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Oral Surgery Patients

After Surgery Care

Care after surgery

Sometimes the after-effects of oral surgery are quite minimal, so not all instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call the oral surgery office for clarification, (505) 892-9010 op. 2..

First Day After 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 is not controlled. The packs may be gently removed after one hour. If active bleeding persists, 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 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff them for more comfortable positioning.

Oozing

Intermittent bleeding, oozing or weeping overnight is normal. In most cases, oozing or weeping may cause the saliva to appear light red, as the majority of the content is saliva with very little blood. This is normal. Strong bleeding appears dark red, and the majority of the content is blood with very little saliva. Placing fresh gauze over the areas and biting in the gauze for 30-45 minutes at a time may control bleeding. Remember to cover your pillow with a towel or rag so as not to drool blood on your pillowcase or bed sheet.

Persistent Bleeding

Bleeding should never be severe. If it is, that usually means that packs are being clenched between teeth only and are not exerting pressure onto the surgical areas of the gums. Try repositioning the packs. If bleeding persists or becomes heavy, you may substitute a tea bag for 30 to 90 minutes. The tea bags should be soaked in very hot water, squeezed damp-dry and wrapped in moist gauze. If bleeding remains uncontrolled, please call our office.

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. When given a prescription pain medication, please take it as directed. You should be able to manage discomfort better when you take the first pill before the anesthetic wears off. Some patients find the stronger pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. The effects of pain medication vary widely among individuals.

If you do not achieve adequate relief at first, and there are no contraindications, you may supplement each pain pill with an analgesic NSAID such as aspirin, ibuprofen (Advil and Motrin) or naproxen (Aleve and Anaprox). Adults may take 600-800 mg ibuprofen every 6-8 hours (do not exceed 2400 mg/24 hours). If you don’t wish to use prescribed narcotic medication, you may take acetaminophen (up to 1000 mg total, not to exceed 4000 mg/24 hours) every 6 hours. You may start with a dose of ibuprofen, followed two hours later by another dose of acetaminophen and repeated.

Remember that the most severe pain is usually within six hours after the local anesthetic wears off, after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. Narcotics containing Tylenol include: Tylenol #3, Vicodin, Lortab and Percocet (please AVOID Tylenol overdose!)

A note on antibiotics: If you received antibiotics, take the full amount prescribed course as directed.

Nausea

Nausea is not uncommon after surgery, and sometimes pain medications are the cause. Preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water can reduce nausea. 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.

Swelling

Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. Swelling will be at its peak the second or third day following surgery.

Exercise Care

Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects. You may brush your teeth gently, avoiding surgical site.

Smoking

Do not smoke for at least 72 hours, since this is very detrimental to healing and may cause a dry socket (preferably, stop smoking permanently).

Alcohol

Do not drink alcohol for at least 72 hours post-operatively or during the use of over-the-counter or prescription drugs.

Diet

Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Avoid spitting, swishing or drinking through a straw for 48-72 hours after your surgery. You may gather the saliva to the front of your mouth and wipe it away with a napkin or tissue. It is sometime advisable, but not required, to confine the first day’s intake to liquids or pureed foods Remember to drink plenty of water and keep hydrated. It is best to avoid foods like nuts, chips, sunflower seeds, popcorn pretzels, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor. Here are a few items you may want to get from the store to make your healing process a bit more comfortable after surgery.

  • Eggs
  • Jello
  • Cream of Wheat Applesauce
  • Soup
  • Mash Potatoes
  • Yogurt
  • Smoothies-no seeds (with a spoon)
  • Pudding
  • Macaroni & Cheese
  • Ice Cream
  • Sorbet
  • Salt (for rinses)
  • Tea Bags (to use in place of gauze to help the healing process. Use with NO spice or Caffeine)

While pureed food and drinks are easy to swallow, it is important to strive for a balance of protein and fiber after having oral surgery since the temptation is to stick with juices which do not provide the necessary nutrition.

Sharp Edges

If you feel something hard or with sharp edges in the surgical areas, it is likely you are feeling the bony walls that 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 our office.

Second and Third Days after Surgery

Mouth Rinses

Keeping your mouth clean after surgery is essential. Use 1⁄4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily.

Brushing

Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort while avoiding the surgical site.

Hot Applications

You may apply warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, or a heating pad) for 20 minutes on 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.

Healing

Normal healing after the 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, you 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.

If you are given a plastic irrigating syringe, DO NOT use it for the first five days. Then use it daily according to the instructions until you are certain the tooth socket has closed completely and that there is no chance of any food particles lodging in the socket.

Sutures

In most cases, sutures are resorbable (dissolvable) and will resorb (dissolve) within 7-14 days. Do not disrupt the sutures in place. If non-resorbable sutures were used, the surgeon will advise you to return for their removal within approximately 7-14 days.

In summary

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have question about your progress, please call the number written above during business hours. Calling during office hours will afford a faster response to your questions or concerns.

Contact Us

If you have any questions, please feel free to contact us at any time. Our emergency line will be available after hours for you.

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