Do not disturb the surgical site.
Avoid vigorous rinsing or touching the wound with your tongue or finger until directed by your doctor. This may dislodge the bone graft and cause the graft to fail. Rinse gently with warm salt water (1/2 teaspoon of salt and 8 oz of warm water- not well water) to keep food from sticking to sutures. Brush teeth in the direction the teeth grow (down on the top and up on the bottom) after meals avoiding the area of surgery. Keep your tongue clean and away from the socket or surgical site.
Absolutely no smoking
Chew on the opposite side if possible
Keep food out of the area at all costs.
Pain is greatest at 72 hours after surgery
If advised by your doctor, please take 3 (200 mg tablets) of Ibuprofen (Motrin or Advil) as soon as possible after surgery and then 2 every 4-6 hours, followed by your pain medication before the numbness wears off.
Note: it is okay to take the Ibuprofen in conjunction with the pain medicine not to exceed 3200 mg in a 24 hour period, also the pain medicine has Tylenol in it (325 mg in each pill) and you should not exceed 3000 mg / 24 hour period as well. Another way to take your medicine is to alternate the pain medicine with the ibuprofen, taking one or the other every 2 hours, allowing you to take the ibuprofen at 4 hour intervals and the pain medicine at 4 hour intervals. Remember to avoid NSAIDS like ibuprofen, Aleve, or aspirin if you have gastritis, ulcers, are allergic, or any other reason listed in the package insert. If there are any questions please contact your family doctor, pharmacist, and /or the package insert.
The most likely reason is the pain medication you are taking or the anesthesia you were given if sedated
Try taking less of the pain medication and take the Ibuprofen regimen above if directed by your doctor
We also likely prescribed an anti-nausea medication such as phenergan or zofran.
If this persists please call the office or answering service (same number) to speak to a nurse or doctor or seek medical attention.
Your doctor may have placed resorbable (dissolvable) sutures that will fall out by day 5-7 and these are usually brown in color. He may have also placed non-resorbable sutures that will remain until the follow up appointment at 1-3 weeks. These will be blue and left long intentionally. These are monofilament and will cause ulcers if cut too short. They will only be annoying if left long and not painful.
Please keep the sutures and the wound in the condition they are the day of surgery by rinsing gently after meals and not allowing food to build up in the graft site.
Never play with them with your tongue. The tongue is loaded with bacteria and yeast and are not good for bone grafts or surgical wounds.
Don’t rub too hard on the socket or surgical area as to not displace the collagen membrane or the bone graft.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 48 hours.
Your surgery may have required a flap to place a bone graft. This reflection of the tissue can cause severe swelling for the first 72 hours sometimes involving the eyes and/or the cheeks. This edema will be greatest at 72 hours and should start to subside after this time.
Your doctor may have used a produce called rh-BMP as discussed in the consult. This will produce swelling starting on the second or third day after surgery.
Please let your doctor know immediately if your temperature is measured >100.4 F
Avoid exercise while on pain medication. Increasing heart rate or blood pressure may increase bleeding. Avoid driving the first 24 hours after surgery if sedated. Avoid driving if still on pain medication.
Donor site care
If this was a hip or tibia graftdo not submerge the site in water for 5-7 days or until directed by your doctor.You can remove the bandage at 2 days and clean with warm water and gentle cleanser, replace bandage and antibiotic cream for a maximum of 5-7 days.Ambulate with assistance on post op day one. Avoid belts or elastic waist bands to contact or rub the site
notify your doctor if any drainage or concern. If you are having difficulty walking notify our office.
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 Drs. Dupree, Neupert, & Chandler if you have any questions.
Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists or is greater than 100.4, notify the office. Tylenol or ibuprofen can be taken to reduce the fever as long it is not contraindicated by your history.
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 or possibly graft materials. Bone projections usually smooth out spontaneously but if you feel the graft is exposed notify our office the next business day.
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.
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. If you are ever concerned or have questions please call our office and let us know.
Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a common post-operative event which will resolve in time. Again, if you are concerned or have questions please call our office or seek medical advice.