Please do your best to chew on the side opposite the graft. There is a bit more bone graft than you need in the socket. Some of this graft (which will feel like a sandy material) may come out over the next week. There is a membrane with sutures holding it in place. This membrane is white, and it sits in place long enough for the socket to form a white scab over the top of it. In most cases, a liquid bandage has been placed over the socket graft. It will likely fall out in 24–48 hours. It is a hard, thin membrane and is no cause for alarm. Please DO NOT clean this area aggressively by swishing your mouth with anything. Aggressive swishing can dislodge and ruin the graft. GENTLE, SHORT swishing can be done once a day with warm salt water, but beyond that, please leave the graft alone and let it heal.
To minimize discomfort following surgery, please follow the below directions.
Keep the protective gauze pack in place for 1 HOUR after surgery to help stop the bleeding. Keep the gauze in place with gentle pressure by biting down. DO NOT change the pack even if it becomes soaked — remember, PRESSURE on the wound stops bleeding. Some slight oozing of blood may continue for several hours, and saliva may remain pink throughout the night and the next day. If bleeding seems to be excessive, there are steps you can take. First, rinse your mouth 1 TIME with cold water to remove any clotted blood. Place a tightly folded piece of clean gauze over the bleeding area. Use enough gauze to apply firm pressure over the area when the jaws are closed. Keep this in place for a full 30 minutes. Remain quiet and sit with your head elevated. If this does not slow the bleeding, wrap a moist black tea bag in gauze and place this over the bleeding area (usually the tooth's socket) and bite firmly. Bright red bleeding that wells up rapidly from the socket rarely occurs, but should this be a problem, please call our office.
Take your prescribed pain medicine as instructed. Take the first dose of pain medicine 1 hour after surgery, preferably with some soft food such as yogurt or applesauce. Replace the gauze pack as needed after this first hour. During the first night, it is a good idea to set an alarm to take a pain pill at regular intervals to make sure that you don't allow the pain medicine to wear off during the night and potentially wake up in pain. Taking MORE than the prescribed dose is not recommended as it can cause nausea as well as more serious problems. Don't drive or operate heavy machinery while taking prescription pain medicine. In most cases, the prescription should only be needed for 1 day and then can be tapered down to over-the-counter drugs such as ibuprofen or Tylenol®. The sooner this transition is made, the faster your recovery will be.
Swelling is expected and will peak 2–3 days following surgery — the THIRD day will have MORE swelling than the first day following surgery. This is normal and should decrease within a day. To minimize swelling, place an ice pack on the outside of the cheek in the area of surgery (20 minutes on and 20 minutes off) for the first 48 hours following surgery. After 72 hours, heat packs (such as a hot water bottle or warm wash rag) may be used in the same fashion.
During the first 24 hours following surgery, cool and soft foods are best. Anything that is NOT HOT or SHARP/CRUNCHY is OK. Do not spit or use a straw for 2 days. Drink plenty of water to keep from becoming dehydrated.
If nausea or vomiting should occur, try the following: drink using small sips of water rather than large gulps, and try taking the prescription with a small amount of food. Nausea is usually caused by either the prescription pain medicine or dehydration. Try taking an over-the-counter pain medicine such as ibuprofen or Tylenol instead of the prescription pain medicine. Also, you can try cutting the prescription tablet in half to help minimize nausea. If this does not help, call our office.
Starting the day after surgery, GENTLE rinsing with very mild warm salt water can be done twice a day. Brushing should also be resumed in a gentle fashion near the surgical site on the second day.
Do not smoke for 48 hours after surgery. Some bruising may occur; remember — ice helps minimize bruising. Sutures will dissolve on their own in 7–14 days.