Tooth Socket Preservation Bone Graft
Post-Operative Instructions
Immediately Following Surgery
· Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing in addition to holding the bone graft and resorbable membrane in place. Please do not touch or lick the area.
· You may see a whitish area at the extraction site. This is the resorbable membrance. Do not touch it or pick at it! It is also normal to notice some tiny granules in your mouth intermittently during the healing period.
· You should avoid vigorous mouth rinsing, spitting or touching the wound area following surgery. Otherwise, it may initiate bleeding by causing the blood clot that has formed to become dislodged. This may also dislodge sutures or introduce bacteria into the wound.
· Take the prescribed pain medications when you begin to feel discomfort. This will usually coincide with the local anesthetic wearing off.
· Restrict your activities the day of surgery and resume normal activity in 2-3 days and only when you feel comfortable. Lying down with your back and head elevated is appropriate. Avoid strenuous activity for at least one week.
· Place ice packs to the sides of your face where surgery was performed.
· DO NOT SMOKE! Do not use straws for several days.
· DO NOT chew on the graft area for two months following surgery.
· DO NOT use a water-pik or an electric toothbrush at the surgical area for 6 weeks.
Bleeding
A certain amount for bleeding is to be expected following surgery. Slight bleeding, oozing or redness in the saliva is not uncommon. Sometime, there might be blood clot present in the mouth as may occur after sleeping. It is normal. Blood is like food coloring and a small amount will turn the saliva pink or red, possibly for several days. Do not spit as this may stimulate bleeding. Excessive bleeding may be controlled by placing a gauze pad (folded to about one inch square) over the area and biting firmly for thirty minutes to one hour. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag 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 for further instructions.
Bruising
In some cases, discoloration or bruising of the skin will appear. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may become visible 2-3 days poster-operatively. Moist heat applied to the area may speed up the resolution of the discoloration.
Pain
The following information is for healthy adult size patients only with normal liver and kidney function and who are not taking other medications.
You may begin taking pain medication as soon as you feel the local anesthetic wearing off. For mild to moderate pain, Ibuprofen (Advil or Motrin) may be taken. Ibuprofen, OTC comes in 200mg tablets: 2-3 tablets may be taken every 6-8 hours as needed for pain. Please do not take it continuously for more than 5 days. For severe pain, 1-2 tablets of Tylenol (Acetaminophen 500mg or 650mg) can be with 2 tablets of ibuprofen 200mg every 6 hours. DO NOT drink alcoholic beverages. For most patients, pain or discomfort following surgery will subside each day after the 3rd day. If pain persists, it may require attention and you should call the office. No NOT take any of the above medication if you are allergic, have had a reaction to, or have been instructed by our doctor not to take it.
Maximum dose of Ibuprofen is 800mg every six hours and 3200mg in 24 hours.
Maximum dose of Tylenol is 1000mg every six hours and 3000mg in 24 hours.
Antibiotics
Take your prescription as directed. Antibiotics are prescribed to help prevent infection. . Please DO NOT discontinue on your own unless there is a rush or other unfavorable reaction. Swelling developing after completion of the antibiotics may be an indication of infection. Please call us if you have any questions or if you develop multiple unformed (watery) bowel movements.
Allergic Reaction
Occasionally, an allergic reaction can occur to one of your medications. Allergic reactions usually consist of itching, rash, or hives. If such a reaction occurs, you should stop taking the medications and call our office. OTC Benadryl may help alleviate these symptoms, but also will cause drowsiness. If a severe reaction such as swelling of the face or neck or difficulty breathing occurs, contact your nearest hospital emergency department and/ or call 911 immediately.
Diet
Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood cote. You may eat anything soft by chewing away from the surgical sites. Soup, apple sauce, jello are easy items to start out with. High calorie, high protein intake is important. Nourishment should be taken regularly. You should prevent dehydration by drinking fluids regularly. Your food intake may be limited for the first few days. You should compensate for this by increasing your fluid intake. Avoid carbonated beverages for the first few days. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. You may consider nutritional supplements such as Carnation Instant Breakfast drink, Ensure, or for diabetics, Glucerna.
Keep the mouth clean
Use the Peridex (Chlorhexidine) or Tooth Tonic mouth rinse as prescribed, two times daily, with a GENTLE swishing for a minimum of 30 seconds. If desired, you can LIGHTLY brush your teeth the night of surgery and rinse gently. The day after surgery you should also with a cup of warm water mixed with a ¼ teaspoon of salt. Do this 2-3 times a day, especially after eating.