First Day After Surgery
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.
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.
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.
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 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 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.
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.
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).
Do not drink alcohol for at least 72 hours post-operatively or during the use of over-the-counter or prescription drugs.
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.
- Cream of Wheat Applesauce
- Mash Potatoes
- Smoothies-no seeds (with a spoon)
- Macaroni & Cheese
- Ice Cream
- 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.
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.