Post-Operative Instructions

For your comfort, safety and to help prevent possible complications, please read the following. Please also review the information at Patient Instructions for Surgery.

ACTIVITY

After leaving the office, relax for the remainder of the day. Avoid strenuous activity or exercise for 3 days. If you have been given a sedative, do not: drive, watch children, make serious decisions or operate machinery for at least 8 to 10 hours.

SWELLING

Some swelling may be present the day after the surgery and may peak at 48-72 hours after surgery. Cold liquids are important for reducing swelling, discomfort, and bleeding. Sip ice water, iced tea, frozen yogurt, milkshakes, or similar cold liquids and keep the surgical area cold for the remainder of the day after surgery. Do not use a straw, as suction can start bleeding. Swelling can also be minimized by placing an ice pack over the treated area, on the outside of the face. Continue for 24 hours after surgery alternating on and off at 20 minute intervals.

BLEEDING

There should be minimal bleeding after surgery. When you leave, you may have gauze placed in your mouth. It may be removed once you get home. You may have a pink discoloration of your saliva for up to 24 hours; frank bleeding (bright red) is not to be expected. Should bleeding occur, take a piece of gauze, make a firm compress and place directly over the area which is bleeding. Apply steady pressure for 30 minutes. Placing a moistened tea bag (black, not herbal tea) over the area may be more effective. The tannic acid in the tea will aid in blood clotting.  Sit quietly in an upright position to control the bleeding. If these measures do not stop the bleeding, call doctor immediately.

EATING, DRINKING, SMOKING

High protein soft foods and liquids are important during the 3-5 day postoperative period. During this time avoid solid, spicy, salty, hot foods, hot or carbonated liquids and do not: spit, smoke, rinse hard, drink through a straw, or create a “sucking” action in your mouth. If you are comfortable you can start eating solid food after 3-5 days. Do not drink alcohol for 8 days following surgery. Do not smoke during the post surgical period, as wound healing will be delayed. Ask us about new treatments to help you quit smoking.

ORAL HYGIENE

Do not brush your teeth or rinse your mouth for the rest of today. Tomorrow you may begin rinsing with your prescription “Chlorhexidine” mouth rinse. It will keep the surgical area clean while it heals. Rinse twice daily for 30 seconds and don’t eat or drink for 1 hour. Make sure you brush and floss the rest of your teeth as usual to minimize infection and staining. Do not disturb the surgical area for 2 weeks; after that lightly clean the teeth using a very soft toothbrush soaked in warm water or cotton swab with Chlorhexidine. Do not brush tissue grafted areas until instructed by Drs. Wunderlich and Chang!

LOOSE STITCHES

“Sutures” are placed to hold the gum tissues in the proper position for ideal healing. Drs. Wunderlich & Chang usually place dissolving sutures. However they will want you to return so that the sutures can be fully removed after sufficient healing time. Disturbing the sutures will impair healing. If you notice a loose or missing suture, it is not urgent; contact us during regular hours for instructions.

MEDICATIONS

Follow the instructions on the bottle for prescribed medications. If an adverse occurs, (nausea, itching, swelling, severe diarrhea), stop the medicine and contact the office immediately .

We normally prescribe these medications to keep our bone graft patients comfortable.

1. Antibiotic: usually amoxicillin or clindamycin. Please take as directed by Drs. Wunderlich and Chang.
2. Non-narcotic, anti-inflammatory pain reliever:
   
   1. “Motrin” or ibuprofen, which will also help reduce swelling and reduce pain. You may take 1 pill 4 hours after surgery and then 3-4 times daily as needed or
   2. "Lodine" which will also help reduce pain and swelling.  You may take this medication immediately after surgery, then every 6-8 hours as needed. 
3. Narcotic pain reliever: “Acetaminophen with hydrocodone.” Although severe pain is unusual, you can take this, every 4 hours as needed after surgery, in addition to the ibuprofen or Lodine . It can cause drowsiness, and is best taken before bedtime.
4. Antiseptic rinse: Peridex “Chlorhexidine" which you can start using the day after surgery to keep the area clean during healing. Rinse after breakfast and before bed, avoiding food or drink for 1-hour. Do not rinse vigorously

DISCOMFORT OR FEVER

A slight fever is usual after a simple procedure for a day or so. Fever may also be caused by inadequate fluid intake. If you have a high fever or more pain than can be controlled with your prescriptions, call Drs. Wunderlich & Chang. Your teeth may be sensitive to extremes of hot, cold, and sweets. This is completely normal and usually diminishes as healing progresses. Good plaque control helps the desensitizing process. It is also helpful to brush with toothpaste for sensitive teeth. If the sensitivity does not improve, let us know.

REMOVABLE TEMPORARY TEETH “FLIPPER”

If an appliance has been given to you for use during healing, leave it in tonight unless otherwise instructed. Tomorrow morning, remove it, rinse it thoroughly, and place it back in your mouth. It not only replaces teeth it acts as a bandage to help keep swelling down. In some cases sore spots may develop. Contact your Dentist or Drs. Wunderlich & Chang after surgery to adjust and relieve those sore spots. Failure to do so may result in severe sores, which may prolong the healing process.

NORMAL BUT UNUSUAL

If bruising occurs, the application of a moist warm towel will help eliminate the discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 36 hours after surgery (ice packs are used for the first 36 hours only). A sore throat may also develop. The muscles of the throat are near the injection sites. This is normal and should subside in 2-3 days.

If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with a lip ointment.

Notify the Office if:

• Your medications do not relieve your discomfort
• If you develop a fever above 99.5F
• If you have any unusual swelling, uncontrolled bleeding or discharge
• If you develop any changes in vision, balance.

In the event you need to reach Drs. Wunderlich & Chang regarding today’s visit, we can be reached at the office (734) 981-7477.

We look forward to seeing you at your next visit.