It is our goal that your oral surgery experience be as positive and as beneficial as possible. We provide our patients with detailed post-operative instructions to guide you through your procedure and recovery.
If you ever have questions about your treatment, please contact our office. Our friendly staff is here to help.
Do not spit. Use a tissue to wipe your mouth as needed or swallow your saliva.
Do not smoke.
Keep your fingers and tongue away from the surgical area.
Spitting, smoking, and poking the surgical area can dislodge the blood clot that is forming and will cause bleeding from the area. Also, smoking can increase the chances of an infection.
BLEEDING
Some minor bleeding is expected after dental implant surgery. It will usually subside quickly and stop within an hour or two after surgery. A little oozing is normal and may persist for several hours.
Keep gauze on the surgical area with some biting pressure for 30–45 minutes.
If all else fails, call the office.
SWELLING
Most patients will experience some swelling after surgery in the mouth. It may be mild or severe and is different for every patient. The swelling may increase for the first 24–48 hours before it starts to go away. It may last for several days. Some bruising may also develop on the face.
DIET
You may start with non-abrasive foods such as mashed potatoes, pasta, cottage cheese, soup, or scrambled eggs as soon as the local anesthetic wears off.
You may resume a regular diet as soon as you feel up to it; however, please try not to chew directly on the implant sites.
ORAL HYGIENE
You may start rinsing tomorrow, very gently, with some warm salt water (1 tsp of salt in 8 ounces of warm water). You may brush your teeth per usual, though be very careful near the surgical sites.
SUTURES
Unless told otherwise, the sutures used during your procedure are dissolvable and will fall out on their own. This generally occurs in the first week after surgery, but timing varies from 4–10 days.
BONE GRAFT MATERIAL
If your surgeon placed bone graft material at the time the dental implant was placed, you might notice some gritty material in your mouth.
This is nothing to worry about and should subside within a day or two.
WILL I BE ABLE TO SEE THE IMPLANT?
Depending on the location and stability of the implant being placed, your surgeon may opt to bury the implant under the gum tissue. In time, you will return and have the implant uncovered so the implant can be restored.
If stability is optimal, the second stage procedure can be bypassed, and an attachment is placed that protrudes through the gum tissue, which will be visible. Once the bone heals, the restoring dentist can access the implant without further surgery.
WHEN CAN THE CROWN BE PLACED?
A dental crown can be attached to a dental implant once the implant has fused to the bone. This is a process called osseointegration.
The length of time the bone must heal varies from case to case and will be discussed with your surgeon. The length of time needed for osseointegration is a function of the bone quality, quantity, and implant stability at the time of placement.
MEDICATIONS
You were probably given one or more prescriptions for medications. Take all as directed on the bottle. Call us if you experience severe nausea or diarrhea, or cannot swallow your pills.
Antibiotics: Continue until the bottle is empty. Do not quit halfway.
Take pain medication in a scheduled fashion (every 4–6 hours) for the first 24 hours and as needed thereafter.
Remember that narcotics can make you drowsy, so no driving, swimming, operating machinery, or drinking alcoholic beverages while you are taking them.
You may wean yourself off the narcotic medication and substitute 500 mg of acetaminophen (Tylenol®).
If directed to do so, you may use ibuprofen, 600 mg, every 6 hours while awake, for the first 4 or 5 days.
ACTIVITY
Once you are no longer taking narcotic pain medication, you may resume your normal activities as you feel up to it. Go easy at first with exercise and recreation and increase your activity slowly over several days back to your normal routine.
Please follow these instructions as closely as possible. They are designed to help you heal quickly and comfortably.
Post-operative instructions for the removal of teeth
Plan to go home and rest after surgery. Activity that requires a lot of moving around, lifting or things that increase your heart rate will increase bleeding, swelling and eventually pain.
Rest reclined with your head above the level of your heart. If you don’t have a recliner, prop up a couple of pillows behind you
Try not to spit. It is ok to swallow your saliva
Bleeding
Bleeding after tooth extraction surgery is expected and usually will significantly decrease over 2-6 hours. During this 2-6 hour time-period, there could be minor constant oozing, periodic bleeding, or no bleeding at all. Significant bleeding after this time is not expected and warrants a call to your surgeon.
If you take blood-thinner medications, the time of expected bleeding will likely be longer. A little pink in your saliva the next day is also common.
Bleeding can increase if you are active right after surgery. Get into a comfortable position and relax. Consider placing some ice-packs on the side of your face over the area where the teeth were removed to help constrict blood vessels that can bleed.
When you left the office you likely were biting on some gauze. Keep that gauze in place for 30-45 minutes. Put the gauze directly over the extraction site and bite down. Try to leave it there without removing it every few minutes to check. The biting pressure on the gauze will stop the bleeding, not the gauze itself.
Remove the gauze after 30-45 minutes and if there is still some bleeding then take another piece of gauze, roll it into a tight ball, put it directly over the site and bite down gently to keep a little pressure on it. You may have to repeat this periodically over the 2-6 hour time span.
If you find the gauze packing isn’t really working try gently rinsing your mouth out with really cold water and using a black tea bag. Get the tea bag moist, fold it in half and put that directly over the extraction site then gently bite down. Tannic acid in the tea can help create a blood clot.
If you still have trouble, please call the office for instructions and help
Swelling
Swelling is common after surgery and can occur in the mouth and on the face next to where the tooth (or teeth) was removed. It may be mild, moderate or severe. Swelling from any surgery can increase for 72 hours before it starts to decrease.
Use an ice pack on your face next to the surgical site. Keep it on for 15-20 minutes and then remove it for 10 minutes. Repeat this until you go to sleep. Ice to the face for the first 24-36 hours will help control bleeding and keep your swelling down.
Rest and sleep with your head elevated slightly (above your heart). A recliner works great for this. If you don’t have a recliner, prop yourself up with a couple of pillows in bed or on a couch.
After using ice for 24-36 hours, change to moist heat instead of ice. Ultimately, everything that heals your surgical sites must come through circulating blood and heat will increase circulation helping to reduce swelling and allowing your body to heal the surgical area.
Swelling should start to decrease after 72 hours. If swelling is increasing after 72 hours, you may have an infection. Please call the office with increasing swelling after 72 hours.
Diet
Generally, after the removal of teeth, you can eat and drink whatever you are comfortable with without having to worry about damaging anything or creating a surgical problem but here are some guidelines to consider:
If your whole mouth is numb then dry foods won’t go down as easy, if at all. Consider more liquid type foods during this initial time. Smoothies, milkshakes, yogurt and applesauce are great examples of what you will find easier to swallow while you are numb.
If your surgeon was concerned about a sinus opening around the upper molars, or if you had sinus surgery, then you should not use a straw.
If you eat food directly on the extraction site it will likely hurt and potentially bleed a little right after surgery so you will be more comfortable chewing in an area of your mouth that wasn’t where a tooth was removed.
Regular food after the removal of a tooth or teeth is at your discretion. Carbonated drinks are also generally ok after the removal of teeth.
Oral Hygiene
Brushing Keeping your mouth clean after surgery is important. If you are able, clean your teeth using your normal protocol as best as you can. If you get your brush near a site where a tooth was removed, be careful and gentle. Try to keep the brush just on teeth in that area. You will likely not be as good at brushing the area where a tooth was removed for a few days but just do your best and each day will be a little easier.
Flossing Floss as best you can. Be careful around the sites that were just operated on and it is ok to skip a couple of days due to soreness. Get back to it when you can.
Mouth rinsing If your normal protocol for mouth hygiene includes mouth rinses then you can continue that. Most mouth rinses have some alcohol in them which may be uncomfortable on new oral wounds so try diluting your mouth rinse first with water to test it out.
If you were prescribed a medicated mouth rinse then start using it on the day of surgery and follow the directions on the prescription for timing and duration of use.
Salt water rinses are likely no better than tap water but will generally not harm anything.
Irrigating Syringe
If you were given an irrigating syringe AND were advised to use it, start using it a week after surgery. Generally, an irrigating syringe is used for lower wisdom teeth sites. (If your extraction sites were grafted with bone then very likely you were asked NOT to irrigate the sites.)
Fill the syringe with lukewarm tap water.
Put the syringe tip inside the holes where the lower wisdom teeth used to be and gently flush them out.
Little bits of food debris will come out of the sockets that if left behind will potentially get infected about a month out from surgery.
Sutures (Stiches)
If sutures were used for your surgery, they are likely dissolvable and require no work on your part except to try to leave them alone. Expect them to be gone in 4-10 days.
If your surgeon used sutures that require removal, you were likely informed, and an appointment was made for removal. Usually, the suture removal appointment is 2-3 weeks after the surgery.
Sedation and General Anesthesia Patients
If you had anesthesia during your procedure, you should remain under the supervision of a responsible adult for the rest of the day.
The IV site may be tender to the touch and you may even develop a bruise over the site. A heating pad and elevating your arm by resting it on a pillow will help to decrease minor swelling around the site. Please call the office if your pain persists or the IV site becomes more swollen.
While resting at home after a sedation or general anesthesia, you can occasionally get lightheaded and dizzy with sudden position changes like when moving from a reclined to a standing position.
If you are reclined or laying down, sit on the edge of the chair or bed for a minute before you stand up.
Medications
You were likely prescribed medications after your surgery. These instructions are meant to be general guidelines for the medications you received but do not supersede the actual instructions your doctor gave you or what is written on your prescription bottle. These instructions are also not a recommendation for medications you were not told by your doctor to take.
Antibiotics:
If you were prescribed antibiotics, start taking them on the day of surgery.
Finish the course no matter how good you feel.
An over-the-counter probiotic can help keep your gut populated with healthy bacteria while on antibiotics.
Sometimes a yeast infection can follow oral antibiotics. If this occurs, call your doctor for instructions.
Narcotic pain medications: (hydrocodone, oxycodone, tramadol, demerol are some examples)
If you were prescribed narcotic pain medication, use the medication for the least amount of time possible.
Narcotics can make you tired and should not be combined with alcohol, sleeping pills or muscle relaxants.
Narcotics can impair your mental acuity and reflexes. Don’t drive while on narcotics.
Ibuprofen/Tylenol
If you were advised (or prescribed) to take ibuprofen and Tylenol AND you were given a pain clock then follow the timing of medication on the clock. The dosages are written on the back of the clock.
The pain clock has arrows that point to times for ibuprofen and acetaminophen (Tylenol). Follow the timing of the clock for the first 48-72 hours taking the medication even if you don’t have pain and even in the middle of the night.
After 48 hours, stop using the clock and take the same medications just based on your need (just don’t take the medication more frequent than the frequency of when you were using the clock). If you are in pain, alternate Tylenol and ibuprofen as needed. You will wean off the Tylenol and ibuprofen over the course of a few days.
Activity
You will need a few days after surgery to recover before engaging in strenuous activity. As your swelling decreases overall, you will feel better and more comfortable with exercise and heavy activity.
After tooth removal, it may be three days before you feel like you are getting better.
Heavy activity or exercise right after surgery when things are still bleeding could prolong your recovery.
It may be a full week or two before you feel like you are back to 100% for heavy physical activity but you won’t damage anything being active after 2-3 days from surgery. Use some common sense in your activity selection: If you are active and you feel pain or throbbing, you need to slow it down.
Dry Socket
A dry socket is a condition that can occur after the removal of any tooth. It is most common, however, in the sockets of lower wisdom teeth. A dry socket is basically an area of exposed bone.
There are many myths about dry sockets and the science isn’t quite settled on what the exact cause of a dry is. Nicotine in any form seems to be associated with a much higher chance of a dry socket. A dry socket is also not an infection and can occur whether or not the extraction site is closed with stiches. Swelling is not associated with a dry socket.
What you will likely experience with a dry socket is:
pain that radiates away from the extraction site. Like up the side of your head and down your jaw line
pain medication is generally ineffective
your breath may smell unusually bad
there may or may not be mild nausea
The symptoms of a dry socket tend to show up 3-5 days after surgery during the time period where you should be feeling better. With a dry socket you may feel that you are getting worse.
Treatment for a dry socket is geared toward treating the symptoms. A dry socket will heal without treatment but it is usually painful for 4-10 days.
If you notice symptoms consistent with a dry socket please call the office.
Questions
Please call the office with concerns or questions (509)783-7600
You were given medication in the hospital to help minimize swelling. Swelling will likely peak 48–72 hours after surgery and decrease from that point.
Keeping your head elevated by resting in a recliner or sleeping with an extra pillow will help limit swelling.
Using ice packs for the first 24–48 hours will also help limit swelling.
CONGESTION / SECRETIONS
Your nose may feel congested after surgery on your upper jaw. Please do not blow your nose as this increases the pressure in the surgical site.
Congestion is at its peak usually between days 3 and 5.
Plan to use a vaporizer in your room.
Your surgeon may have discharged you from the hospital with decongestant medications; follow the directions on the bottles.
PAIN
Your surgeon gave you a prescription for pain medication. It is expected that you will need pain medication for a few days following your jaw surgery. If you are not experiencing any pain, then you do not need to take the medication.
Tapering down on your medication is also encouraged. If your pain medication is not adequate or if you are experiencing dizziness or headaches following pain medication, please call your surgeon.
NAUSEA AND VOMITING
Call your surgeon if you experience nausea following surgery or with pain medication use. Medication is available to help with this.
ORAL HYGIENE
Good oral care after surgery keeps the surgical area clean and helps prevent infection. It also helps promote a feeling of comfort to have your mouth clean. Oral care begins within 12 hours after surgery and must be continued when you go home.
RINSES
Saline (saltwater) rinses should be done every 4 hours, or more often if needed. Use 1/4 teaspoon of table salt dissolved in 8 ounces (1 cup) of warm water for the saline rinses.
Avoid the use of strong mouthwashes. In addition to this, you will have a prescription for a bottle of chlorhexidine (Peridex™) to use as a rinse twice daily. Please use this for the first 7–14 days after surgery.
TOOTH BRUSHING
Brushing should be done with a soft, small toothbrush.
Your swollen lips will make it more difficult for you to be aware of the saliva that collects in your mouth. Thus, you may experience some drooling. This is only temporary.
Your lips, particularly the lower lip and some of your gum tissue, may feel numb after surgery. Brush carefully and keep the toothbrush on your teeth.
EMOTIONAL SUPPORT
You may find that the first days and weeks after surgery are difficult both physically and emotionally. At times, you may wonder why you decided to go forward with surgery. These feelings are common and usually quickly subside as you begin to feel and look better. Be prepared to make adjustments in the following areas:
COMMUNICATION
You will likely have elastics on between your upper and lower teeth.
Talking may be frustrating for you, especially with elastics on, but you will not hurt anything by talking.
You may want to write on a tablet or whiteboard to communicate during the first few days after surgery.
Talking will become easier once facial swelling decreases.
REACTION TO YOUR APPEARANCE
Jaw surgery changes your appearance. If your appearance is markedly different after surgery, you can expect family and friends may be surprised by the difference.
Instead of having to explain your surgery to each person you encounter, let family and friends know ahead of time that you will look different following surgery and that their support will mean a lot to you.
DIET
Adequate nutrition is important right after surgery. For a few days after surgery, you will likely not feel hungry or thirsty. It is important to remain well-nourished and well-hydrated.
Plan for a puréed diet for the first 2–4 weeks after surgery. After the first 2–4 weeks, you may advance your diet to things like mashed potatoes, scrambled eggs, and soft pasta. The timing of your diet advancement will be discussed in detail with your surgeon at follow-up visits.
Maintaining adequate fluid intake is critical to your health and well-being.
Caffeine products will dehydrate you and are not recommended for a couple of weeks after surgery.
Alcohol can make you nauseated and impair your judgment; this places you in danger.
ACTIVITY
Beginning the day after surgery, you will be encouraged to get out of bed to walk or to sit in a chair. When you get home it is important to move around.
Expect to be fatigued from simple activities.
It is okay to shower — the steam will help with nasal congestion — but a long hot shower could make you dizzy!
Make sure that several times a day you are getting up and moving around, changing position and taking deep breaths.
MEDICATIONS
The medications that you take home with you after your jaw surgery may include an antibiotic, a decongestant, and pain medication. Your medications will likely be in liquid form. If you have other medications that you normally take your surgeon will discuss with you how to take those medications with tight elastics in place.
Antibiotics: Continue until the bottle is empty. Do not quit halfway.
Pain Medicine: Tyke opioid (narcotic) pain medication in a scheduled fashion (every 4 hours) for the first 24 hours and as needed thereafter. Remember that narcotics can make you drowsy, so no driving, swimming, operating machinery, or drinking alcoholic beverages while you are taking them.
You may wean yourself off the opioid medication and substitute with 500 mg of acetaminophen (Tylenol®).
If directed to do so, you may also use ibuprofen, 600 mg every 6 hours while awake, for the first 4 or 5 days.
Peridex™ (chlorhexidine) mouth rinse: Use twice daily for 2 weeks after surgery.
Call your physician promptly if you experience any of the following symptoms:
Fever of 100.4° F (38° C) or higher
Pain that worsens or is not relieved by medication
Do not spit. Use a tissue to wipe your mouth, or swallow your saliva.
Do not smoke.
Keep your fingers and tongue away from the surgical area.
FOR TWO WEEKS FOLLOWING SURGERY
No nose blowing.
If you have to cough or sneeze, make sure your mouth is open.
No drinking from a straw.
If you have sleep apnea, your surgeon will discuss your use of a CPAP.
Smoking will be detrimental to your healing and increases your risk for infection and need for more surgery.
BLEEDING
Some minor bleeding is expected after surgical treatment. It will usually subside quickly and stop within an hour or two after surgery. A little oozing is normal and may persist for several hours. It is not unusual for there to be a little trickle of blood from your nose on the same side as the sinus surgery in the first couple of days after surgery. This can be prevented by keeping your head above the level of your heart.
Keep gauze on the surgical area with some (biting) pressure for 30–45 minutes.
Remove the gauze after 30–45 minutes and replace it with a new piece of gauze if you are still bleeding. It is important to make sure the gauze is directly on the surgical site. Firm pressure for another hour should stop the bleeding.
If you find that this is not working after your third attempt, use a moistened tea bag instead of gauze. The tannic acid in tea will help form a clot and stop the bleeding.
If all else fails, call the office.
SWELLING
Most patients will experience some swelling after surgery in the mouth. It may be mild or severe and is different for every patient. The swelling may increase for the first 24–48 hours before it starts to go away. It may last for several days. Some bruising may also develop on the face.
Use an ice pack on the cheek or face next to the surgical site. Keep it on for 15–20 minutes, then off for 10 minutes, and repeat until you go to sleep. Start again the next day.
Sleep with your head elevated slightly (above the heart). This will keep swelling down.
On the third day, change to moist heat instead of ice packs. This will bring the swelling down quicker.
MEDICATIONS
You were probably given one or more prescriptions for medications. Take all medications as directed on the bottle. Call us if you experience severe nausea or diarrhea or cannot swallow your pills.
Antibiotics: Continue until the bottle is empty. Do not quit halfway.
Pain Medicine: Take pain medication in a scheduled fashion (every 4–6 hours) for the first 24 hours and as needed thereafter. Remember that narcotics can make you drowsy, so no driving, swimming, operating machinery, or drinking alcoholic beverages while you are taking them.
OVER-THE-COUNTER MEDICATIONS
Decongestants – to promote sinus drainage. Use these only if your surgeon recommends them.
Nasal sprays – to promote drainage. Saline nasal sprays can be purchased at the pharmacy (for example, Ocean® Nasal Spray). Two puffs in each nostril 6 times per day plus as needed to promote drainage.
Antihistamines – to avoid sneezing. Ask your surgeon prior to using antihistamines.
If you have a question about your procedure or treatment plan, our center has 24-hour surgeon availability. If you would like to speak to your surgeon, please contact us at any time.
During business hours, please call our office. After hours, please call our office, and our answering service will page a surgeon. We’ll get back to you as soon as possible.
Get Connected
Submission Received.
Chelsey Lancaster
Highly recommend, You guys are amazing!
Brittany Hilker
Two of my daughters had surgery here recently and they are absolutely amazing. Such nice staff that made us feel so comfortable.
Sofia Roach
Dr. Reddinger's compassionate, attentive bedside manner reassured me, and I’m grateful for the excellent care.
