POST-OPERATIVE INSTRUCTIONS

Do not drive following IV sedation. Your escort should drive you to the pharmacy and home.
Remain biting on the gauze for 30-90 minutes. Make sure the gauze is placed directly over the surgical sites. These should remain in place until the bleeding has mostly stopped.
Smaller amounts of bleeding or “oozing” will continue throughout the next few days. This is normal. The gauze is only meant to aid in stopping more extensive bleeding which immediately follows surgery.
Begin a nutritious liquid/soft diet and rehydrate with fluids. See food recommendations below.
Begin taking medications. Follow the medication instruction sheet provided to you. DO NOT take medications on an empty stomach. Taking medications on an empty stomach can cause nausea/vomiting.
Take 600mg ibuprofen or 500mg Tylenol if it is taking longer than expected to get your prescriptions.

Day 1-3: Liquid food: yogurt, pudding, applesauce, Jell-O, smoothies, ice cream, nutritional shakes, protein shakes, juice, milk, Gatorade.
Day 4-7: “Soft Solid” food: boiled pasta, scrambled eggs, oatmeal, mashed potatoes, cottage cheese.
Avoid foods with hard seeds or pieces that can get stuck in the area: raspberries, popcorn, nuts, etc.

Do not drive or operate heavy machinery for 24 hours following surgery.
Refrain from strenuous physical activity (weightlifting, contact sports, heavy physical labor) for a minimum of 3 days. After 3 days, use your best judgment to continue physical activities.
Avoid alcohol and tobacco products for 1 week following surgery. These slow down and complicate the healing process.

Symptoms and swelling peak around day 4 following surgery. This is normal and can be the most painful time during healing. The following post-op and medication instructions are critical to minimizing these symptoms.
After day 4, symptoms should begin to improve. After 1 week, the pain should have largely subsided, with some discomfort still lingering in the surgical sites.
Even after pain and swelling disappear, surgical openings in the gum tissue take 4-6 weeks to fully heal. Keeping the areas clean with the irrigation syringe is important for proper healing and to prevent infection.

Avoid spitting, vigorous swishing, drinking through a straw, or smoking for 1 week. These activities cause suction in the mouth and can dislodge the blood clot which is trying to form in the extraction site.
Disturbing the blood clot will cause a dry socket, which adds significant pain to the healing process. Risk of dry socket is highest in the first 72 hours following surgery. For this reason, also DO NOT use the irrigation syringe you have been given in the first 72 hours.
After 72 hours, the risk of a dry socket is low. Begin rinsing the surgical sites with the irrigation syringe provided. Draw up some prescription rinse or warm salt water into the syringe, place the tip directly into the lower extraction sites and gently flush the sites. Do this 2-3x per day to prevent food impaction. Food impaction in the area can cause significant pain, delay healing, and add to risk of infection.
If you received PRF “dry socket prevention,” wait 1 full week before using the irrigation syringe.
Resume brushing your teeth as normal, however, be very gentle around the lower back molars. During surgery, the gums were separated in this area and need to reattach and heal.
Stitches are not required most of the time. If you do have stitches placed, they will either dissolve or fall out after about 1 week.

Ice packs can help minimize swelling and pain. Ice packs should be applied for 15 minutes on and 15 minutes off for the first 24 hours. Focus on applying the ice packs on either side of the lower jaw. This is where post-op swelling is most profound.
If bleeding seems persistent, you can soak a large tea bag in cold water and bite with pressure just like with gauze. This can help control bleeding and also provide a soothing sensation.
It is normal to remain numb through the entire first day and night following surgery. This can affect the entire lower lip, tongue, gums, and even your upper face and eyelids.
One drop of blood mixed with an entire mouth of saliva looks like an entire mouth of blood. This may concern you and make you think you have excessive bleeding. However, the majority of what you see is saliva and not blood. Do not be concerned about excessive bleeding if the color is light red and clear.
“Stiff jaw” is a common symptom during healing. This is difficult opening and closing for days following the procedure. Jaw stretches and heat compress on the cheeks can help with this.

Swelling below the jaw which involves the neck and is restricting the ability to breathe
Swelling on the palate (roof of your mouth) which is increasing in size
Persistent and heavy bleeding. Excessive DARK RED bleeding which is not transparent or clear
Numbness that lasts more than 24 hours
Swelling that reoccurs 4+ weeks following surgery
Swelling in the first week is expected. If swelling disappears after a week and then comes back 4+ weeks later, this is a sign of post-operative infection that needs antibiotics or to be surgically drained.