Post Operative Care
Instructions

What to Do/Expect on Day 1

Diet

• Avoid chewing on the surgery site and gently clean the area after every meal
• Begin with soft and cold foods—yogurt, pudding, applesauce, smoothies, ice cream, protein shakes
• If certain food causes pain, try softer foods
• Hydrate! Water is best. No straws.
• Normal diet can be resumed as tolerated

Pain Management - Staying on top of the
pain is key!

• We recommend alternating over-the-counter acetaminophen (Tylenol) 1000mg and ibuprofen 600mg every 6 hours—by staggering the medications, you will be taking something every 3 hours
• Narcotic pain medication may have been prescribed to manage moderate to severe pain
• The narcotic may be taken in addition to your scheduled ibuprofen and acetaminophen, as prescribed
• If the narcotic is combined with acetaminophen, you will need to reduce the use of acetaminophen accordingly (e.g. Norco, hydrocodone/APAP)
• Do not work, drive, or go to school if you are taking any narcotics

Swelling

• Apply ice packs to the outside of face for the first 24- 48 hours in 20-minute increments
• Try your best to sleep on your back and not on the side of your face where you had surgery
• Keep head elevated

Controlling Bleeding

• Place folded, moist gauze directly over surgical site and bite down firmly
• Replace gauze every 30 minutes until bleeding subsides or is light pink
• Do not fall asleep with gauze inside the mouth
• Depending on if dissolvable or non-dissolvable sutures were placed, they will be removed at your post-op appointment
• If bleeding continues, biting on a moist black tea bag for 30-minutes can help constrict blood vessels
• If you continue to have large blood clots form in your mouth, wipe the area off firmly until you can see the surgical site, then apply pressure with cold, moist gauze for 30 minutes.
• Sleep with a towel on your pillow for the first night is advisable if you drool
• If persistent or heavy bleeding lasts longer than 8 hours and cannot be controlled, call us!

Oral Hygiene

• Resume normal brushing and flossing being very gentle around the surgical sites
• Gently rinse mouth after meals to avoid getting food trapped in sockets—Do not spit after rinsing
• Complete gentle warm salt-water rinses 3-5 times per day for the first 7 days
• Mix 1 tsp of salt with 1 cup of warm water until salt is dissolved—Gently rinse
• Standing over a sink, allow salt-water to fall out of mouth—Do not spit!

Day 2 through 7

Pain & Swelling

• Around day 2, increased pain due to swelling and absence of local anesthetic is normal
• The use of ice, pain medication schedule, rest and elevation of the head should help manage discomfort
• Applying ice packs to the cheeks, alternating sides every 20 minutes, can help minimize swelling
• Swelling can last up to 7 days or longer
• Around day 3 –4, use moist heat compresses for pain management

Curved Syringe

• If provided a curved syringe, it may be used 5 days after your procedure for removal of debris that is not cleared with gentle rinsing
• Irrigate surgical sites with warm water until food debris has been cleared
• Avoid aggressive use of the syringe as this may dislodge the blood clot
• You may use the syringe until sockets have completely healed – up to 2 months

Dry Sockets

• 3-5 days after your procedure, dry sockets can occur. Watch out for:
  • Increased pain that progressively worsens despite medication
  • Radiating jaw or ear pain
  • Foul taste or smell near the extraction site
• For 7 days, avoid the use of a straw, spitting, or smoking as these actions may cause blood clots to become dislodged.
• Call our office at (617) 456-9714 if you notice signs of dry socket

Week 1 – Week 2

• Use over-the-counter pain medication as needed
• Diet can return to normal as tolerated
• Continue using curved syringe as needle up to 2 months after your procedure