the initial stages of healing. We recommend that you avoid stretching your mouth to look at the site and avoid playing with your tongue on the surgical sites.

Bleeding: — “Pink” saliva is normal for a few days. If you have bleeding, wipe the area clean of any “blood clots” first. It has to be thoroughly cleaned first. Then apply gentle (it doesn’t need to be real hard) pressure to the extraction site for 10 straight minutes with a soaking wet tea bag (black tea works the best), or a soaking wet gauze pad, or a clean washcloth, etc. Be sure it is soaking wet. If it is not, the clot will stick to it and start bleeding again when you pull it away. If it just won’t stop, call.

Food: — Stay on a soft diet, chew away from the extracted tooth/teeth, and avoid any foods that would be more likely to get stuck in the extraction site, such as corn, popcorn, nuts, and seeds (fruit like strawberries have seeds). Do this for at least 5 weeks (if we used a non-resorbable barrier we removed it, then for 1 week after the barrier is removed). Citric juices, carbonated beverages or acidic foods, like tomatoes, may make it hurt, but won’t damage the graft healing though. For the first 7 days avoid really hot foods or drinks. Consider a nutritional food supplement (Carnation Instant Breakfast drink, Ensure, Slim-Fast, etc.). Ensure makes a product called Glucerna for diabetics. After 5 weeks, there should be no eating restrictions. Don’t use straws for the 1st week. No milkshakes with a straw for 4 weeks.

Smoking: — Don’t. Smokers have a much higher incidence of dry sockets. If you do smoke, keep it 5 cigarettes or less per day and only smoke half the cigarette. No cigars or pipes. Do this for at least 6 weeks.

Aspirin: — Unless you have a special medical reason for taking aspirin (tell us at least a week ahead of time if this is the case), do not take aspirin products for 7 days prior to thru 7 days after the extraction procedure. Aspirin can cause bleeding.