RYAN REYES, DDS MS
Periodontist and Oral Surgery

 

 

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

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 minutues 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.

BLEEDING - In most cases, there will be minimal bleeding since the wound is often closed with sutures. If used, the sutures are usually the dissolving type which will fall out on their own 5–10 days after surgery. Some bleeding and oozing may be expected during the first 24 hours. Please keep firm biting pressure on the gauze pack over the surgery site for about one hour. Remove the gauze and then check the site for bleeding. If significant bleeding continues, a new gauze pack should be placed and firm pressure should be applied for one hour. Repeat as necessary. A tea bag can be used if your gauze supply runs low. Avoid vigorous chewing, spitting, or rinsing your mouth or sucking through a straw for 24 hours. Allowing the tissues to rest undisturbed assists the healing process. Avoid continually pulling at your lip to check the operative site.

SWELLING- Depending on the procedure, you may or may not experience swelling. Swelling may be at a maximum about 2 or 3 days after surgery. Keeping your head elevated (in a recliner or on several pillows) will reduce swelling. Ice packs applied continuously are helpful for the first day or so.

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.

DIET - The day of your surgery, start with nourishing liquids and soft/colder foods, such as ice cream, pudding, yogurt, etc. Avoid extremely hot foods, foods with sharp edges (chips, pretzels, etc.), and do not chew immediately over the surgery area. Avoid straws for the first 24 hours. Gradually return to your normal diet as tolerated, usually 4-7 days after surgery.

ACTIVTY - Limit physical activity during the first 24–48 hours after surgery. Overexertion may lead to post-operative bleeding and discomfort. When you lie down, keep your head elevated on a pillow. You may wish to place a towel on your pillowcase to avoid staining from any blood-tainted saliva.

SMOKING  / VAPING - It is advisable that you refrain from smoking for at least 3 days after the surgery, as this increases the risk of infection and may delay healing.

ARNICA CREAM / GEL -  Apply gel to the outside of the face 3 times a day over the area that was treated.  Continue for several days after surgery. to help reduce bruising and swelling.  Arnica gel can be purchased at CVS and like stores.

FOODS TO AVOD Following Dental Surgery, Implants or Wisdom Teeth Extractions:

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

DENTAL PROSTHESIS - Partial dentures, flippers, or full dentures should not be used after surgery unless otherwise advised by your doctor. These may need to be adjusted at or after your first post-operative return visit.

POST OPERATIVE APPOINTMENTS - It is important to return for your post-op visit, generally scheduled 4 weeks after treatment. Contact Dorien  if you have questions or problems before that time.


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!