RYAN REYES, DDS MS 

FIRST HOUR:

MEDICATION – You may have been prescribed all or some of the following medications based on individual needs.

Ibuprofen 800mg - You have been given a prescription for 800 Mg Ibuprofen, which is an anti-inflammatory analgesic. Please take one tab every 8 hours for the first 3 days. This drug will greatly decrease the possibility of post-surgical swelling and pain and has been shown to accelerate healing. 

For discomfort, the combination of  (1) Extra Strength (500mg) Tylenol and (1) (800 mg) Ibuprofen taken every 6-8 hours as needed, should keep you comfortable. This combination should be taken in place of Norco, if desired.

Norco 5/325mg - Should intense discomfort occur at any time after the surgery, please take the Hydrocodone (Norco) that has been prescribed to you.  Follow the instructions on your medication bottle.  You may take both Norco and the Ibuprofen together. Their analgesic effect will be synergistic.

Medrol Dose Pack 4mg - This medication is a short course steroid that will greatly help with healing and reduce swelling and inflammation. (Not given to all patients)  If you do not have this prescription, please disregard.

ANTIBIOTICS:  It is VERY important for your healing that you take your antibiotics as directed and take all of the medication prescribed. You will be given Amoxicillin Oral Tablet 500 MG #21.  Take one tablet by mouth three times a day until gone.  If you are allergic to Amoxicillin you will be given Zithromax Z-Pak Oral Tablet 250mg #1 Take 2 tabs by mouth the first day, on days 2-5 take one tab per day.

WOMEN: Antibiotics can render birth control ineffective. They can also put you at risk of yeast infection or upset stomach. You could take probiotics with your antibiotics to minimize this. If you get diarrhea from your antibiotics, discontinue and call us right away. It is important to take all the entire prescription of antibiotics.

GAUZE PRESSURE – Bite down firmly on the gauze packs that have been placed over the surgical areas, make sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is heavy. After 30 minutes, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 20 to 30 minutes). It is best to slightly moisten the gauze with tap water and loosely fluff for more comfortable positioning. Bleeding from oral surgery may take 24 hours to fully stop. Read below. 

PROTECTING THE BLOOD CLOT – Do not rinse, smoke, vape or drink with a straw for at least 48 hours after your surgery. If you have been prescribed an antibiotic mouthwash, you may begin to use it gently at bedtime the night of your surgery. 

The chemicals in cigarettes are caustic and will significantly delay healing, increase postoperative pain, swelling, risk of infection, and dry socket. 

ICE PACKS – Swelling is common following oral surgery. Swelling can be minimized by using cold packs, or a bag of frozen peas applied firmly to the cheek nearest to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24-48 hours after surgery. Do not ice for more than 20 minutes at a time.

 

ELEVATE - Keeping your head elevated above your heart will also help. One to two days after surgery, moist heat will help resolve minor swelling.  

PROBIOTICS - may prevent and relieve some of the common side effects of antibiotics such as nausea, stomach upset, and diarrhea. Probiotics are considered safe and are naturally contained in products such as yogurt. We recommend taking PROBIOTICS while you are taking antibiotics we prescribe for you. Probiotics come in several forms and can be obtained over-the counter at your local pharmacy or supermarket. It is important that you notify your doctor if you experience side effects as they may also be a sign of other serious conditions that may require medical attention. 

AFTER THE FIRST HOUR: 

PERSISTENT BLEEDING – Mild bleeding or oozing is normal during the first 24 hours. If necessary reposition the gauze packs directly over the surgical site. If bleeding persists or becomes heavy you may substitute a black or green tea bag (soaked in very hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. The tea contains a beneficial tannins that locally constricts blood vessels. If bleeding remains uncontrolled after a full hour of using the tea bags, call our Surgical Care Coordinator. Remove the gauze while you eat and sleep. Place an old towel over your pillow, as one drop of blood will turn a mouth full of saliva red. It is completely normal to experience mild oozing of blood from the surgical area for a full 24 hrs. Once the bleeding has stopped you do not have to use anymore gauze.  If you are unable to reach our Surgical Care Coordinator, and you are concerned about bleeding, please go to your local emergency room evaluation.

MANAGING POST-OPERATIVE PAIN – Unfortunately, most oral surgery is accompanied by some degree of discomfort and you may be given a prescription for pain medication. To best manage your discomfort, you should take the first pain pill before the numbness has worn off. If you find you are taking large amounts of pain medicine at frequent intervals, please call our Surgical Care Coordinator. 

NAUSEA – Nausea can occur after anesthesia or surgery. It generally improves within 4-6 hours. Nausea following anesthesia is best managed by avoiding all foods until you are feeling hungry. Try sipping small amounts of clear liquids to prevent dehydration. If the pain medication is the cause, try taking Maalox immediately before the medication and drink plenty of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. Classic Coca Cola may also help with nausea. 

PAIN MEDICATION PRECAUTIONS – The prescription pain medication given to you by the doctor may cause drowsiness, decreased reaction time, blurred vision and change in mental status. Do not drive, operate dangerous machinery, make important decisions or perform strenuous exercises while taking these medications. Failure to follow these instructions increases your risk of causing injury to yourself and others. 

 ** No exercise, heavy lifting, cardio or vigorous physical activity for 4-5 days following dental  surgery.**                                      

ARNICA CREAM / GEL: You may apply gel to the outside of the face 3 times a day over the area that was treated to help with any bruising.  Continue for several days after surgery. Arnica gel can be purchased at CVS and like stores.

 

DO NOT BRUSH THE SURGICAL AREA DURING THE FIRST 24 HOURS

POST-OP DAY #2 AND BEYOND: 

BRUSHING -  Do not brush the surgical sites or rinse, spit, swish, smoke, drink through a straw, or suck on anything for the first 24 hours after surgery. After 24 hours, begin rinsing twice daily with mouthwash, but continue avoiding brushing the surgical areas for the first 7 days. You may gently soak the area with warm salt water (¼ to ½ teaspoon of salt in 8 ounces of water). The exposed areas can be gently swabbed with a Q-tip dipped in water or mouthwash at bedtime, in the morning, and after meals. After one week, start gentle soft brushing of the surgical sites for 3 days, then gradually resume normal brushing, being careful not to brush the surgical areas too hard. Continue regular brushing and hygiene in all untreated areas.  Do not use an electric toothbrush in the surgical area until after your post op appointment.

HEALING – Normal healing after tooth extraction should be as follows: The first three days after surgery are generally the most uncomfortable and there is usually some swelling. On the 4th day you should be more comfortable and, although still swollen, can usually begin a more normal diet. The remainder of the post-operative course should be a gradual, steady improvement. If you do not see continued improvement, please call our Surgical Care Coordinator. 

DRY SOCKET – A dry socket is a painful condition that results from premature loss of the blood clot. Risk factors for developing a dry socket are extracting painful or infected teeth, wisdom tooth surgery, females, smokers, and oral contraceptives. Symptoms of a dry socket typically occur on the 3rd or 4th postoperative day. Severe stabbing pain (think ice pick type of stabbing), which is not responsive to pain medications. This condition requires an office visit where your surgeon will gently place a medicated dressing into the tooth socket. Pain relief is often immediate once the site is treated. A few visits may be necessary in some cases. 

SHARP EDGES/SUTURES – If you feel something hard or sharp edges around the surgical areas, it is likely you are feeling the bony walls, which once supported the extracted teeth or the ends of the sutures. Occasionally small slivers of bone may work themselves out during the following weeks. This is normal but if they cause concern or discomfort, please call our aftercare nurse. Dissolvable stitches begin to melt away as you heal. 

EATING - You may eat softer foods, no seeds or any food that is crunchy or hard or sticky for 4-7 days after surgery.  Please see the list of foods below:

Foods To Avoid Following Dental Surgery, Implants or Wisdom Teeth Extractions:

 

AVOID:

-Tomatoes or tomato sauce – acidic and may burn or cause pain immediately after dental surgery
-Orange Juice – be cautious with OJ or any other acidic juices. They may cause burning or pain if ingested too soon after dental surgery.
-Seeds – anything seedy may get stuck in a surgery site and cause   discomfort or get infected.
-Cracked Pepper – much like a seed this can get lodged and cause pain.
-Popcorn – the corn hulls can become lodged
-Spicy Foods – may lead to pain and discomfort
-Crunchy or Difficult to Chew Foods – these foods may interfere with the blood clotting following dental surgery

Comprehensive List of Foods To Eat After Dental Surgery, Implants, or Wisdom Teeth Extractions:

 

Applesauce
Avocado
Baked Apples
Bananas
Biscuits – flakey, soft or soaked to become soft after surgery biscuit
Broccoli – steamed soft
Broth
Butternut Squash – cooked soft
Carnation Instant Breakfast Drinks
Carrots -steamed soft
Casseroles
Cheese
Cheesecake
Cold Cereal – soaked in milk until soft
Cottage Cheese
Cake
Canned Peas
Cream of wheat – maybe a little to grainy depending on the type of dental surgery.
Crème Brule
Cupcake
Custard
Doughnuts
Ensure / Protien Drinks
Eggs (poached, fried or scrambled)
Egg Noodles
Egg Salad
Fettuccine
Fish (no bones)
Frozen Yogurt
Fruit Juice
Fruit – soft or grind (no seeds)
Gravy
Ground Turkey
Ground Beef/Pork
Ground Chicken
Guacamole
Humus
Ice cream
Jell-O
Juice vegetable
Macaroni and cheese
Malt-0-meal
Mangos
Mashed potatoes
Matzo Ball Soup
Meatloaf
Meatballs
Melons (Very Ripe)
Milk Shake – Avoid using a straw
Miso Soup
Mousse
Muffins
Oatmeal
Pancakes
Pasta
Pies
Polenta
Pot roast with vegetables – cooked to falling apart
Probiotics
Protein Powder – can be added to any liquid meal for added energy and healing
Pudding
Ramen Noodles
Refried Beans
Ricotta cheese
Risotto
Rice
Sandwich Meats
Sherbet
Smoothies ( No seeds)
Soft bread – soak in soup
Souffle
Soup
Spaghetti
Spinach
Steamed Vegetables
Sweet Potatoes
Tapioca Pudding
Tea
Tofu
Tuna Salad
Waffles
Yellow Squash
Yogurt

WHAT TO DO IF YOU HAVE CONCERNS OR QUESTIONS REGARDING YOUR AFTER CARE:

Please do not reach out to the dental office as we are a traveling surgical team, and we are trained to answer your questions, give advice and are educated on what is normal and what is not. Text or call Dorien, our surgical post operative nurse at (530) 410-3356.

Please be patient when waiting for a reply, especially on the weekends.  We will get back to you!