Every effort has been made to ensure that you receive the best possible care at Loudoun Oral and Maxillofacial Surgery. To aid in the healing process, we need your cooperation in a few aspects. The following instructions have been prepared to help you minimize discomfort during and after surgery and to promote healing. We invite you to read and follow these instructions carefully. If you have any questions, please feel free to call or visit our office.

Medications

We will prescribe all the necessary medications to make your post-operative period as comfortable for you as possible. Discomfort varies with the amount and type of oral surgery performed. Remember to take all the medications as directed to minimize any discomfort

  • You may require prescribed medication during the first and second days or possibly through the first week following surgery. After that time, you may find that over-the-counter pain relievers will keep you comfortable.
  • To avoid an upset stomach, do not take your pain medication on an empty stomach. If you have a reaction to any medication, please contact us so that another medication can be substituted, if necessary.

While taking your pain medication such as Tylenol #3, Vicodin, or Percocet, do not drink alcoholic beverages at any time. If the medication includes any narcotics, do not operate a car or other machinery because of the drowsiness and impaired reflexes that can develop with this type of medication.

In some cases, our doctors will prescribe an antibiotic. Antibiotics are used to help treat or prevent infection and allow for normal and proper healing. They should be taken until the prescription is completely used up. Do not stop taking the antibiotics even if you are not experiencing any pain or discomfort. If you develop a reaction to the antibiotics, please call us for further instructions.

Please take all prescriptions as directed.

Women: Some antibiotics may interfere with the effectiveness of birth control pills. Please check with your pharmacist to see if this is the case with your antibiotic. If this is the case, an alternate method of birth control should be practiced.

What to Expect

In most cases, the after-effects of oral surgery are minimal, which means that not all of these instructions may apply to your unique situation. Common sense will often dictate what you should do; when in doubt, however, follow these guidelines or call Loudoun Oral and Maxillofacial Surgery at any time for further instruction or clarification.

Following oral surgery, you may experience the following conditions, all of which are considered normal:

  • The surgical area will swell.
  • Swelling peaks on the second or third day after surgery.
  • Trismus (stiffness of the muscles) may create difficulty when opening your mouth for a few days.
  • A sore throat may develop.
  • You may have a slight earache.
  • Your other teeth may temporarily ache. This is referred pain and will subside with time.
  • If the corners of your mouth are stretched out they may become dry and crack. Use cream or ointment to keep your lips moist.
  • If an extraction was performed, there will be a space where the tooth was removed. After 24 hours, this area should be rinsed after meals with warm salt water until it is completely healed. In time, this cavity will fill in with new tissue.
  • Your temperature may be higher for 24 to 48 hours. If the temperature continues, notify us.
  • Bruising may develop in the area of the surgery.

The First Hour after Surgery

Gently but firmly bite down on the gauze packs that have been placed over the surgical areas, making sure that the gauze packs remain in place and undisturbed. DO NOT CHANGE OUT THE GAUZE PACKS DURING THE FIRST HOUR UNLESS THE BLEEDING IS NOT BEING CONTROLLED. Keep your fingers and tongue away from the surgical site or socket.

Steady Bleeding

Intermittent oozing is considered normal but bleeding should never be significant or severe; if it is, it usually means that the gauze packs, rather than pressing on the surgical area, are being clenched between your teeth. Try repositioning your fresh gauze packs so that pressure is directly on the surgical area and your remaining teeth are kept slightly apart.

  • Remove gauze
  • Gently rinse your mouth to remove any excess blood or clots
  • Moisten the gauze slightly as this will help prevent the blood clot from adhering to the gauze and removing part of the clot when the gauze is removed
  • Reposition the gauze so that pressure is applied to the bleeding site
  • Bite on the gauze for one hour
  • Keep your head elevated
  • Apply an ice pack to the face in the area of the procedure

If bleeding persists and/or is bothersome, you may try applying pressure with a teabag instead.

  • Moisten a teabag and place it directly over the surgical site to apply pressure to the area. Keep the teabag in place for one hour. You can also elevate your head, minimize physical activity, and apply ice to your face to aid in clotting the blood and stopping the bleeding. If necessary, repeat. If bleeding still persists and is bothersome, contact Loudoun Oral and Maxillofacial Surgery.

Discomfort

Most oral surgery is accompanied by some degree of discomfort. The most discomfort usually occurs after the anesthetics wear off. Take the first dose of pain medicine before you start to feel the beginning of discomfort in order to manage the discomfort better. Try not to take the pain medicine on an empty stomach so you can avoid an upset stomach. Bland foods such as yogurt and cool soups will help settle your stomach. For mild discomfort, take ibuprofen (Advil) 600 to 800mg every six hours or Tylenol every four hours. For severe discomfort, use the medication prescribed to you by our doctors. This prescribed pain medication can also be combined with ibuprofen as above, which aids in its effectiveness.

Swelling

Swelling after oral surgery is normal and reaches its MAXIMUM IN 48 to 72 HOURS. Swelling may persist for 7-10 days following your oral surgery. You can minimize facial swelling by keeping your head elevated with two pillows when lying down. Applying cold compresses or a bag of frozen peas to your face (30 minutes on, 10 minutes off) for the 48 hours following surgery can also help minimize swelling. After 48 hours, warm compresses can be used to help reduce the swelling. These should be continued (30 minutes on, 10 minutes off) until the swelling has subsided.

Rinsing

Avoid rinsing your mouth for at least 24 hours after surgery as it may disturb the clot. The day after, use warm (NOT HOT) salt water rinses (1 teaspoon in 6 ounces) to rinse your mouth. Repeat this rinse after every snack and meal for seven days. Rinsing is important because it removes debris and food particles from the socket area, thus helping to prevent infection as well as promote healing.  To improve the flavor of the rinse, you may add a small amount of mouthwash. Remember to rinse GENTLY at least three or four times each day.

Brushing

Oral hygiene is important, but please remember to be gentle when brushing and flossing around the surgical sites. You can resume your normal oral hygiene routine 24 hours following your oral surgery. Occasionally soreness and swelling will prevent you from brushing the surgical sites, but still gently brush any areas you feel comfortable with. To keep bacterial growth at a minimum, don’t forget to brush your tongue.

Diet

A nutritionally-balanced diet is always very important, but especially following oral surgery. During the first 24 hours after your surgery, eat soft foods and soups that are easily chewed and swallowed. Drink plenty of fluids but DO NOT use a straw. If desired, you can liquefy meats, vegetables, and fresh fruit in a blender. It is important to avoid chips, nuts, pretzels, popcorn, and any other hard foods that may lodge in the surgical site. Gradually progress to eating solid food and do not skip meals. If you eat regularly, you will feel better, have less discomfort, gain strength, and heal faster. Take any prescribed food supplement as directed by our doctors or your physician. If you are a diabetic, remember to maintain your normal diet and take medication as usual and directed.

Nausea

To ease nausea, take one ounce of a carbonated drink such as cola or ginger ale every hour for five to six hours. Then drink clear broth or mild tea and eat soft foods like ice milk or yogurt before resuming your regular diet. If nausea persists, you may be given medication to help.

Discoloration of the Skin or Bruising

Sometimes surgery will produce bruising, but it may not appear for 24 to 48 hours. Applying heat to the involved area (30 minutes on, 10 minutes off) will help you return to normal.

Smoking

Do not use tobacco at all during the first two weeks following surgery. Tobacco products will slow the healing process and cause significantly more discomfort.

Stiff Jaw

Chew gum regularly, especially while you are applying moist heat on your jaw, to help reduce swelling and relax muscle tension. As the swelling is reduced, the stiffness will abate.

Sharp and Bony Edges

If you feel anything hard or “bony” when you place your tongue on the surgical site, you may initially think it is part of your tooth. This is actually the hard, bony wall that originally supported your tooth. Remember to leave the surgical site alone to encourage proper healing. Most bony prominences result from differential areas of remodeling in the surgical site and will smooth out given some time.

Physical Activity

Minimize heavy physical activity and reduce unnecessary talking for the first 24 hours following your surgery.

Remember your Follow-up Visit

We often recommend returning to Loudoun Oral and Maxillofacial Surgery for a post-operative visit to ensure that healing is progressing satisfactorily. A follow-up visit will be scheduled in advance. In the meantime, remember to maintain a healthful diet, observe rules for proper oral hygiene, and visit your general or family dentist for regular check-ups.

In Case of Problems

As long as you follow the suggestions and instructions as outlined, you should experience no trouble. If any difficulty arises at any time, please call or visit our office as soon as possible. We want you to know that our interest in your care and health does not end after your surgery. There is always someone on call to help with any concerns that may arise.