Post-Operative Instructions:
Extractions and Bone Grafting

General Instructions

After extraction of teeth and bone grafting, a blood clot forms in the remaining socket. To prevent post-operative inflammation and infection, it is important to keep this blood clot in place.

For the first 48 hours after extraction and grafting:

• DO NOT vigorously rinse your mouth as this may rinse away the blood clot however use the mouthwash with a gentle swishing motion.
• DO NOT use drinking straws.
• DO NOT smoke.
• DO NOT disturb the extraction site with tongue or fingers.

Bleeding

After tooth removal, it is normal to ooze blood from the tooth socket for approximately 24 hours. To minimize bleeding, do the following:

• Bite on damp gauze for 1 hour after extraction.
• Repeat with fresh gauze every 20 minutes as needed.
• DO NOT lie flat. Elevate your head with a pillow.
• Limit activity for the first 2-3 days.

Swelling

It is normal to swell after tooth removal and grafting. The swelling is greatest 2-3 days after surgery, and may remain for an additional 3 days before it starts to resolve.

• Immediately after surgery, place ice packs over the area.
• Leave the ice pack on for 20 minutes and then off for 20 minutes for the rest of the day.
• After the first 24 hours, it is not necessary to continue cold packs.

Postoperative discomfort

After removal of teeth or grafting, it is normal to experience some amount of discomfort when the anesthesia wears off. Taking prescribed medication as directed should control discomfort, but may not eliminate it.

• DO NOT operate a motor vehicle or machinery while taking pain medication. It can make you drowsy.

Infection

After surgical procedures, there is always a chance that infection might develop. This does not happen in most cases. A prescription may be written for you after a procedure that has a higher incidence of post-operative infection.

• Take all prescribed antibiotics until finished.
• Women taking oral contraceptives (birth control pills) are recommended to use other methods of contraception while taking antibiotics. Penicillin and penicillin-like medications temporarily decrease effectiveness of birth control pills.

Sutures

Depending on the extent of the procedures, sutures (stitches) may be placed in order to help wound healing. If you have sutures, the doctor will inform you of this after the procedure.

• Sutures that dissolve should fall out in about 1-7 days.
• The non-dissolvable sutures need to be removed as early as 7 to 10 days. However, most are removed at 3 weeks.

Other Instructions

• It is not uncommon to lose small particles of graft material during the healing phase.

If you have had IV sedation or general anesthesia for your procedure, you should rest at home with moderate activity as tolerated.

For the next 24 hours following anesthesia:

• DO NOT drive a car or operate machinery or power tools.
• DO NOT drink any alcoholic beverages including beer.
• DO NOT engage in any moderate to high intensity physical activity (e.g., running, weight-lifting)

Brushing

• Begin normal hygiene the night of surgery or the next day, brush lightly as you get closer to the area of surgery.
• DO NOT spit.

Diet Suggestions

Begin with clear liquids, such as apple or cranberry juice, 7 Up^® ,or ginger ale.

Advance diet the first day as tolerated, such as Jell-O^®, applesauce, or milkshakes.

Soft, non-chewy foods are recommended for 1 week after surgery, such as mashed potatoes, scrambled eggs, or pasta.

DO NOT eat popcorn, peanuts, seeds, or chips for at least 2 weeks after surgery to prevent an infection in the surgical site from impacted food debris.

DO NOT rinse your mouth for the first 12 hours after surgery. After that, rinse gently with the oral rinse, if prescribed by your doctor, or with warm salt water (1/2 teaspoon salt dissolved in 8 ounces of warm water) 2-3 times a day for 1 week. Brush your teeth gently, but avoid the area of surgery for the first 24 hours.

Warning Signs

If any of the following should occur, do not hesitate to contact us during regular office hours at (702) 660-5574. During the evening or night hours call (702) 660-5574 and follow the prompts.

• Bleeding that cannot be controlled by firmly biting on a gauze for 60 minutes.
• Pain which is not controlled by the prescribed dose of medication. DO NOT take higher doses.
• Persistent nausea or vomiting.
• An increase in swelling after the first 72 hours or swelling that interferes with swallowing.
• A very foul-tasting discharge that is unrelieved by normal oral hygiene.
• Fever greater than 101 degrees Fahrenheit.

FAILURE TO FOLLOW INSTRUCTIONS MAY BE LIFE-THREATENING.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but please contact our office if you have questions about your progress.