Post-operative Instructions for Oral Procedures

Things to Avoid

  • Smoking
  • Using a straw, spitting or vigorously rinsing (swishing) or anything creates negative pressure in your mouth (sucking effect).
  • Chewing or eating solid foods until your numbness has completely worn off.
  • Pulling on your cheek and lip to look inside, this can tear the sutures and opens wound.
  • Applying excessive pressure with your tongue of finger will disturb normal healing.
  • Brushing aggressively the first 2 weeks, instead dip your toothbrush in medicated rinse and gently brush your teeth 4-7 days after surgery or as suggested by your surgeon.
  • Heavy exercise for first week, no yoga, aerobics, swimming, running, cross-fit, etc.
  • Hot, spicy or acidic foods (orange juices, tomatoes, salsa) for one week.
  • Drinking hot temperature liquids.
  • Eating crunchy or sticky acidic foods and small seeds (i.e., peanut butter, quinoa, strawberries, and chia seeds) for two weeks.
  • Drinking excessive alcohol for one week or if you are taking prescribed antibiotics.
  • Using any none-prescribed rinses or apply aspirin to surgical site in your mouth.
  • Using an electric toothbrush or waterpik until approved by your dentist.
  • Drinking color hot drinks (i.e., tea, wine, soda, coffee) while using the medicated rinse which causes staining.

Things you should be doing

  • Keep the medicated gauze on surgical area for 1 hour following surgery until the bleeding has stopped-however, do not sleep with gauze in your mouth. Drink some water to wet gauze when removing.
  • Place an icepack on your face (20 minutes on and 20 minutes off) repeat as much as possible for the first 24 hours.
  • Try to stay still for the first 24 hours. Sleep in elevated 45 degree position for the first few days. Use an extra pillow or two behind your back and neck. Cover up your bed sheets with old towel and expect blood drooling out from the mouth during sleep.
  • Please rinse gently with prescribed mouth rinse after 48 hours for 1 minute, then let it flow out your mouth. Do not swish or spit! Repeat prescribed number of times per day, not more.
  • Rinse as mentioned above after meals with warm salt-water (1 teaspoon of salt in 8 oz. glass of warm water) after 48 hrs.
  • Chew on the side opposite to your dental treatment. Eat only soft foods for 5 days.
  • In case of persistent bleeding use Lipton (black tea) teabag soaked in cold water and apply consistent gentle pressure to surgical site or use clean moist gauze or paper towel.
  • Take all prescriptions as directed. Call your dentist at below number if unsure about anything.

Normal Concerns

  • You can expect to find small particles (bonegraft) in your mouth for the first week.
  • Oozing of blood is normal for the first 24 hours and after eating.
  • Depending on your treatment swelling is normal. Swelling peaks mostly on the 3rd day and starts to go down on the 7th day.
  • You may notice shrinkage of the gum tissue, additional spaces between teeth, exposed margins of crowns and food trap areas between teeth after surgery. This is normal side effect of the surgery.
  • You may notice increased sensitivity to hot and cold temperature food and drinks.
  • You may experience some tooth discoloration and staining from the use of medicated rinse. This is fully reversible and can be removed with cleaning/polish.

Food to Eat

  • Soft or blended foods (i.e., yogurt, ice cream, pudding, noodles, pasta, mash potato, scrambled eggs, flaky fish, cold soups, Jell-O, applesauce, Ensure shakes, etc.)

Foods to Avoid

  • Crunchy, spicy, sticky foods (i.e., peanut butter, candy bars, seedy food, strawberry, quinoa, poppy and flax seeds, popcorn) Avoid hot and spicy foods and soups.

Additional instructions if you had a sinus procedure

  • DO NOT for next 4 weeks blow your nose, scuba dive, fly, scuba dive, pinch your nose when sneezing, lift heavyweights, blow balloons or play instruments that you have to blow through your mouth.
  • DO use a nasal decongestant like Afrin or Sudafed if you are stuffed up or have a runny nose. Sneeze with mouth open.
  • If you had an implant and the healing cap come off, do not worry; save it and bring it with you to see the dentist. Minimum nosebleed for the first 48 hours is normal and expected.
  • Call your dentist if: any unexpected or unusual flow of air or liquids between your mouth and nose, excessive nosebleed or presence of bone particles green/yellow nasal discharge.

Additional instructions if you had any type of gum grafting

  • DO NOT pull on your lips or cheek to look at the graft, do not bite on any hard foods (i.e., apples carrots, and hard bread)

For 1st week:

Please DO NOT BRUSH OR FLOSS the surgical site during this week. Use cotton ball or Q-Tip dipped in medicine rinse and gently clean and dab around surgical area. Very gently rinse with prescribed medicated rinse only two times per day. When rinsing, do not aggressively swish around: just hold the rinse in the area for 1 minute and let it drool out.

If needed you may brush the teeth over the surgical site starting about days after surgery, however, please do not directly brush gums.

After 2nd week

Stop the prescribed medicated rinse (longer or more frequent use may lead to increased staining of teeth). You may resume very gentle oral hygiene; brush a manual soft toothbrush (not Electric), gentle flossing and rinse with warm salt-water two times a day. Do not use any other mouthwashes.

Additional instructions if you have crown lengthening or osseous surgery:

You may feel line be lower than the crown. You may have more sensitivity to temperature if the tooth is not root canaled. You may get more food stuck between your teeth after treatment. All these symptoms are normal and part of the healing.

Use Sensodyne toothpaste until the sensitivity subsides. You can gently remove particle between your teeth by rinsing with salt water or using toothpick or Proxabrush (interdental Christmas shapes brushes) If your temporary crown falls off, try to come back to the office and have it recemented within 24-48 hours.

Notify the office or your dentist:

  • If several sutures fall out within 2 days.
  • If a membrane or gum graft that has been placed should loosen within the first few days.
  • If a large number of particles are lost from the bone graft surgical site.
  • If your medications do not relieve your discomfort or still have severe pain after one week.
  • If you start have a bad taste or bad smell in your mouth, usual swelling, or fever.
  • If you have an adverse reaction to prescribed medication, (rash, diarrhea), stop and call dentist, if you have an anaphylactic reaction and have difficulty in breathing, call 911 right away.

Thank you for trusting us with your oral health. We hope that you have a quick and uneventful recovery. We look forward to seeing you back on your follow up visits.

Bleeding

Slight bleeding for a number of hours following surgery is not unusual. Your saliva may be tinged with blood during first two days after surgery. Cover up your bed sheet with an old towel and expect blood drooling out from the mouth during sleep. Drops of blood in saliva may be interpreted as false bleeding: however, if heavy and continual bleeding is still present a few hours after surgery, moisten a washcloth or wrap a tea bag in moist gauze and place it over the area, applying light pressure for 10 minutes. Repeat if necessary. Holding small amounts of iced water in mouth will usually stop any light oozing. If there is excessive uncontrolled bleeding the day after surgery, please call for instructions.

Pain

You will probably have pain in the area the day of and the day following surgery, and possibly longer. Take your prescribed pain medication after surgery even if you do not feel pain. It is easier to prevent pain than decrease it. Take pain medication (Ibuprofen 600mg/Tylenol 500mg together if no contraindications or allergies) when you arrive home and every 6 hours for the next 24 hours, then as needed. Do not dive or operate machinery when taking narcotic medicines such as Vicodin (Hydrocodone), Percocet (Oxycodone), Tylenol #3 (Codeine) or Tramadol.

Swelling

To minimize swelling, place icepack intermittently on your face next operated area (20 min on and 20 min off), repeat as much as possible for the first 24 hours. Bed rest immediately after surgery, sleep in elevated position for first few days. Use an extra pillow or two behind your back and neck. By limiting your activity, the day of surgery, you will significantly limit the degree of swelling. Swelling usually peaks 3 days after surgery and may persist for several days after. There may be numbness associated with swelling. Fair skinned patients or those who bruise easily may anticipate some discoloration of the skin over the area. If swelling is severe and/you feel feverish, please call for instructions.

DIET AFTER SURGERY

Do NOT chew until after the local anesthetic has worn off, as you may unknowingly bite yourself. A soft diet is recommended for the first week. Chop food into smaller pieces or use a blender. A nutritious dies throughout the healing period is important to your comfort, temperament, and healing. Patients that maintain a good diet of soft of soft foods generally feel better, have less discomfort, and better. Daily multiple vitamins are also recommended. Food supplements such as metrical Nutrament, Ensure, Enrich, Sego, Carnation instant breakfast, etc. maybe helpful (do not use straw if had extractions). Please avoid acidic food such as tomatoes, peppers, citrus fruits, and highly seasoned foods. Also avoid foods that require heavy biting pressure for chewing.

Dr. Steve Tatevossian

Office 909-792-5000

Cell 951-295-2898 for after hours

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