Patient Post-Operative Instructions

To contact a doctor after hours, please call the office (231) 775‐1268 or (800) 968‐1268 for special instructions. In case of malfunction of our answering machine, please follow instructions listed in last paragraph.

BLEEDING: Immediately after oral surgery, damp gauze packs will be applied. These should be left in place, with moderate pressure for 1/2 hour and then removed. If bright red oozing continues, 2‐3 gauze pads should be dampened and folded twice and reinserted. These pads should be placed directly over the extraction site. Proper gauze placement should “cover” the extraction site and produce a clot down in the extraction site. You may experience a red tinged appearance to the saliva lasting up to 24 hrs. However, if bright red, coagulated “jelly‐like” clots are constantly forming several hours after surgery and do not decrease with time, please call the office.

DISCOMFORT: If throbbing or aching pain develops 2‐3 days after extractions, and does not respond to pain medication, please contact the office; a “dry‐socket” (disintegration of the blood clot) may be present. Medicated dressing may be placed to control the pain. There is no additional charge for dry‐socket treatments. If symptoms develop during non‐office hours, “Red Cross Toothache Drops”‐ (oil of cloves) or Anbesol drops (topical anesthetic) dripped into the socket (DO NOT USE COTTON PELLETS) after irrigating with water, can provide some relief.

BONY EDGES: Small sharp bone fragments may work up through the gums during healing. These are not roots; if annoying, return to this office for their simple removal.

HYGIENE: For 6 hrs after surgery, avoid manipulating the extraction site with your tongue. Avoid vigorous sucking, spitting, and foods containing hard particles. Gentle oral rinsing can be done the day of surgery to cleanse the mouth. Careful brushing of the adjacent teeth is strongly advised to remove plaque and associated bacteria. The clot is strong enough to withstand more vigorous rinsing the day following surgery. Also, any stitches should be gently brushed to remove food debris at this time. With the removal of lower teeth or impactions, there is a tendency for food to collect in the sockets. A plastic syringe may be provided which can be inserted 1/4 inch into the socket for irrigation with warm tap water. Do not irrigate until THREE days after surgery, otherwise the blood clot may be disrupted.

SWELLING: Swelling and possible bruising will occur. Swelling will reach its peak 2‐3 days after surgery, then will gradually decrease. Elevating the upper body and ice packs the first day may minimize the swelling. Apply ice for 20 minutes on and off. Muscle stiffness may also develop, which may limit opening. Moist heat applied to the face after the first day may improve this condition.

DIET: Drink plenty of fluids the day of surgery. A soft diet may be resumed once the gauze is removed and the local anesthetic has worn off. Patients are encouraged to resume a normal diet the following day. This too may help with muscle stiffness.

MEDICATION: Usually, Ibuprofen 200‐600 MG every 4 hrs is very effective in controlling post‐operative pain and swelling. Side effects are minimal and it can be safely used while driving or working. For difficult oral surgical procedures, narcotic pain medications may be prescribed to control discomfort. The narcotic medication is best utilized between the scheduled dosages of Ibuprofen, minimizing the total amount of narcotic required. Do not operate cars or dangerous machinery if narcotic pain medications are used. Driving is not allowing until the next day if intravenous sedation has been utilized. It is recommended you be monitored at home after surgery. If you are a woman on oral birth control medication, you must consider the fact that antibiotics, if prescribed, might make oral birth control less effective.

EMERGENCIES: If there is an emergency that cannot wait until the next day, you may contact the doctor who treated you by calling Dr. Stegmann 231-935‐5000, Dr. Olsen 734-883‐6288, Dr. Fountain 231-392‐5810, Dr. Madion 231-881‐2100. If there is no answer, you may call Munson Medical Center at 231-935‐5000 and have the switchboard operator page the doctor.