Post-Operative Instructions

Bleeding

After surgery, the assistants will show you how to place gauze in the area and bite down to hold pressure. We recommend biting down on the gauze for the first 2–3 hours, changing the gauze every 45 minutes or so. When you remove the gauze, examine the gauze to see if there is any white or pink on the gauze. If there is any white or pink on the gauze, it means you are not really bleeding anymore, and you do not have to place another gauze. It is normal to continue oozing for the first day or two after surgery or to have some blood on your pillow in the morning. However, we do not consider this bleeding. Bleeding is when you remove the gauze and it is fully saturated with bright red blood, and there is no white or pink remaining. If the gauze continues to be saturated with bright red color, you can moisten a tea bag, place it on top of the gauze, and apply direct pressure with the tea bag to the surgical site.

It is very important that you do not rinse, spit, or drink through a straw for the first 12 hours after surgery. These three things cause pressure in the mouth that dislodges the clot and will cause bleeding to resume. If you forget and you start to bleed again, replace the gauze in your mouth and start the original instructions again. It is ok to brush your teeth the next day after surgery; just be gentle with the rinsing and spitting.

Diet

After surgery, it is OK to start eating soft foods, such as chocolate pudding, mashed potatoes, yogurt, ice cream, soup, etc. Some people can even tolerate pasta and scrambled eggs on the first evening after the surgery. On the second day, if you are feeling up to it, you can try to slowly advance the diet to harder foods, such as soft bread. Please be aware that if your lips are numb, it is possible to chew on your lip without knowing. This is especially important for children, and we recommend that they do not CHEW any foods until the numb feeling in the lip has disappeared.

Sutures (stitches)

Unless the doctor tells you otherwise, the stitches that are in your mouth are dissolvable. They are dissolved by your saliva. Everyone’s saliva is different. With some people, the stitches dissolve after one day, while with others, it can take a week. You might feel a string in your mouth at some point, and it will likely dissolve or go down with your food without you knowing. If any stitches remain at your 2-week check, we will remove them at that time.

Swelling

It is normal to have swelling after the procedure. The swelling will be biggest 48–72 hours after the surgery. Place ice on the area 20 minutes on and 20 minutes off for the first 24 hours only.

Medication

Please take your medication as prescribed on the bottle. Most surgeries will require an antibiotic to prevent infection and a painkiller to be taken as needed. Here is a common list of medications given by our office:

• Take any antibiotics (amoxicillin, clindamycin, Augmentin^®, Avelox^®, Levaquin^®, azithromycin) as directed until finished. If you have an adverse reaction, please stop the medication and call our office.
• You may be prescribed an antibiotic mouthwash such as Peridex™ (chlorhexidine).
• Take pain medications such as Percocet^® (oxycodone), Vicodin^® (hydrocodone), Tylenol® with codeine, Nucynta^®, or tramadol on an as needed basis, as directed.
• IMPORTANT NOTE: Our office may prescribe ibuprofen to be taken in addition to a painkiller. The more ibuprofen you take, the less of the painkiller you will need. We recommend you take the ibuprofen every 6 hours around the clock for the first 24 hours — unless, of course, there is a medical reason you cannot take the ibuprofen.
• Ibuprofen from the office: 1 pill = 600 mg every 6 hours
• Alternatively, you can take ibuprofen from the bottle: Motrin^®, Advil^®, or generic ibuprofen 1 pill = 200 mg.
• You can take 3 or even 4 pills (800 mg) every 6 hours. Anti-swelling medication — Decadron^® (dexamethasone) — may be given for cosmetic reasons (so you do not have too much swelling).