After Bone Grafting
Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.
Immediately Following Surgery
o The gauze pad placed over the surgical area should be kept in place for a half hour. Refer to the section on bleeding for more information.
o Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
o Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
o Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
o Place ice packs to the side of your face where surgery was performed. Refer to the section on Swelling for an explanation.
CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. Make sure you sit up for one minute before standing.
Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: Dr. Henry or your family dentist.
o If numbness of the lip, chin, or tongue occurs post-operatively there is no cause for alarm. This is usually temporary in nature. If this does occur, call our office.
o A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Advil (ibuprofen) should be taken to reduce the fever.
o You should be careful going from the lying down position to standing. If you were not able to eat or drink prior to surgery, 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.
o Occasionally, patients may feel hard projections in the mouth with their tongue. They 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. Henry
o If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
o Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
o Stiffness 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.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair.
Swelling may not become apparent until the day following surgery and will not reach its maximum until two to three days post-operatively. However, the swelling will be minimized by the use of ice packs for the first 48 hours. The ice packs provided by our office (or bags of frozen peas) should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake (an ace bandage is helpful to keep the ice packs in place). After 48 hours, ice has no beneficial effect.
If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. After 48 hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office.
Take any pain medication prescribed by our surgeons as directed.
o Begin taking pain medication as the local anesthetic is wearing off, usually three (3) to eight (8) hours after surgery. Prescribed pain medicine may make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages.
o For break-through pain (pain that persists after taking prescription pain medication) you can alternate with ibuprofen (i.e. Motrin, Advil). Do not exceed 600mg of ibuprofen in six (6) hours. Do not take acetaminophen (aspirin, Tylenol).
o Nausea with pain medication may occur but can be reduced by eating food 30 minutes before taking your pain medication. If you do become nauseated, you can also take one-half of your prescribed dose more frequently. If you continue to experience nausea or vomiting, please contact the office.
o Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
Antibiotics will be given to help prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed. It is important to completely finish all of the medication; however, discontinue antibiotic use in the event of a rash or other unfavorable reaction and call our office.
You may find that eating yogurt with live and active cultures will decrease your chances of stomach upset and/or yeast infection while taking antibiotics.
If you are taking birth control pills, please note that antibiotics may make your birth control pills less effective.
Nausea & Vomiting
In the event of nausea and/or vomiting following surgery or medications, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip slowly on Coke, tea, or ginger ale over a 15-minute period. When the nausea subsides, eat something 30 minutes before taking your pain medication or antibiotics. Call the office if you have any questions.
Do not use straws when drinking from a glass. The sucking motion can dislodge the bone graft. Drink lots of liquids after IV sedation to prevent dehydration. At least five to six glasses of liquid should be taken daily.
Avoid hot foods until all bleeding stops. Cold foods often can soothe an uncomfortable area. Milk shakes, yogurt, pudding, Jell-O, and applesauce usually work well. You may advance to normal food as you feel able, but avoid crunchy foods like popcorn and potato chips until gum tissue has healed.
Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. You may eat anything soft by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.
Sutures may or may not be placed in the area of the graft. The suture(s) will either be removed by your surgeon or left to dissolve (can take up to six weeks).
Good oral hygiene is essential to good healing. Brush your teeth gently around the surgical site. DO NOT use an electric or mechanical toothbrush such as a Sonicare or a WaterPik. The sonic vibration can be harmful during the healing stage. You may go back to using your electric toothbrush or WaterPik upon approval by your surgeon.
Use the chlorhexidine (Peridex) mouth rinse three (3) times per day. You may also rinse your mouth with a mixture of half peroxide/half water three times a day in order to maintain cleanliness.
Reduce physical activity for 2-3 days. Avoid lifting, bending, running, etc to help minimize swelling. Rest and sleep with your head elevated. After 2-3 days, you may resume normal activity as you feel able.
If you are involved in regular exercise, be aware that your normal nourishment intake may be reduced. Exercise may weaken you. If you get light headed, stop exercising.
Dentures & Prostheses
Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. If you have a temporary “flipper” to wear do not place it until the numbness in the area is gone. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until your general dentist or our office can see you