POST-OPERATIVE INSTRUCTIONS


***PLEASE READ ALL OF THESE INSTRUCTIONS CAREFULLY***
Sometimes the "after-effects" of oral surgery are quite minimal, so not all of these instructions may apply.  Common sense will often dictate
what you should do.  However, when in doubt, follow these guidelines or call our office for clarification.  Our number is (541) 382-7981.
PLEASE NOTE:  Telephone requests for narcotic (pain killer) prescriptions renewal are ONLY accepted during  regular office hours.


DAY OF SURGERY:

FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical areas, making sure they remain in
place.  Do not change them for the first hour unless the bleeding saturates the gauze.  The packs may be gently removed after one hour if
bleeding has stopped.  If active bleeding persists, fold several pieces of gauze into a tight square and place directly over the surgical
wounds. The gauze may subsequently be changed as necessary (typically every 30 to 45 minutes).  It is best to moisten the gauze slightly
prior to placement to avoid having the gauze stick to the wounds.

HYGIENE:  Do not disturb the surgical area today.  Do NOT rinse vigorously or probe the area with any objects.  You may brush your teeth
gently.  PLEASE DO NOT SMOKE. Smoking is detrimental to the healing process and will increase the risk of dry socket, postoperative pain
and delayed healing.

OOZING:  Intermittent bleeding or oozing is normal during the healing process as the "healing" tissue is very vascular. This is most
common after eating or brushing. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45
minutes at a time. If bleeding persists, call the office.

PERSISTENT BLEEDING:  Bleeding should never be severe.  If so, it usually means that the packs are being clenched between teeth only
and are not exerting pressure on the surgical areas. Try repositioning the packs.  If bleeding persists or becomes heavy you may substitute
a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes.  If bleeding persists, please call
our office.

SWELLING:  Swelling is expected after oral surgery. It is the body’s normal response to "injury" even controlled injury such as surgery and is
the beginning of the healing process. It is the result of increased blood flow to an area the body recognizes as needing attention. Swelling
will increase over the first 48-72 hours and subside over the next 5-7 days. It can be minimized by placing a cold pack, ice bag or a bag of
frozen peas wrapped in a towel on the skin directly adjacent to the surgical sites.  This should be applied twenty minutes on and twenty
minutes off during the first 24-48 hours after surgery.   Keeping the head elevated for the first 72 hours using pillows under the back and
head while sleeping.

PAIN:  Unfortunately,  most  surgical procedures have  potential to cause varying degrees of discomfort.   Fortunately, this discomfort is less
than anticipated for most persons undergoing oral surgery. There are several reasons for this. During surgery, most persons will receive  
medications which minimize swelling, inflammation and pain at the surgical sites. At the completion of surgery an long acting local
anesthetic is infiltrated to control pain. Pain is best kept under control by starting prescribed medications prior to the numbness wearing off.

NAUSEA:  Nausea is not uncommon after surgery.  This can be related to sedation, pain medication, NSAIDS, swallowing blood, anxiety
etc.   Nausea can usually be controlled by preceding each pain pill with anti-nausea medications  small amount of soft food, and taking the
pill with a large volume 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 help with nausea.

DIET:  Eat any nourishing food that can be taken with comfort.  It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may
get lodged in the socket areas.  Over the next several days you may gradually progress to solid foods. If you are a diabetic, maintain your
normal eating habits or follow instructions given by your doctor.

SHARP EDGES:  If you feel something hard or sharp edges in the surgical areas, it is likely you are feeling the bony walls which once
supported the extracted teeth.  Occasionally small slivers of bone may work themselves out during the following week or so.  If they cause
concern or discomfort, please call the office.


INSTRUCTIONS FOR THE SECOND AND THIRD DAYS

MOUTH RINSES:  Keeping your mouth clean after surgery is essential.  You may drink, but do not rinse for the first 12 hours following
surgery. After 12 hours, gently rinse the hole/cavity with warm salt water (1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water)
using a plastic irrigation syringe.  Repeat after every meal, before going to bed and upon waking.  Continue to use it daily until you are
certain the hole/cavity has closed completely and that there is no chance of any food particles lodging in the socket.  The cavity will gradually
fill in with new tissue over the next month.  

BRUSHING:  You may brush your teeth the day after surgery, being careful in the areas where surgery was performed. Soreness and
swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

SUTURES:  If sutures were placed, they will dissolve by themselves unless you were specifically told that non-dissolvable sutures were
used.  Sutures may loosen or come out prior to your next appointment (if required).

HEALING:  Normal healing after tooth extraction should be as follows: The first two days after surgery are generally the most uncomfortable
and there is usually some swelling.  On the third day you should be more comfortable and, although still swollen, can usually begin a more
substantial diet. The remainder of the post-operative course should be gradual, steady improvement.  If you don’t see continued
improvement, please call our office.  


OTHER COMPLICATIONS AND CONSIDERATIONS:

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in
    nature. You should be careful to avoid biting your lip or tongue as it will be numb and you will not feel any sensation. Call Dr. Schock
    if you have any questions.
  • A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
  • You should be careful going from the lying down position to standing.  Taking pain medications can make you dizzy. You could get
    light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. These 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. Schock.
  • If the corners of your mouth are stretched, they may dry out and crack. These areas should be kept moist with an ointment such as
    Vaseline or Chapstick.
  • Sore throats and pain when swallowing are not uncommon. The muscles become swollen, the normal act. of swallowing can then
    become painful. This will subside in two to three 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 that will resolve in time.
  • 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 to the ear may occur two to three days following surgery. Call the office if this occurs.
  • If an immediate denture was placed following your surgery, do not remove it unless the bleeding is severe. Expect blood to ooze
    around the side of the denture. Try not to swallow the blood, lean over the sink or a bowl and gently spit the blood out. If immediate
    dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and
    make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may
    prolong the healing process.
  • Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of
    liquid the first day.
  • It is normal for it to take several days to feel that you can resume your normal activities. If you have heavy bleeding, severe pain, or a
    reaction to the medication, call the office immediately at (541) 382-7981.


WITHIN THE 24 HOUR PERIOD FOLLOWING IV SEDATION AND/OR WHILE YOU ARE TAKING PRESCRIPTION PAIN MEDICATION: DO NOT
DRIVE OR OPERATE ANY MACHINERY. DO NOT DRINK ANY ALCOHOLIC BEVERAGES. DO NOT TRAVEL ALONE. DO NOT SIGN ANY LEGAL
DOCUMENTS. DO NOT TAKE FULL CHARGE OF ANY OTHER INDIVIDUAL.

    If you have any questions about your surgical procedure or your recovery from surgery, please contact (541) 382-7981.
Todd A. Schock D.M.D. M.D. Facial & Oral Surgery        1893 N.E. Neff Road • Bend, Oregon 97701        Tel 541-382-7981        Fax 541-389-6953