After Your Surgery

Careful post-op care keeps pain, swelling and infection to a minimum. Please read these instructions before your surgery and keep this page handy for the next few weeks.

Bridgeport · Commerce Park
4747 Main Street, Bridgeport, CT 06606
(203) 371-5595

Fairfield · Brick Walk
1305 Post Road, Suite 201, Fairfield, CT 06824
(203) 259-2665

Your recovery at a glance

• Day of surgery: Bite on gauze, start ice and ibuprofen, take it easy. No rinsing, no straws, no driving for 24 hours after sedation.
• Day 1: Start rinsing 3 times a day with warm salt water or the prescribed mouth rinse. Swelling starts to show.
• After 36 hours: Stop ice. Switch to moist heat on the sides of the face.
• Days 2–3: Swelling, sore throat and bruising are at their peak, then ease.
• Days 3–4: If pain suddenly gets worse, it may be dry socket. Call the office.
• After 1 week: Wisdom teeth: start using the irrigating syringe on the lower sites.
• 2 weeks: Finish your mouth rinses.
• Up to 6 weeks: Keep irrigating the lower sockets until they have closed.

Right after surgery

• Gauze: Keep the gauze pad over the surgical area for 30 minutes, then remove and discard it. Repeat as needed for 2 hours, then switch to moist tea bags.
• Antibiotic: If prescribed (amoxicillin or clindamycin, for example), start it only with food.
• Ibuprofen: Start taking ibuprofen immediately. Take it every 6 hours for 5 days, together with one Extra-Strength Tylenol.
• Medrol dose pack: If prescribed, see the attached instructions. No matter what time your surgery was, take all of the first day’s doses before going to bed that night.
• Mouth rinse: Do not start the warm salt water rinse (or Peridex rinse) until tomorrow. Then rinse 3 times a day for 2 weeks. Avoid vigorous rinsing or touching the area today; it can dislodge the blood clot and restart bleeding.
• Activity: Limit your activities today and return to normal when you feel comfortable. No driving for 24 hours after sedation.
• Ice: Place ice packs on the sides of your face where surgery was done. See Swelling below.

Bleeding

Some bleeding is expected. Slight oozing or redness in your saliva is normal.

If bleeding is heavier, wipe or rinse away any old clots, place a gauze pad over the area and bite down firmly for 30 minutes. Repeat if needed.

If it continues, bite on a moistened tea bag for 30 minutes. The tannic acid in tea helps a clot form. Sit upright, avoid exercise and limit talking, since talking takes pressure off the site and delays clotting.

If bleeding does not slow down, call the office for further instructions.

Swelling and bruising

Swelling around the mouth, cheeks, eyes and sides of the face is a normal part of healing, and it is usually in proportion to the surgery. It often isn’t noticeable until the day after surgery and peaks 2–3 days after.

Ice: Use ice packs right away and keep them on continuously while you are awake. After 36 hours ice no longer helps.

Heat: After 36 hours, moist heat on the sides of the face helps bring the swelling down.

Swelling or jaw stiffness that lasts several days is a normal reaction and no cause for alarm.

Bruising

Black, blue, green or yellow discoloration of the skin can follow swelling, usually 2–3 days after surgery. It is caused by blood spreading under the tissues and is normal. Call the office if you have questions.

Pain and medicine

Moderate pain

Take 200–600 mg of ibuprofen every 6 hours for 5 days. Or you may take Tylenol every 4–6 hours instead. You can also take both, at the same time or staggered. Your doctor will tell you if this needs to change because of other medications or medical conditions.

Severe pain

Keep taking ibuprofen and/or Tylenol as your baseline. You may also be prescribed a narcotic pain medication.

• Do not take it unless you are in severe pain.
• Do not plan to leave the house, exercise or operate machinery while taking it.
• Do not combine it with other sedatives or alcohol.

Antibiotics

If you were prescribed antibiotics, take them as directed. Never take them on an empty stomach. Stop taking them if you develop a rash or other bad reaction, and call the office.

Nausea and vomiting

If you feel sick or vomit, take nothing by mouth, including your medicine, for at least an hour. Then slowly sip cola, tea or ginger ale over about 15 minutes. Once the nausea passes, start solid food and your medicine again. Your doctor may prescribe a dissolvable form of Zofran to help.

Eating, drinking and exercise

• After IV sedation, start with liquids. Drink from a glass. Do not use straws; sucking can dislodge the clot and cause more bleeding.
• Eat anything soft, chewing away from the surgical sites.
• High-calorie, high-protein food is very important. Try not to miss a meal. You will feel better, have more strength, have less discomfort and heal faster if you keep eating.
• Drink at least 5–6 glasses of liquid a day to stay hydrated, especially while you’re eating less.
• If you exercise regularly, remember you’re taking in less food than usual, and exercise may weaken you. Stop if you feel lightheaded.

Keeping your mouth clean

No rinsing of any kind until the day after surgery. You can brush your teeth the night of surgery; just be gentle around the surgical sites.

Starting the day after surgery, rinse as directed with either the chlorhexidine (Peridex) mouthwash or warm salt water.

Stitches

Stitches help control bleeding and help healing. They usually dissolve within several days. If one comes loose, that’s no cause for alarm; just remove it from your mouth and throw it away.

Long-term care for wisdom teeth

One week after surgery, start rinsing the lower surgical sites with the irrigating syringe we gave you, using warm salt water or mouth rinse. Do this 3 times a day for 6 weeks, or until the sockets have fully closed.

Dry socket

Dry socket is not an infection. Sometimes, 3 or 4 days after surgery, pain at the extraction site (usually a lower tooth) suddenly gets worse. If ibuprofen and/or Tylenol doesn’t control it, you may have dry socket.

Call the office to discuss. Dry socket heals on its own, but we can often make you more comfortable while it does.

Other things you may notice

Numbness

Numbness of the lip, chin or tongue is usually temporary and no cause for alarm. Be careful: if your lip or tongue is numb, you could bite it without feeling it. Call the office with any questions.

Slight fever

A slightly raised temperature right after surgery is common. Take Tylenol or ibuprofen to bring it down. If it continues, call the office.

Dizziness when standing

You may not have eaten much before or since surgery, and pain medicine can make you dizzy. Before getting up from lying down, sit for one minute, then stand.

Hard edges in the socket

You may feel hard edges with your tongue. These are not roots; they are the bony walls that held the tooth. They usually smooth out on their own. If not, they can be removed with a minor procedure.

Dry, cracked corners of the mouth

If the corners of your mouth were stretched, keep your lips moist with an ointment such as Vaseline.

Sore throat

Sore throat and pain when swallowing are common because the muscles swell. This eases in 2–3 days.

Jaw stiffness

Stiff jaw muscles (trismus) can make it hard to open your mouth for a few days. This is normal and will go away.

Oral Surgery Associates · Abed E. Alkhatib, DMD · Robert P. Horne, DDS