Lewis D. Gilbert, DDS, LTD

Post-Op Instructions


Sometimes the after-effects of oral surgery are quite minimal, so not all of these instructions may apply to you. It is our desire that your recovery be as smooth and pleasant as possible, but if you have additional questions about your progress, please call the office location where you had your surgery. A 24-hour answering service is available to contact the doctor on call after hours. Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: IN ACCORDANCE WITH STATE AND FEDERAL LAWS, NARCOTICS WILL NOT BE PHONED IN TO A PHARMACY AT ANY TIME OR UNDER ANY CIRCUMSTANCES!

PROTECTION OF THE BLOOD CLOT AND POST-OPERATIVE BLEEDING: Bite down gently but firmly on gauze that has been placed over the surgical area, making sure the gauze remains in place. Change gauze as needed every 15 to 30 minutes until bleeding is controlled. If bleeding persists, bite onto a tea bag that has been moistened and wrapped in a piece of gauze. Bleeding should never be severe. Check the positioning of the gauze and note if it is clenched between teeth rather than on the surgical site. Do not sleep unsupervised with gauze in your mouth. Intermittent bleeding or oozing overnight is normal, especially for those on blood thinners or aspirin therapy, or those who have had multiple teeth extracted.

POST-OPERATVIE COURSE: Do not rinse or use mouthwash for at least 24 hours. You may brush your teeth gently if you desire. After 24 hours, warm salt water soaks (1/2 teaspoon in 8 oz. of warm water) are recommended every 1-2 hours, especially after eating. Day Two, start warm salt water soaks. Use ½ teaspoon of salt in 8oz of warm water. Rinse several times a day for the first week particularly after eating. Resume regular brushing of teeth, taking care around the surgical sites. Do not spit for 5 to 7 days. If you smoke, do not smoke for 5 to 7 days, since this is very detrimental to healing and may cause dry sockets. Do not use a soda straw for 5 to 7 days. If you have had bone grafting or implants please refrain from wearing partials and dentures for the first week or until you are told by the Doctor or our staff you can wear them.

SWELLING: Swelling can be minimized by applying an ice pack to the outside of the surgical area for 20 minutes on and 10 minutes off for the first 48 hours. If you have been prescribed medication for the control of swelling, please take as directed. Swelling will peak on 2nd to 3rd surgical day. Stiffness of the jaw which leads to difficulty in opening and closing the mouth can occur during this time. When swelling subsides, full range of motion of your jaw should return.

ACTIVITY: Rest for the first two post-operative days to minimize bleeding and swelling. Elevate head on a couple of pillows to further minimize swelling. If you had impacted teeth removed or full mouth extractions, you should avoid all strenuous activities for one week. For routine extractions, two days of limited activity is usually adequate.

EATING AND DIET: A soft, liquid diet is recommended for the first 48 hours such as soups, puddings, yogurts, and milkshakes. Avoid extremely hot and spicy foods. Avoid foods like nuts, seeds, popcorn and chips for a week as they may get lodged in the socket areas. Over the next several days you may gradually add solid foods to your diet. It is important that you do not skip meals. Eating regularly will make you feel better, gain strength, and heal faster.

PAIN: Unfortunately most oral surgery is accompanied with some degree of discomfort. You will usually have a prescription for pain medication. If you take the first pill before the anesthetic has worn off, you should be able to manage the discomfort better.Some patients find that stronger pain medicine causes nausea, but if you take the medication with food, chances for nausea will be reduced. The effects of pain medications vary among individuals. If you do not achieve adequate relief at first, you may supplement each narcotic pain pill with over the counter medication such as ibuprofen (Motrin) or acetaminophen (Tylenol). If you develop severe throbbing pain down deep in the jaw near the ear 3 or 4 days after the tooth is removed, contact our office as you may be developing a dry socket. If numbness of the lip, chin or tongue persists, it will most likely be temporary and will go away on its own in a few days although the numbness can last for several weeks.

MEDICATIONS AND ANESTHETICS: Patients receiving intravenous sedation must be accompanied home by a responsible adult who will drive them home after surgery. Medications, drugs, prescriptions and anesthetics may cause drowsiness and lack of awareness and coordination, thus we advise that you do not operate any vehicle or hazardous device for at least 24 hours after your release from surgery. Beer, wine or other alcoholic beverages can magnify the effect of the drugs to dangerous levels and could cause a fatal overdose. Recreational drugs are never to be used along with the medication prescribed by our office.

SUTURES: If they were used, they will dissolve and come out on their own, usually in a week to ten days.

ALLERGIC REACTIONS: For generalized rash, itching, hives, call our office immediately. If you experience severe hives, wheezing, difficulty in breathing go directly to the nearest hospital emergency room.

We are sending an irrigating syringe home with you; DO NOT USE SYRINGE FOR FIRST SEVEN DAYS!! Begin flushing the extraction sites with warm water on day seven to remove impacted food from the sockets. Do this every time you eat until the sockets are closed, usually for 10-14 days. Take all medication exactly according to the directions on the bottle.

ANSWERING SERVICE AND EMERGENCY ROOM RECOMMENDATIONS: If you develop a significant problem after surgery and/or after regular business hours, we are always available for phone consultation and recommendations through our 24/7 answering service. Occasionally, if you cannot contact one of the doctors and you feel you have a serious or emergency situation, ALWAYS seek out medical attention at your local hospital emergency room. Never delay treatment for incidents such as severe post op bleeding, severe allergic reactions, or airway obstruction from severe swelling as these could be life threatening and treatment time is critical to successfully reverse the problem.