Postoperative Instructions

Informed Consent Presentation

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It is highly important that you follow all postoperative instructions given to you by Dr. Narra and his staff at Issaquah Implants & Oral Surgery in order to minimize pain and the risk of complications.

The gauze pad(s) placed over the surgical area(s) should be kept securely in place for half an hour before being carefully removed with clean hands and discarded.
Vigorous rinsing, sucking or touching of the wound area following surgery should be avoided. This may dislodge the blood clot and cause dry sockets.
Take the prescribed pain medications as soon as you begin to feel discomfort. This signifies that the local anesthetic is wearing off.
Restrict your activities the first three to four days following surgery and resume normal activity when you feel comfortable.
Place ice packs to the sides of your face to reduce swelling and discomfort. Refer to the section on swelling for more information.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

The swelling around the mouth, cheeks, eyes and sides of the face is common and usually proportional to the complexity of the procedure. It will not become apparent until the day following surgery and will not reach its maximum until 2-3 days afterwards. Nonetheless, swelling may be minimized by the immediate application of ice packs to the affected areas. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. At this time, the application of moist heat to the sides of the face is beneficial to reducing swelling.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen (Motrin or Advil) four 200 mg tablets may be taken every 6 hours.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.

Alternating the Ibuprofen or Tylenol with the prescribed pain medication is usually the best form of pain control.

When you arrive home take the Ibuprofen or Tylenol and 3 hours later take the pain medication and 3 hours later the Ibuprofen or Tylenol and continue this rotation for the first day or two depending on your level of discomfort.

Diet

After general anesthesia or I.V. sedation, liquids should be consumed initially. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. High calorie, high protein intake is very important (refer to the section on suggested diet instructions at the end of the oral surgical brochure you will be given). Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 6-8 glasses of liquid should be taken daily to prevent dehydration and undernourishment. You will feel better, have more strength, less discomfort and heal faster if you continue to eat and drink what you can.

Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep in mouth clean

No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse gently. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating with a cup of warm water mixed with a teaspoon of salt.

Nausea and Vomiting

We usually administer anti-nausea medication after surgery to help reduce chances of nausea or vomiting.

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

Other Complications

If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation – so be careful. Call Dr. Sasi Narra at (425) 391-8284 if you have any questions.
Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Narra.
If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with the lip balm you were given or an ointment such as Vaseline.
Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

Oral Hygiene

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. Brush your teeth and tongue as best you can.

Activity

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.

Other Information

Sutures are sometimes placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged, this is no cause for alarm. Just remove the suture form your mouth and discard it. The sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is no discomfort associated with this procedure.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call our office at (425) 391-8284 for instructions.
There will be a cavity where the tooth was removed. The cavity will gradually fill in with the new tissue over the next month. In the mean time, the area should be kept clean especially after meals with salt water rinses or a toothbrush.
Your case is individual; no two mouths are alike. Do not accept well intended advice from friends. Discuss your problem with the professionals best suited to assist you: Sasi Narra, B.D.S., M.D.S.
Brushing your teeth is okay – just be gentle at the surgical sites.
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.