Post-operative Instructions

After the removal of multiple teeth

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. if bleeding continues, bite on a moistened black tea bag for thirty minutes.

The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. If you had an immediate denture placed the day of surgery, do not remove it! Unless the bleeding is severe. Expect some oozing around the side of the denture.

Use ice packs or cold compress on the cheek near the surgical site. Apply ice for the first 48 hours for 20 minutes on and 20 minutes off. Apply ice continuously while you are awake.

For mild discomfort use Tylenol, or any similar medication; two tablets every 34 hours. Two to three tablets of Ibuprofen (Advil or Motrin) can be taken every 3-4 hours.

For severe pain, use the prescription given to you. If the pain does not begin to subside after 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, make sure to finish your prescription unless you have an allergic reaction.

Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be rep|aced. Drink at least six glasses of liquid the first day.

Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in one cup of warm water). After you have seen your dentist for denture adjustment, take out the denture and rinse 3 to 4 times a day.

Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to resume your normal diet.

The removal of many teeth at one time is quite different from the extraction of just one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:

• If you had multiple Extractions the surgical site will swell, reaching its maximum on day 3 or 4. Swelling and discoloration around the eyes may occur. Cold compress may be applied to the skin to minimize swelling. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as is tolerable, beginning 36 hours after surgery. (Remember: ice packs are used for the first 36 hours only).
• A sore throat may develop. The muscles of the throat are near the extraction sites.
  Swelling into the throat muscles can cause pain. This is normal and should subside in 3~4 days.
• If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24—48 hours. If your temperature continues to rise, notify our office.
• If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.

If you ever have any questions or concerns please call our office: Katy Periodontology And Oral Surgery: 281-394-9340.

After tooth Extraction

After tooth extraction, it’s important for a blood clot to form to stop the bleeding and begin the healing process. Bite on a gauze pad for 30-45 minutes immediately after the appointment. if the bleeding or oozing still persists, place another gauze pad and bite firmly for another 30 minutes. You may have to do this several times to staunch the flow of blood.

After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, smoke, drink alcohol or brush teeth next to the extraction site for 72 hours. These activities may dislodge or dissolve the clot and hinder the healing process. Limit vigorous exercise for the next 2—3 days, as this increases blood pressure and may cause more bleeding from the extraction site.

After the tooth is extracted you may feel some pain and experience some swelling. An ice pack or cold compress may be applied to the area will keep swelling to a minimum. Take pain medications as prescribed. The swelling usually begins to subsides after 3-4 days.

Use pain medication as directed. Call our office if the medication doesn‘t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extraction. You can eat normally as soon as you are comfortable.

It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth at least once a day. This will speed healing and help keep your mouth fresh and clean.

After a few days the pain should start to subside and can resume your normal activities. If you have increase in swelling, heavy bleeding, severe pain, continued swelling after day 4, or a reaction to the medication please call our office immediately at Qty Periodontology And Oral Surgery: 281-394—9340.

AFTER EXPOSURE OF AN lMPACTED TOOTH Do not disturb the wound. If surgical packing was placed, leave it alone. The packing helps to keep the tooth exposed. If it gets dislodged or falls out, do not get alarmed but please contact our office for instructions.

BLEEDING Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding that rapidly fills your mouth with blood can frequently be controlled by biting with pressure on a gauze pad placed directly on the bleeding wound for 30 minutes. if bleeding continues, please call for further instructions.

SWELLING Swelling is a normal occurrence after surgery. To minimize swelling apply an ice bag or a plastic bag filled with ice cubes on your cheek near the area of surgery. Apply the ice for 20 minutes on and 20 minutes off for the first 48 hours.

DIET The day of surgery we will need you on a soft cold food diet. ice cream, yogurt, milk shake ect. Hot liquids, crunchy, chewy and/or hard foods should be avoided. Return to a normal diet as soon as possible unless otherwise directed.

PAIN You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2—3 tablets may be taken four times daily, not to exceed 3200mg daily for an adult. Consult our practice for individuals under 18.

For severe pain, the prescribed medication should be taken as directed and may be combined with Ibuprofen. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

ORAL HYGIENE Oral cleanliness is essential to good healing. Clean your mouth thoroughly after each meal, beginning the day after surgery. You may brush your teeth as normal but avoid the surgical site. Rinse with warm salt water (1 teaspoon of salt in a cup of warm water) six times a day. Continue this procedure until healing is complete.

REMEMBER: A clean wound heals better and faster.

ACTIVITY Keep physical activities to a minimum immediately following surgery. Avoid exercise for the first 5-7 days. If you do exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. if you get light headed, stop exercising.

If ever you have any questions or concerns please call our office: Katy Periodontology And Oral Surgery -281—394-9340.

After Placement of Dental Implants

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. In some cases there may be a metal healing abutment protruding through the gingival (gum) tissue. Other times the tissue is completely closed and covered around the implant. You will not see anything.

BLEEDING Some bleeding or redness in the saliva is normal for 24 hours. Bleeding controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. After that, replace and repeat if necessary. If bleeding continues profusely, please call for further instructions.

SWELLING Swelling is a normal occurrence after surgery. To minimize swelling apply an ice pack or cold compress to the cheek of the surgical site. Apply the compress for 20 minutes on then 20 minutes off. Ice as much as possible, for the first 36 hours.

DIET Drink plenty of fluids. Begin with soft cold foods the first day. Ice cream, yogurt, milk shake ect. Avoid any hot liquids, spicy or chewy foods. You may resume a normal diet when you feel comfortable but avoid chewing directly over the implant site for about 7-10 days or unless otherwise directed. Dietary intake is an important aid to the healing process.

PAIN You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2—3 tablets may be taken four times daily, not to exceed 3200mg daily for an adult. Consult our practice for individuals under 18.

For severe pain, the prescribed medication should be taken as directed and may be taken with Ibuprofen. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should resolve over the next 2-3 days . if pain persists, it may require attention and you should call the office.

ANTIBIOTICS Be sure to take the prescribed antibiotics as directed to help prevent infection.

ORAL HYGIENE Good oral hygiene is an essential component to the healing process. The night of surgery, if prescribed use the Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily; after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day as well, especially after meals. Resume brushing your teeth as normal the day after surgery, avoid brushing the implant site for 5-7 days. Be gentle initially while brushing the surgical areas.

ACTIVITY Keep physical activities to a minimum immediately following surgery. Exercise needs to avoided for the first 5—7 days after surgery. If you excerise throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise.

WEARING YOUR PROSTHESIS Partial dentures, flippers, or full dentures, should not be used immediately after surgery for at least 10 days unless otherwise discussed.

General Guidelines

• Avoid tabacco products for at least 1 week post opperatively.
• Do not pull or pick at the sutures. Typically the sutures will dissolve with 5-7 days of surgery. If they have not fallen out in that time, the doctor may remove them at your post operative appointment.

If ever you have any questions or concerns please call our office: Katy Periodontology And Oral Surgery: 281-394-9340.

After Wisdom Tooth Removal

The removal of impacted teeth is a serious surgical procedure. Post—operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully.

IMMEDIATELY FOLLOWING SURGERY The gauze pad placed over the surgical area should be kept in place and keep pressure on the site for a half hour. After this time, the gauze pad should be removed and discarded. Bleeding is typical for the first 24 hours.

Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to
become dislodged.

Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.

Restrict your activities the day of surgery. You can typically resume normal activities 5—7 days after surgery unless otherwise directed.

Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for a more thorough explanation.

BLEEDING A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call our office for further instructions.

SWELLING The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by keeping the head elevated at all times fro the 2-3 days followig surgery. The immediate use of ice packs or cold compress will help prevent swelling. Placing them should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal
reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

PAIN For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken four times daily, not to exceed 3200mg daily for an adult. Consult our practice for individuals under 18.

For severe pain, the prescribed medication should be taken as directed and may be taken with Ibuprofen. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. if pain persists, it may require attention and you should call the office.

DIET The clay of surgery we need you on a soft cold food diet. Things like ice cream, yogurt, milk shake ect. Hot liquids, crunchy, chewy, and/or hard foods should be avoided. We use long acting anesthetics so soft cold food need to be consumed to help prevent bleeding and hitting your lip. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

CAUTION: Immediately following surgery, If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.

KEEP THE MOUTH CLEAN No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water.

Bruising: In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence. Moist heat applied to the area may speed up the removal of the discoloration. This will resolve within 5—7 days of surgery.

ANTIBIOTICS If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions.

NAUSEA AND VOMITING In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including the prescribed medicine. You should then sip on coke, tea, or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

lf numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation.

Slight elevation of temperature immediately following surgery is not uncommon. if the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.

You should be careful going from the lying down position to standing. You could get light headed from low blood sugar or medications. Before standing up, you should sit for one minute before getting up.

Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Drs. Bachoura, Michael & Young.

If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.

Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.

Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

General Considerations

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.

There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month . In the meantime, the area should be kept clean, especially after meals, with salt water rinses or a toothbrush.

Your case is unique, no two mouths are alike. Discuss any problems with the trained surgeons best able to effectively help you:

Brushing your teeth is okay —just be gentle at the surgical sites.

A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain near the ear may occur 3-4 days following surgery. Do not smoke. Smoking in any amount in the first few days can cause a dry socket and will dramatically delay wound healing. Call the office if this occurs.

Do not drink alcoholic beverages, drive , or operate machinery for the first 24 hours following General Anesthesia. Do not combine pain medication with alcohol.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

Please contact our office is you experience any of the following. Excessive bleeding, persistant nausea, severe uncontrolled pain, temperatures greater 101.F ( by mouth), rashes/itching/wheezing, or drainage of the surgical site.

If you ever have any questions or concerrs please call our office : Katy Periodontology And Oral Surgery: 281-394-9340

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