Oral Surgery Instructions

Instructions for Oral Surgery

Bleeding

Following surgery, it is normal to have blood on gauze that you remove from your mouth, or in your saliva, for several days afterwards.  To control, prevent, and minimize bleeding after surgery:

  1. DO NOT SPIT OUT BLOOD OR SALIVA. Gently wipe away instead
  2. Place a one inch thick pad of gauze DIRECTLY over the site of surgery, and bite down for 30 minutes.  Do not chew it – instead, bite down with firm and constant pressure.  If bleeding persists (or if no gauze is available), use 1-2 tea bags moistened with warm water.

If bleeding is still persistent, call your surgeon.

Swelling

Swelling usually starts just after surgery, and peaks at the third day, before taking another 3-5 days to resolve.  Swelling may extend up to and around the eye, or extend under the chin, jaw, or into the neck.

To minimize swelling, use a frozen pack on the face next to the site of surgery for 20 minutes on, 20 minutes off, for 24-48 hours.  Then, switch to a warm moist compress on the swelling for 20 minutes in each hour.

Pain

Pain is a normal part of surgery, and will start after freezing/local has worn off.  You may receive an instruction sheet detailing when and how to use over-the-counter pain medications (eg Tylenol, Advil).  You should follow the dose instructions on the bottle, unless otherwise instructed.

You may also receive a prescription for pain medication.  You can use the pain medication as per the instructions on the bottle, and should follow any other verbal instructions given to you at the time of surgery.

Pain usually increases and decreases along with swelling, so you can expect a peak of discomfort up to 3 days after the surgery.  Should pain be persistent or worsen, call your surgeon as you may be experiencing a dry socket (see below).

Bruising

Bruising (a black/blue mark) may develop after surgery, and may extend underneath the eye, or onto the side of the jaw.  The bruising may travel with gravity down the jawline, onto the neck, and sometimes onto the chest.  The bruise will change multiple colours with time, but should resolve in 7-14 days.  Use of heat (as described above) may help the bruise resolve more quickly.

Jaw Tightness

Difficulty opening the mouth and jaw tightness are normal after-effects of surgery.  This may sometimes last for several weeks, but usually improves with time.  To encourage a normal return of opening, begin chewing 2-3 pieces of sugarless gum 2-3 days after surgery, when the swelling begins to resolve.  Also practice opening and closing the jaw.

Numbness

Numbness may be complete (no feeling) or partial (slight feeling).  This is generally related to the local “freezing” given for the surgery, and will usually wear off in several hours.  Please call the office should the numbness persist more than a day.

Nearby Teeth

Teeth near the surgical site may ache for some time afterwards.  This is temporary, and is known as “sympathetic pain”.  Similarly, adjacent teeth may feel slightly loose after surgery; this is a result of normal swelling around the teeth.

In some cases, infection, cysts, or an impacted tooth may have already damaged surrounding teeth.  Your surgeon will discuss potential problems with you at the consultation appointment or at the time of surgery.

Lips

Your lips may feel stretched after surgery, especially at the corners of the mouth.   Apply Vaseline or a bland cream to the lips and corners of the mouth for a few days after surgery.

Oral Care

After a tooth or large cyst has been removed, it is normal for a cavity or “hole” to be in the gums at the site.  This will gradually fill in with gum tissue, but may take days-weeks.

The day following surgery, rinse gently with warm salt water rinses (1/2-1 teaspoon of salt in a large glass of warm water) after each meal.  Gently brush all your teeth, to prevent food buildup. Take care not to disturb the surgical site.

Diet

Maintain a good nutritious diet during the healing period, as this will help your body recover.  A liquid diet may be easier to swallow for the first few days; however, try to eat solid foods as well.  A mild laxative may be required especially if strong pain medication is taken for many days.

Fever

There may be a slight elevation in temperature for 1-2 days following surgery. If the fever lasts longer than 3 days, notify your surgeon.

Be sure to take all medications prescribed, and to follow closely any instructions given.

Dry Socket

Dry socket occurs following tooth extraction, when the blood clot dissolves and exposes bone, causing sharp pain that spreads along the jaw and to the ear.  To minimize the risk of developing a dry socket:

  1. Do not smoke for 48 hours
  2. Do not use a straw to drink for 48 hours
  3. Do not rinse or spit vigourously

Open Sinus

Sometimes removing upper teeth exposes the sinus, or antrum, above the upper teeth.  If this occurs, you may feel as if liquids or air can pass between your nose and mouth.  Should an exposure occur, your surgeon will give you specific instructions to help your body heal the opening, including:

  1. Do not blow your nose – 2 weeks
  2. Cough or sneeze through your open mouth, not your nose – 2 weeks
  3. Do not use a straw – 2 weeks
  4. Do not smoke
  5. Use medications exactly as prescribed

Dentures

If dentures are inserted at the time of surgery, do not remove them for 24 hours (unless instructed otherwise).  Rinse around them gently with warm salt water after meals.  After 24 hours, remove the dentures and clean them thoroughly, and rinse your mouth with warm salt water.  Do this after every meal.

Dentures placed immediately after teeth have been extracted are only temporary in their fit, and must be adjusted by your dentist or denturist.  Be sure that you have an appointment with whomever made the denture, so that their fit can be adjusted during and after healing.

There is always a doctor on call from our office 24 hours a day, seven days a week.  Should there be a serious problem after office hours, please call and our answering service will have us contact you.

Emergency Number: 888-623-3810