Home Care Instructions: Surgery or Implant

After an extraction, implant or surgical procedure, the surrounding gum tissue, jaw muscles and bone may be sore for several days. This tenderness is normal and is no cause for alarm. Below are some home care instructions following your surgical procedure.                     

TREAT THIS AREA LIKE A CUT: The initial healing period typically takes from 1-3 weeks, and complete healing of the bone can take about 4-6 months. Some discomfort, light bleeding, bruising and swelling should be expected in the next 24-72 hours as your mouth heals. Following these simple instructions will normally be all that is needed. As your mouth heals, you can promote faster healing and avoid complications by simply following the instructions below.

DO NOT DISTURB THE WOUND: In doing so, you could invite irritation, infection and/or bleeding. The healing process begins immediately after surgery as your body sends blood to nourish the wound.  Visible healing will take one to two weeks and swelling may last 48-72hours. In the case of extraction, simple pressure from a piece of gauze is usually all that is needed to control the bleeding and to help a blood clot to form in the socket. In cases where sutures are used: normally, your sutures will dissolve, but sometimes sutures will need to be removed in 7-10 days. Keep your fingers and tongue away from this area (don’t play with it!).  Do not pull or tug on your lip to look at the incision site, as this will loosen or break the sutures.

DO NOT SMOKE OR USE TOBACCO PRODUCTS OR ALCOHOL FOR 72 HOURS AFTER YOUR SURGERY: Continuing to smoke or drink alcohol during these first few days will slow healing and soft tissue will not be able fill in the socket to form the blood clot needed for healthy healing. Smoking can also interfere with the bone growth or regeneration. In cases of extraction, bone graft and/or implants, this could result in dry-socket or failure of the graft and/or implant.

BRUSHING: For several days after the surgery, it is important to keep the area as clean as possible to prevent infection and promote healing. Do not directly brush the surgical site for the first 3 days after surgery, but continue to brush the remaining teeth. Do not use any toothpaste for 3 days. Rinsing toothpaste from your mouth could remove the blood clot. Instead, the surgical site can be gently and carefully wiped with a clean, wet gauze pad or cloth. On your 4th day, you may carefully brush your teeth around this area and floss gently. If you have just had Endodontic Surgery (Apicoectomy), you can continue to brush the teeth, even at the surgical site, but keep your toothbrush away from the incision site. If you have had an implant placed, do not use an electric tooth brush near the implant for 8 weeks following your surgery.

MOUTHWASH: Avoid all rinsing for 24hours (this include water or saltwater, but also Listerine etc). This is to ensure the formation of a blood clot. Disturbance of this clot can lead to increased bleeding or the loss of the blood clot. After the first 24 hours you should VERY GENTLY RINSE this area 4 times a day using warm salt water (1 tablespoon salt in 8oz of warm water). Rinse very gently after every meal and snack, making sure that the water reaches the surgical site. Rinsing removes food particles and debris from the socket to help promote healing. Do not aggressively swish or rinse the area. Do this for 48-hours following your surgery.

DO NOT SPIT, BLOW YOUR NOSE OR SUCK THROUGH A STRAW: This will promote bleeding and may dislodge the blood clot or loosen the bone graft, resulting in delayed healing and/or dry-socket.

BLEEDING: When you leave the office, you will be given verbal instructions regarding the control of postoperative bleeding. A gauze pad may be placed on the surgical site that you are asked to keep firm pressure on in some cases.  We do not typically place gauze over an implant site or Apicoectomy site. It is normal for a small amount of bleeding to come from the area of surgery for the first 12 hours. Please contact our office if you have excessive bleeding that does not stop or slow down after 3hrs postoperatively.

                                                                                                                                                      MEDICATIONS: Some discomfort is normal after surgery. Analgesic medications like Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) or any non-aspirin can be taken. We recommend three Ibuprofen capsules (200mg each) every six hours or one strength Acetaminophen capsules (1000mg each) every six hours. You may also alternate medications to maximize results. A prescription for pain medication will be administered at the doctor’s discretion.

SWELLING: To prevent swelling, apply an ice pack or a cold towel to the outside of your face. Apply alternately, 5 minutes on then 5 minutes off. Ice is the best restriction to excessive swelling. The more ice, the less swelling. Continue in the area of the surgery during the first 24 hours. After 24 hours, ice will not stop swelling.

DIET: For the first 72hours, you should maintain a diet of liquid and soft foods, such as Jell-O, pudding, yogurt, ice cream, mashed potatoes, popsicles, mac & cheese and clear or blended soups. Be sure to chew on the opposite side in order to keep food away from the extraction site.   Foods to avoid for 72 hours following your procedure: spicy,  citrus, crunchy, hard or sticky foods. Food that crumbles such as potato chips, popcorn, crackers, cookies and bread should be avoided. Hot spicy foods should also be avoided to prevent irritation of the extraction site. Also avoid carbonated and hot beverages for 3 days. Eating and drinking immediately following the procedure is not recommended.  Please allow 3-4 hours before eating or drinking.

ACTIVITY: For the first 24 hours, your activity should be limited because increased activity can lead to increased bleeding. No prolonged bending over or heavy lifting for 2-3 days. Do not play any wind instruments or blow up balloons for a period of 10-14 days. When lying down, elevate your head slightly, and rest on the cheek opposite your surgical site (or on your back when possible).

PAIN: Discomfort or soreness that lasts for up to a week or so but is gradually improving should be considered normal.  Please contact us if the pain seems to be getting worse after three days (instead of better). After 24 hours, applications of heat over the jaw joints may help with soreness as a result of prolonged opening of the mouth and tightness in the jaw near the injection site.

In most cases, there will be a follow-up appointments to evaluate healing. We want to evaluate the treatment outcome, be sure that you have regained normal function and determine the presence of bone healing.