Do NOT disturb the wound. Avoid touching the wound or spitting for a week after surgery. Try to maintain all graft material at the surgical site. You will have a 1 week follow up appointment with Dr. Curtis and should be very cautious with the area until you return to see him.
Some minor residual bleeding or redness is normal for 48 hours following surgery. If your mouth is filling with blood, ensure that you have eaten something cold e.g., smooth ice cream or a milkshake, as this will slow down the bleeding. NO hot foods the day of surgery as this will cause more bleeding. Stick to cold, smooth foods on the first day. If you have tried the cold foods and bright red blood is still filling your mouth, please call our office for further instructions.
Swelling is a normal occurrence after surgery. To minimize the swelling, apply an ice pack (or a plastic bag or towel filled with ice) on the cheek in the area of surgery. Apply the ice continuously, 20 minutes every hour for the first 24 hours. After the first 24 hours, you need to switch to warm moist heat (heating pad, rice bag, wet towel warmed in the microwave to the touch) for 20 minutes every couple of hours for 3–7 days until swelling has come down. Swelling should peak on or around day 3–5 and should dissipate after that.
Drink plenty of fluids, avoiding hot liquids the first couple of days. A diet of zero consistency foods is advised for the FIRST WEEK. This can include protein shakes, smoothies, milk shakes, smooth ice cream, yogurt, pudding, JELL-O®. This is to ensure that you avoid disturbing the grafting site allowing everything to heal in the correct placement. Disturbing the placement of the graft can cause the grafting site to fail.
You should begin taking pain medication before the local anesthetic wears off. For moderate pain, 1 or 2 REGULAR strength Tylenol® (325 mg) may be taken every 4 hours (no more than 2600 mg/24-hour period). Ibuprofen (also known as Advil® or Motrin®) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200mg tablets: 3 (200 mg tablets; total of 600 mg) tablets may be taken every 6 hours as needed for pain (No more than 3200 mg/24-hour period). For severe pain, the prescribed medication should be taken as directed. (Please note: if the prescription has Tylenol [APAP] in it, you have to wait 4 hours from the previous Tylenol dosage time). Do not take any of the above medication if you are allergic or have been instructed by your doctor to not take it. This may include but is not limited to patients with liver or kidney disease, as well as post gastric surgery patients, or patients under the care of gastroenterologists.
You MAY be prescribed an antibiotic to take post-operatively. Please take as directed to help prevent infection.
Avoid touching the wound or spitting for a week after surgery. If you need to spit for any reason, just hang your head and let it fall out. You will start rinsing the day after surgery, the first few days of rinsing will just be gentle back and forth motions with your head allowing that movement to clean the area, NO actual swishing as that can dislodge the placement of the bone grafting. Once done with the rinse, hang head allowing rinse to fall out of the mouth, DO NOT SPIT as that could also dislodge the grafting that has been done. Brushing can resume the next day AVOIDING the tooth before and after surgical site, the rinsing will be what keeps surgical site clean. Dr. Curtis will often provide a prescription for Peridex™, an antibiotic mouth wash that should be used for a week, morning and night, following surgery. You should also be doing warm salt water rinses 4-5 times daily especially after meals. Warm salt water rinses can be made by mixing a ½ teaspoon of salt in a cup of warm water, stirring until dissolved.
For some procedures you may have sutures placed. They can either be sutures that come out on their own lasting 3-10 days or sutures that will need to be removed in or around 2 WEEKS. You will be brought in for a 1-week follow up and a 2-week follow up. At the 1-week follow up you can expect the surgical site to be looked at to ensure everything is healing as it should. You may be told that you can advance to a soft food diet or may even be told to remain on the liquid diet. This is determined on an individual basis determined by healing progression. It will be at this appointment that we let you know if you are able to use a soft bristled toothbrush to begin brushing the surgical site, expect some minor bleeding at first that will dissipate as the healing progresses during the brushing. At the 2-week appointment, you can expect the surgical site to be checked again as well as removing any sutures that you may have. You may also be told at this appointment that you can resume normal eating habits as well as physical activity.
Keep physical activities to a minimum for the first week following surgery. Avoid bending over, heavy lifting, straining, or cardio, as this will cause a rise in blood pressure not allowing the surgical site to heal and or cause more significant bleeding. Keep in mind that you are probably not taking in your normal nourishment. This may weaken you and further limit your ability to exercise.
Partial dentures, flippers, Essex retainers, or full dentures should NOT be used immediately after surgery. The ability to wear the prosthesis will usually be evaluated at your 1-week post-operative appointment. This is to ensure that it is not causing any pressure to the grafting site, if it does put any pressure on the grafting site it will cause the graft to fail.
