Post-Operative Instructions

Post-operative care is very important. Unnecessary pain and complications such as infection and swelling can be minimized if these instructions are followed carefully. Please call our office if you need assistance: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.

Medications

  • Start taking Aleve (Naproxen) 440mg immediately then every 8 hours, with food.
  • Take Keflex (Antibiotic), if prescribed, as directed on the bottle with food.
  • Take Percocet (Narcotic) as needed every 6 hours with food.
  • Place ice on the face all day for the first 24 hours.
  • Use moist heat, massage and stretching of the jaw on days 2-7.
  • To avoid nausea eat stomach-coating foods (at least 2 cups) prior to taking any medications.  Also drink at least 8 large glasses of water on the day of surgery (after surgery) to flush the anesthesia out of your body as quickly as possible.

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded. You may replace the gauze with fresh gauze after eating and drinking.
  • Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take prescribed pain medications as soon as you begin to feel discomfort. This usually coincides with the local anesthetic diminishing.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs on the sides of your face for the first 24 hours. Refer to the section on swelling for a more thorough explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is common. 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 black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting bleeding vessels. To minimize further bleeding, sit upright, do not become excited, and avoid exercise. If bleeding does not subside, call our office for further instructions: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes, and sides of the face is common. This is the body’s normal reaction to surgery and eventual repair.  Swelling will not become apparent until the day following surgery and will not reach its maximum until 2–3 days post-operatively. However, swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect.

If swelling or jaw stiffness persists for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling. Massaging the cheeks and jaw as well as stretching the jaw is very important on days 2 – 7.

Pain

For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every 3–4 hours. Aleve (Naproxen) or Ibuprofen (Advil or Motrin) may be taken instead of Tylenol.  Aleve can be purchased over the counter in 220mg tablets. Two tablets can be taken every 8 hours Ibuprofen bought over the counter comes in 200 mg tablets: 2–3 tablets may be taken four times daily, not to exceed 3200 mg daily for an adult. Call our office if questions and consult our practice for individuals under 18: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665. Do not take the two medications at the same time.

For severe pain, the prescribed narcotic medication should be taken as directed. Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take them. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more every day. If pain persists, it may require attention and you should call the office: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.

Diet

After general anesthetic or IV sedation, only liquids should initially be consumed. Drink from a glass and only use straws with clear liquids. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. A high calorie, high protein intake is very important. Our staff can provide suggested diet instructions. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5–6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

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 up for one minute before standing.

Keep the Mouth Clean

No rinsing of any kind should be performed until the day following surgery. The day after surgery you should begin rinsing at least 5–6 times a day, especially after eating, with a teaspoon of salt mixed into one cup of warm water.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2–3 days after surgery. Moist heat applied to the area may speed up normal coloration returning.

Antibiotics

If you have been prescribed antibiotics, take them as directed. Antibiotics are given to help prevent infection. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call the office if you have any questions: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.

Nausea and 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 carbonated water, soda, tea, or ginger ale. 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 reviewed in your consultation, 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. Call Dr. Kiken and Dr. McAninch if you have any questions: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.
  • Slight elevation of temperature following surgery is not uncommon. If the temperature persists, notify the office: Santa Barbara: 805-682-0933or Lompoc: 805-735-3665. Tylenol or ibuprofen should be taken to reduce the fever.
  • Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported a tooth. These projections usually smooth out spontaneously. If not, they can be removed by Dr. Kiken and Dr. McAninch.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline or lip balm.
  • 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 (trismus) 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. This is relieved more rapidly when moist heat, massage and stretching of the jaw is started on Day 2.

Final Tips for Post-Op Care at Home

Sutures are 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. Simply remove the suture from your mouth and discard it. The sutures will be removed approximately one week after surgery if they do not dissolve on their own. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.

Pain and swelling should subside more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.

There will be a void where a tooth was removed. The void will fill in with new tissue gradually over the next months. In the meantime, the area should be kept clean, especially after meals, with salt water rinses and a toothbrush.

Your case is unique, no two mouths are alike. Discuss any problems with the trained experts best able to effectively help you: Dr. Kiken and Dr. McAninch (Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665) or your family dentist.

Brushing your teeth is important — just be gentle near the surgical sites.

A dry socket occurs when a blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and pain near the ear may occur 2–3 days following surgery. Call the office if this occurs: Santa Barbara: 805-682-0933 or Lompoc: 805-735-3665.

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.