After leaving the office, relax for the remainder of the day. Avoid strenuous activity until your two-week post-operative appointment. Try your best to keep your tongue, food, and drinks off the surgery area.
SWELLING, BLEEDING, AND DISCOMFORT:
Some swelling may be present the day after the surgery and may peak at 2-3 days after surgery. Cold liquids are very important for reducing swelling, bleeding, and discomfort. Drink plenty of fluids, especially if you have taken sedation medication. Eat and drink items like: iced tea, frozen yogurt, milkshakes and/or protein drinks which will help to keep the surgical area cold (avoid hot food and drinks). Swelling, bleeding, and pain can be minimized by placing an ice pack over the operated area on the outside of the face for the remainder of the day after surgery, alternating 10 minutes on and 10 minutes off. Try to keep your head in an upright position (sitting is better than lying down) when awake and keep your head and shoulders elevated when you sleep (3-4 pillows/recliner position). Also try to sleep on your back or on the non-surgery side, if possible.
MORE ABOUT BLEEDING:
There should be minimal bleeding after the surgery is completed. There may be a pink discoloration of your saliva for the first 24 hours. Heavy bleeding (bright red) is not to be expected. Do not use a straw (and no sucking) and do not spit because it can cause more bleeding. If excessive bleeding occurs, place wet gauze (or wet caffeinated tea bag) over the area and hold firmly against the area for 20 minutes with head upright. If there is a cover/dressing over the surgical site, you should not apply pressure, as described above. When the numbness first wears off, the bleeding can start. If you are eating/talking and bleeding starts, please avoid those activities the best that you can. If the bleeding is a concern or persists longer than a couple hours, please call.
For at least the first few days or longer, soft/cold foods should be eaten such as yogurt, mashed potatoes, applesauce, Ensure drinks, soups, and eggs. Avoid hot foods/liquids, spicy/acidic foods and hard, crunchy foods like peanuts, popcorn, rice, chips, and hard bread for at least the first week even you are able to eat on the opposite side. Chewing should only be done on the opposite side and away from the surgical site.
SMOKING and ALCOHOL:
Please refrain from smoking and alcoholic beverages during the post-surgical period, as wound healing and medication interactions may occur. Smoking and alcohol slows down and interferes with healing.
If a dressing (PerioPak, a pink putty-like substance) has been placed over the surgical site, stay away from it with your tongue and food/drink. The dressing usually comes off in 2 days to 2 weeks depending on the size of your teeth (it sticks to your teeth) and how well the area can be left alone. If it starts to get loose, you can gently push it back in with your tongue or a clean finger. It will typically come off in one piece. Don’t try to pull it off- just let it fall off naturally. If you need to have it removed or checked, please call.
CLEANING AND OTHER ACTIVITIES:
No brushing or flossing in the surgical area for two weeks or until your follow up appointment. Use the rinse prescribed or a warm, saltwater rinse** to keep the surgical area clean (SEE BELOW). Don’t use an electric toothbrush or waterpik on the surgical area until directed. Stitches are usually dissolvable, and they usually dissolve (get loose and fall out) in 4-10 days. Do not pull on stitches to remove them. Avoid anything that causes pain or bleeding. Please continue to brush and floss the unaffected area as usual.
Limit the amount of talking or moving of your mouth especially the first couple of days or if talking increases pain or bleeding. Communicate with emails/texting when you can. Please don’t pull on the cheek/lip to look or play with your tongue on the surgical area because it can cause gum tissue to detach. If you use a nightguard, retainer, or denture (anything removable), you may not be able to wear them during the healing process, please do not force it into place if it does not want to fit. Bring your appliances to your appointments.
Antibacterial rinse: Start the rinse the day after surgery. The rinse will keep the surgical site clean. Brush your other teeth first, then rinse (30 seconds, twice daily for one week). Do not eat/drink for at least an hour after the rinse. Do not swish vigorously, instead, gently tilt your head toward the area and let gravity bathe the area and then gently spit out- do not swallow. Please note, rinse can cause staining if used too much.
**Warm salt water: After the first week, rinse (1/4 teaspoon , 1 cup water) for 30 seconds, several times a day.
Do not brush or bite on food where the implant(s) were placed. If you have a stayplate or denture (aka “flipper”), make sure the plastic is not pushing on the implant. If you use denture glue, make sure the glue does not get into the surgical area. Biting on the area, with or without the denture, can cause unwanted pressure on the implant, which can interfere with healing. If you can see the healing abutment (temporary cylinder) above the gum, use the rinses to keep it clean, until directed.
Please follow the instructions on the bottle for any medications prescribed. Remember to eat some food before you take medications if you can to help your stomach. Ask the pharmacy for all directions. If any adverse reactions to medications should arise, such as nausea, itching, swelling, or any allergic symptoms, please contact the office or Doctor immediately and discontinue all medications that might be causing the problem.
ANTI-INFLAMMATORY (you should have stopped other blood-thinners prior to surgery, as directed):
Choose one NSAID (non-narcotic anti-inflammatory) to take after the appointment and for the first 3-7 days to minimize swelling and discomfort. Motrin (Advil/Ibuprofen) or Aleve are common NSAIDS. Aspirin is also in the same class (NSAID). Do not take too much NSAIDs and confirm with your Doctor or pharmacy, if needed.
Motrin (Advil): 600mg or 800 mg, 1 tab every 6 hours (healthy adults: Maximum: 3200mg per 24 hours).
Aleve: (220 mg Naxopren) 2 tabs for the first dose then 1 tab every 12 hours.
- Don’t take NSAIDS if you are on other blood-thinners (fish-oil and other meds can be blood-thinners)
NARCOTICS (typically contain Tylenol (Acetaminophen)):
Codeine with Acetaminophen (Tylenol 3) can cause drowsiness, so (DO NOT DRIVE OR OPERATE MACHINERY). Other “Strong” pain pills are Norco (Hydrocodone with Acetaminophen), Ultracet (Tramadol with Tylenol) and Percocet (Oxycodone with Tylenol).
Tylenol 3: 1 tab every 6 hours as needed for pain.
- NOTE: You can Alternate the Motrin and Tylenol products. For example: Advil at 9am, Tylenol based at 12pm, Advil at 3pm, Tylenol based at 6pm, etc. So, you will always have at least one working and are waiting at least six hours before taking the same medication again.
- If you do not need extra pain control or if you do not want/need to take narcotics, regular Tylenol can be substituted for Tylenol 3 or Norco. (DO NOT TAKE THE NARCOTIC IF YOU DO NOT NEED IT)
- Because your narcotics already contain Tylenol, do not take them together with more over the counter Tylenol. They need to be taken at least 6 hours apart.
PROBLEMS, QUESTIONS, OR CONCERNS:
During regular business hours, you can call the office at:
Placerville: (530) 626-6320
El Dorado Hills: (916) 941-0604
Citrus Heights: (916) 965-1200
AFTER hours: Please contact Dr. State at (415) 577-0618 or Dr. Pham at (909) 533-8888