Instructions for after Oral Surgery
It is our goal at The Woodlands Facial & Oral Surgery Center that your recovery be as smooth and comfortable as possible. By carefully following these instruction you will minimize any discomfort and swelling and lessen the chance for infection and complications.
Please read these instructions carefully. If after reading this set of instructions you still have questions feel free to text Dr.Muniz to 936-524-6028. He will answer your question as soon as possible.
• PAIN MEDICATION – As instructed by your surgeon, you should alternate every 4 hours between Ibuprofen 800 and Tylenol 1000. If you are allergic to Aspirin, just take Tylenol every 6-8 hours. Take the first dose immediately, before the local anesthesia wears off. A narcotic might be prescribed, but most of the time this regimen has been scientifically proven to work as good as morphine. If Tylenol 3 was prescribe, take one tablet, on a full stomach, every 4 to 6 hours as needed. Dr. Muniz doesn’t prescribe any other narcotics than codeine or tramadol. The DEA is very strict about narcotic and our office is taking a stand in fighting the narcotic crisis that is affecting the U.S.A.
• GAUZE PRESSURE – Bite down firmly on the gauze packs that was placed over the surgical areas after surgery, and make sure they remain in place. Do not change them for the first 30 minutes unless the bleeding is heavy. If bleeding continues after removing the first set of gauze, 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 20 to 30 minutes) if bleeding continues. It is best to slightly moisten the gauze with tap water and loosely fluff for more comfortable positioning. Bleeding from oral surgery may take 24 hours to fully stop. If bleeding continues, please call the office.
• PROTECTING THE BLOOD CLOT – Do not rinse, smoke, spit, consume carbonated liquids or drink with a straw for at least 48 hours after your surgery. If you have been prescribed an antibiotic mouthwash (Chlorhexidine Gluconate) you may begin to use it 48 hours after the surgery. The chemicals in cigarettes are caustic and will significantly delay healing, increase post-operative pain, swelling, risk of infection, and the possibilities of developing a dry socket. Smokers should expect a tougher recovery from oral surgery, infections and that the pain medication prescribed might be less effective.
• ICE PACKS – Swelling is common following oral surgery. Swelling can be minimized by using cold packs, or a bag of frozen peas applied firmly to the cheek nearest to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. Do not use any ice after the first 36 hours.
• FOOD — For the first 48 hours try to consume soft and cold foods such as ice cream, smoothies, milks shakes, apple sauce. The evening of surgery you can have room temperature soup, mashed potatoes, eggs, pasta. After 48 hours, the patient can start to gradually return to their normal food habits.
• STEROIDS – If you have been prescribed medicine to minimize swelling (Dexamethasone 4 mg tablets), be sure to take it as directed. Take 2 tablets the evening you had your surgery and 2 tablets the morning after surgery. If a Medrol Dose Pack was prescribed, start it a soon as possible. Directions are on the packing.
• ANTIBIOTICS — Clindamycin or Amoxicillin was prescribed. Start the antibiotic prescribed the day surgery. Usually your first large meal after surgery is recommended to begin this prescription. Both antibiotics are taken every 8 hours for 7 days.
• PROBIOTICS- They may prevent and relieve some of the common side effects of antibiotics such as nausea, stomach upset, and diarrhea. Probiotics are considered safe and are naturally contained in products such as yogurt. We recommend taking probiotics while you are taking antibiotics we prescribe for you. Probiotics come in several forms and can be obtained over-the-counter at your local pharmacy or supermarket.
AFTER THE FIRST HOUR
• PERSISTENT BLEEDING – Mild bleeding or oozing is normal during the first 24 hours. If necessary reposition the gauze packs directly over the surgical site. If bleeding persists or becomes heavy you may substitute a black tea bag (soaked in tap water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. The tea contains a beneficial chemical that locally constricts blood vessels. If bleeding remains uncontrolled after a full hour of using the tea bags, call our office. Remove the gauze while you eat and sleep. Place an old towel over your pillow, as one drop of blood will turn a mouth full of saliva red. It is completely normal to experience mild oozing of blood from the surgical area for a full 24 hrs. Once the bleeding has stopped you do not have to use anymore gauze.
• MOUTH OPENING EXERCISES – Jaw stiffness is common following oral surgery. You can reduce this stiffness by stretching your mouth open with two fingers each hour.
• MANAGING POST-OPERATIVE PAIN – Unfortunately, most oral surgery is accompanied by some degree of discomfort and you may be given a prescription for pain medication. To best manage your discomfort, you should take the first pill before the numbness has worn off. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.
• NAUSEA – Nausea can occur after anesthesia or surgery. It generally improves within 4-6 hours. Nausea following anesthesia is best managed by avoiding all foods until you are feeling hungry. Try sipping small amounts of clear liquids to prevent dehydration. If the pain medication is the cause, try taking Maalox immediately before the medication and drink plenty of water.
• PAIN MEDICATION PRECAUTIONS – The prescription pain medication given to you by the doctor may cause drowsiness, decreased reaction time, blurred vision and change in mental status. Do not drive, operate dangerous machinery, make important decisions or perform strenuous exercises while taking these medications. Failure to follow these instructions increases your risk of causing injury to yourself and others.
POST-OP DAY #2 AND BEYOND
• ORAL HYGIENE – Keeping your mouth clean after surgery is essential. In addition to any prescription mouth washes you may have been given, 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 twice a day. Avoid commercial mouthwashes, as the alcohol they contain may irritate the surgical site. Avoid brushing the surgical area for at least two weeks. However, we do encourage you to brush and floss all other areas.
• HEALING – Normal healing after tooth extraction should be as follows: The first three days after surgery are generally the most uncomfortable and there is usually some swelling. On the 4th day you should be more comfortable and, although still swollen, can usually begin a more normal diet. The remainder of the post-operative course should be a gradual, steady improvement. If you do not see continued improvement, please call our office.
• DRY SOCKET – A dry socket is a painful condition that results from premature loss of the blood clot. Risk factors for developing a dry socket are extracting painful or infected teeth, wisdom tooth surgery, females, smokers, and oral contraceptives. Symptoms of a dry socket typically occur on the 3rd or 4th post-operative day. Severe throbbing pain, which is not responsive to pain medications and bad breath, are the usual complaints. This condition requires an office visit where your surgeon will gently place a medicated dressing into the tooth socket. Pain relief is often immediate once the site is treated. A few visits may be necessary in some cases.
• SHARP EDGES/SUTURES – If you feel something hard or sharp edges around the surgical areas, it is likely you are feeling the bony walls of the empty tooth socket (that once supported the extracted tooth), or the ends of the sutures. Occasionally, small slivers of bone (small pieces of dead bone) may work themselves out during the following weeks after your surgical procedure. If they appear in the area towards the tongue, they can cause an ulcer in the lateral border of the tongue. This ulcers can be painful. If they can de discomfort, please call the office. Dissolvable stitches begin to melt away as you heal. Loose ends may be cut short with a clean sharp scissors or gently can be pulled , if loose, with clean tweezers.
Following these instructions will assist you, but if you have questions about your progress, please call the office. Calling during office hours will result in a faster response to your question or concern. PLEASE NOTE: Telephone calls for renewing narcotic (pain killer) prescriptions must be made during regular office hours as pharmacy’s do not accept over-the-phone narcotic refills.