Post-Op Instructions


General Guidelines for all procedures:

Do not chew on hard, sticky or chewy foods for a least 24 hours. Never chew on ice. Avoid aggressive chewing and sticky foods such as “hard tack” candies that can loosen or damage a restoration. Carefully follow all guidelines provided by the doctor and their staff and most importantly practice good oral hygiene. Additional instructions following various types of treatment are listed below. Please click on the below topics for detailed instructions. In the event of an emergency, please call our office. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.


Instructions Following Implant/Bone Graft/Sinus Lift Surgery:

Expect to have some bleeding from the surgical site post operatively. You might be asked to bite down on some gauze after the surgery, changing it every 15 minutes for no longer than 2 hours. If profuse bleeding continues after the 2 hours of using gauze then you may place a moist tea bag over the surgical site for 20 minutes. Occasionally after implant surgery the blood clot can form over the metal abutment that is protruding through the tissue. If this happens, take a damp piece of gauze and wipe the clot away. Then place another piece of damp gauze over the abutment and apply pressure with your thumb and index finger on the sides of the abutment. If the bleeding continues after doing this a few times, then give us a call.
Begin the day of surgery, rinse gently, using ½ oz Periogard/ Peridex mixed with ½ oz water solution. This is important for healing and hygienic purposes. These rinses should be repeated 4 times a day (after every meal and at bedtime) and continue until the post –op visit. The first two days avoid swishing vigorously and spitting. Rather, hold the liquid in your mouth, tilt your head back and forth and let the liquid fall into the sink. Tooth brushing can be resumed immediately just avoid brushing too aggressively around the surgical sites. The use of a Q-tip dipped in this solution (begin the day after surgery) to keep the surgical site clean is helpful if using your toothbrush is too uncomfortable. At time of implant surgery an abutment is usually placed over the implant and protrudes through the gum tissue. Do not use an electrical tooth brush over the abutment while it is in the mouth.
It may be necessary to eat soft foods such as soup that is cooled to room temperature, Jello, cereal, eggs, or yogurt for several days. Some of the liquid diet preparations are helpful, such as Ensure, Carnation Instant Breakfast or protein shakes /smoothies. You will feel better, have more strength, less pain and heal faster if you continue to eat a healthy diet. Follow the rule: If your mouth hurts, then continue with soft foods.
Fluids are very important, especially after an intravenous anesthesia, even though it may be uncomfortable. An adult should consume two to three quarts of fluids every day. Avoid alcoholic beverages for the entire time you are on prescription medication and avoid using straws and drinking carbonated beverages for at least 48 hrs, or longer if a sinus lift / push up procedure was performed (see below for sinus precaution). Hot beverages may promote bleeding, so room temperature or colder beverages are recommended the day of surgery.
It is always important to get plenty of rest with any surgery or illness. Please remember not to lie flat for 24 hrs. Stay propped up at a 45-degree angle in a recliner or by use of pillows. This will help reduce swelling, bruising and bleeding. Avoid vigorous activity such as exercising or lifting heavy objects for 5-7 days after a bone graft or multiple implant surgery. Avoid vigorous activity for 2-3 days after only 1-2 implants have been placed. Resume exercise only if you are not experiencing symptoms.
The incisions are closed with sutures. The sutures are usually either dissolvable or non-dissolvable or a combination of both types. The dissolvable sutures take about 5-7 days to dissolve. If sutures are still present at the post operative visit, the doctor or the assistant may remove them.
Some swelling is to be expected following surgery, sometimes up to one week after surgery. To help control this, apply an ice pack on the outside of your face near the area of the surgery for 20 minutes, remove for 20 minutes. Repeat this alternating process for the first 24 – 48 hours. After 48 hours ice packs should be discontinued and moist heat (i.e. warm moist wash cloth) should be applied at 20 minutes intervals. Continue this until swelling has subsided. Once swelling peaks (after 48 hrs) it can take up to a week for it to go down. Please call if swelling occurs several days/weeks after surgery.
You can expect bruising to appear 2-3 days after surgery, the amount of bruising depends on the extent of the surgical procedure. Areas of probable bruising would include the face, under the eye, chin, neck and chest. Use ice packs on the day of surgery and the day following surgery. After 48 hours use warm, moist heat every day until the bruising dissipates (may last about a week). This process will help reduce the amount and duration of bruising.
Usually can be worn if it does not interfere with the incision. The doctor will check prosthesis, relieve any pressure points and determine whether it can be worn after surgery.
The amount and duration of pain varies per patient. If you are having more pain than can be controlled with Ibuprofen (or similar over-the-counter pain medications) or with the prescription pain reliever your doctor gave you, you should call the office.
Please follow sinus precautions for 2-3 weeks, but only if you have had a sinus lift/ sinus push up procedure (in the upper jaw):

  • Avoid blowing your nose.
  • Try to sneeze with your mouth open.
  • Do not spit or cough forcefully.
  • Do not drink through a straw.
  • Scuba diving and flying in pressurized aircraft should be avoided.
  • Avoid bearing down during exertion, lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure.
  • The doctor may also recommend a nasal decongestant to help drain and reduce pressure in the sinuses (e.g. Mucinex, Sudafed or Coricidin).
Patients should not expect to have a fever but if you do and it is over 101 degrees Fahrenheit, you should call the office and let us know.

Instructions Following Dental and Wisdom Teeth Extractions:

Place a gauze compress directly over the surgical site and bite down. Replace the gauze every 15 minutes or as needed for one to two hours. After 2 hours of biting of using gauze pads, TAKE THEM OUT AND LEAVE THEM OUT! They will usually still be red- THAT’S NORMAL. The rate of bleeding or degree of clotting cannot be inferred from the redness of the gauze. A small, steady trickle of blood from the site(s) is perfectly acceptable and continued use of the gauze for more than 2 hours SHOULD NOT BE NECESSARY. It may make the bleeding worse. Do not resume using the gauze unless the mouth is filling up with profuse amounts of blood. Place moist tea bag(s) over the surgical site(s) or wedge in place between the teeth and bite for 20-30 minutes. This may help slow the bleeding but, if you insist on putting the gauze back in, do it for only 20-30 more minutes at the most- NOT ALL DAY LONG. If you have any concerns then call our office.
Avoid rinsing your mouth rigorously for two days after surgery. You may brush your teeth; however, you should avoid brushing aggressively over the surgical site(s) until it is less tender. For those NOT provided with and irrigating syringe, after 48 hours, vigorously rinse with 50/50 mixture of water and Peridex/ Periogard after every meal and bedtime for 10 days. For those NOT provided with a prescription rinse please use warm salt water or gold Listerine as a substitute. If your prescription rinse runs out, you may substitute it with warm salt water or gold Listerine. If you have any questions, or are not sure you are doing this procedure properly, please call the office for assistance.
In some cases, a syringe will be provided to flush food debris out of the tooth socket(s). Food debris will tend to collect in the area of lower tooth sockets. This step is extremely important to prevent infections and promote healing. To minimize food accumulation, begin the procedure described below two (2) days after surgery and continue until the sites are healed (usually 2-3 weeks).

STARTING 48 Hours after surgery, carefully but thoroughly flush all lower surgical sites after every meal and at bedtime using a 50/50 mixture of water and Peridex/Periogard (when prescribed). Place the tip of the syringe into the mixture, and pull back on the syringe to load. Position the plastic tip of the syringe slightly into the opening or incision above the extraction site. Slowly flush each lower socket with one or two full syringes of the liquid. This is best accomplished initially by looking in a mirror with your mouth well lighted (a flashlight helps!). Be sure to continue the irrigation of each site until the areas look clean, and further attempts yield no more food particles or other debris.

It may be necessary to eat soft foods for several days or weeks after surgery (soup that is cooled to room temperature, Jello, cereal, eggs, yogurt, ice-cream, applesauce, pasta, well cooked vegetables, etc.) Some of the liquid diet preparations are helpful as well, such as Ensure, Carnation Instant Breakfast or Protein shakes / smoothies. You will feel better, have more strength, less pain and heal faster if you continue to eat a healthy diet. You may return to your normal diet as comfort allows.
You may start drinking right away (take the gauze out of your mouth before doing so). Fluids are very important, especially after intravenous anesthesia, even though it may be uncomfortable. An adult should consume two to three quarts of fluids every day. Children should have a proportional amount. Avoid alcoholic beverages for the entire time you are on prescription medication and avoid using straws and drinking carbonated beverages for at least 48 hrs. Hot beverages may promote bleeding, so room temperature or colder beverages are recommended the first day after surgery. Drinking iced tea may assist in slowing down the bleeding the first few days after surgery. Other good beverages include: milk, juice, Gatorade, Instant Breakfast, Ensure, smoothies, milkshakes, and water.
It is always important to get plenty of rest with any surgery or illness. Avoid rigorous activity such as exercising and lifting heavy objects for the first 2 days (for wisdom teeth surgery, 5-7 days.) Resume exercise only if you are not experiencing symptoms.
In some cases, sutures have been placed. Certain types are designed to dissolve on their own, but if it is necessary to remove the sutures, an appointment will be made for this.
Some swelling is to be expected following surgery, sometimes up to one week after surgery. To help control this, apply an ice pack on the outside of your face near the area of the surgery for 20 minutes, remove for 20 minutes. Repeat this alternating process for the first 24 – 48 hours. To be most effective, the application of ice packs should begin as soon as possible after surgery. After 48 hours ice packs should be discontinued and moist heat (i.e. warm moist wash cloth) should be applied at 20 minutes intervals. Continue this until swelling has subsided. Please remember not to lie flat for 24 hrs. Stay propped up at a 45-degree angle in a recliner or by use of pillows. This will help reduce swelling, bruising and bleeding.

You can expect bruising to appear 2-3 days after surgery, the amount of bruising depends on the extent of the surgical procedure. Areas of probable bruising would include the face, chin, neck and chest. Use ice packs on the day of surgery and the day following surgery. After 48 hours use warm, moist heat every day until the bruising dissipates (may take up to a week). This process will help reduce the amount and duration of bruising.

Usually can be worn if it does not interfere with the surgical site(s). The doctor will check the prosthesis, relieve any pressure points and determine whether it can be worn after surgery. When comfortable, return to wearing your retainer as soon as possible.
The amount and duration of pain varies per patient. It is not uncommon to still need OTC pain medication (ibuprofen, Tylenol) for several weeks after oral surgery. If you are having more pain than can be controlled with Ibuprofen (or similar over-the-counter pain medications) or with the prescription pain reliever your doctor gave you, you should call the office.
For highly impacted upper teeth only, please follow sinus precautions for 2 weeks:

Avoid blowing your nose, try to sneeze with your mouth open, do not spit or cough forcefully, do not drink through a straw, scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided, avoid bearing down during exertion, lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure. The doctor may also recommend a nasal decongestant to help drain and reduce pressure in the sinuses (e.g. Mucinex, Sudafed or Coricidin).

A low grade fever is not unusual even after a simple procedure. Fever may be caused by inadequate fluid intake as well. If your temperature exceeds 101 deg. F, do not hesitate to phone the office.
Lastly, DO NOT SMOKE at all for a minimum of 7 days to avoid a painful dry socket.

Additional Post-Op Instructions:

  • The swollen area may become quite large and increase in size for 2-3 days.
  • Stiffness of the muscles may cause difficulty in opening the mouth.
  • You may have a slight earache.
  • A sore throat may develop.
  • Numbness about the corners of the mouth, on the tongue, lip or chin on the side from which the sur­gery was done may develop. This is most often a temporary condition, which will usually correct itself. It may remain anywhere from a few days to a few weeks.
  • Your other teeth may ache temporarily. This is called sympathetic pain and is a temporary condition.
  • If the corners of the mouth are stretched, they may dry and crack. Your lips should be kept moist with a cream or ointment such as Vaseline or cold cream.
  • There will be an opening where the tooth was removed. This area should be rinsed following meals with warm salt water or diluted mouthwash. This space will gradually fill in with new tissue.
  • Bruising may occur on the outside of the face near the area of surgery. This occurrence is not unusual and will resolve itself within several days.
  • There may be a slight elevation of temperature for 24-48 hours. If tempera­ture continues, notify this office.
  • Sutures (stitches) may be used to close the surgical wound. They will be removed at a subsequent office visit, if they are not the type which dissolve.
  • Do not blow your nose for 3 weeks.
  • Sneeze with your mouth open for 3 weeks.
  • Do not smoke for 3 weeks.
  • Sniffing in occasionally is okay, if you feel your nose is runny.
  • Take antibiotics as directed.
  • Take over-the-counter or prescribed decongestant as directed 2-4 times a day for 2 weeks.
  • It is not uncommon to experience a nosebleed after your procedure and you should not be concerned. It usually will resolve on its own within a day or two.