BALACI Oral and Facial Surgery Post-Operative Instruction Manual

Oral and Facial Surgery Post-Operative
Instruction Manual

Oral and Facial Surgery Post-Operative

Post-Operative Instructions: After General Anesthesia
Please read and follow these instructions carefully.
The after-effects of oral surgery vary per individual, so not all of these instructions may apply. Please feel free to call our office anytime should you have any questions or are experiencing any unusual symptoms following your treatment.

DAY OF SURGERY

Immediately After Surgery
Patients who received a general anesthetic should return home from the office immediately upon discharge and lie down with the head elevated until all the effects of the anesthetic have disappeared. Anesthetic effects may vary by individual, and you may feel drowsy for a short period of time or for several hours. You should not operate any mechanical equipment or drive a motor vehicle for at least 36 hours or longer if you feel any residual effect from the anesthetic.

• Do not drive or use appliances or equipment that could be dangerous, such as power tools, stoves, lawnmowers, or garbage disposal.
• Watch out for dizziness. Walk slowly and take your time. Sudden changes of position can also cause nausea.
• Do not make any important decisions. You may change your mind tomorrow.
•  Do not drink any alcoholic beverages. The drugs in your body may cause a reaction to alcohol and can be dangerous.
• Diet: If you feel nauseated or sick to your stomach, drink clear liquids like 7-Up®, broth, apple juice, ginger ale, tea or cola, or eat Jell-O ®. If these liquids do not make you sick, try eating soft foods like potatoes, rice, pasta, and cereal.

Oral Hygiene and Care
Do not disturb the surgical area today. Bite down gently but firmly on the gauze pack that we have initially placed over the surgical area, making sure that they remain in place. Do not change them for the first hour unless the bleeding is not being controlled. This is important to allow blood clot formation within the surgical site. The gauze may be changed when necessary and/or repositioned for comfort. DO NOT drink with a straw and DO NOT rinse or brush your teeth vigorously or probe the area with your tongue, any objects, or your fingers. You may brush your teeth gently, carefully avoiding the surgical site. DO NOT SMOKE for at least 48 hours, since it is detrimental to the healing process.

Bleeding
Bleeding should not be severe. If the bleeding persists, this may be due to the gauze pads being clenched between the teeth rather than exerting pressure on the surgical site. Try repositioning the gauze. If bleeding persists or becomes heavy, substitute a moist tea bag (first soaked in warm water, squeezed dry, and wrapped in moist gauze) placed on the area for 20–30 minutes. If bleeding continues, please call our office.

Swelling or Bruising
Swelling is to be expected and usually reaches its maximum in 48 hours. To minimize swelling, cold packs or an ice bag wrapped in a towel should be applied to your face adjacent to the surgical area. This should be applied 20 minutes on and then removed for 20 minutes during the first 12–24 hours after surgery.
If you were prescribed medicine for the control of swelling, be sure to take it as directed. Bruising may also occur but should disappear soon. Tightness of the jaw muscles may cause difficulty in closing the mouth. This should disappear within 7 days. Keep lips moist with cream or Vaseline® to prevent cracking or chapping.

Diet
Eat any nourishing food that can be taken with comfort. It is advisable to confine the first day’s food intake to bland liquids or pureed or soft foods. Avoid foods like nuts,  sunflower seeds, or popcorn, which may get lodged in the socket areas. Over the next several days, you may progress to more solid foods. Proper nourishment aids in the healing process. If you are a diabetic, maintain your normal diet as much as possible and follow your physician’s instructions regarding your medication schedule.

Pain and Medications
Unfortunately, most oral surgery is accompanied by some degree of discomfort. Take the pain medication prescribed as directed. Since local anesthetic administered with the general anesthetic will wear off in 2–3 hours, we advise you to take the pain medication within 2 hours after your surgery. Taking the pain medication with soft food and a large volume of water, as well as taking it separately from the antibiotic (if prescribed), will lessen any side effects of nausea or upset stomach. (If you are prescribed an antibiotic and are currently taking oral contraceptives, you should use an alternate method of birth control for the remainder of this cycle.)

Orthodontic Appliances
If you wear orthodontic appliances, replace them immediately after surgery unless instructed otherwise. If these appliances are left out of the mouth for any length of time, it is often difficult or impossible to reinsert them.

INSTRUCTIONS FOR THE FOLLOWING DAYS

Oral Hygiene
Keeping your mouth clean after oral surgery is essential. Keep using warm salt water rinses (1 tsp of salt to 8 ounces of warm water) to rinse your mouth at least 2–3 times daily for the next five days. Begin your normal tooth brushing routine as soon as possible after surgery. Soreness and swelling may prevent rigorous brushing in all areas, but make every effort to clean your teeth within your comfort level.

OTHER POSSIBLE POST-SURGERY EFFECTS

Dry Sockets
The blood clot on the surgical site may be lost causing a dry socket (usually in the third to fifth day). There will be a noticeable, distinct, persistent pain in the jaw area, often radiating toward the ear and forward along the jaw, which may cause other teeth to ache. If you do not see steady improvement during the first few days after the surgery, or if severe pain persists, please call the office to report these symptoms.

Skin Discoloration
Discoloration of the skin may be expected and is usually limited to the neck or cheek area near the surgical site. It is caused by bleeding through the mucous membranes of the mouth beneath the skin and appears as a bruise. If discoloration occurs, it often takes a week to completely disappear. Occasionally, the arm or hand near the IV site may be inflamed and tender. The application of moist heat to this area will usually correct these symptoms.

Numbness
Loss of sensation of the lip and chin may occur, particularly following lower wisdom teeth removal. This is usually temporary and disappears within a few days or weeks.  Occasionally, some numbness may persist for months or be permanent, due to the close association of the roots of the teeth to the nerve that supplies sensation to these areas described.
It is our desire that your recovery is as smooth and pleasant as possible. If you have any questions about your progress or any symptoms you are experiencing, please call our office at 717-273-6745
After office hours, you may call our 24-hour answering service, which may be reached by calling the above numbers, and our on-call doctor will contact you as soon as possible.

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