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Expose & Bond
Post-operative Instructions

Extraction, Surgical Expose and Bond- Post Surgery Care

Oral Surgeons of Southern Illinois

618-628-1800

Call 911 in a life-threatening emergency.

Please call the office if you have any questions

5 pm - 8 am or on weekends/holidays an answering service will direct your call.

The answering service cannot make or reschedule appointments.

 

Postoperative care is very important to prevent complications and unnecessary discomfort following the procedure.  Please read the instructions carefully.

 

Bleeding - It is normal to have some bleeding following tooth removal, tooth exposure, and placement of a bonded bracket and chain. Blood mixed with saliva can give the appearance of an increase quantity of blood.  A folded piece of gauze should be placed over the surgical site.  Please bite with firm pressure for 30-45 minutes. Repeat as needed during the first evening.  Avoid changing the gauze too frequently, it can prolong bleeding.  Ice compresses and keeping your head elevated with minimal activity (limit talking, moving your jaw, disturbing the wound site) to help minimize bleeding.

-If bleeding continues the gauze can be replaced with a moist tea bag (black tea bags are slightly better).

 

Swelling - Swelling following this procedure is normal.  It will increase until the third day after surgery. Ice packs should be placed on the outer skin near the surgery site for 20 minutes of every hour for the first 24 hours to help minimize the swelling.  After this time frame, the ice can be replaced with warm moist heat.  A clean washcloth can be dampened, minimally heated in the microwave.  The cloth (at a comfortable temperature to touch) can be used to lightly massage the area.

-Sleeping with your head slightly elevated will also help prevent the swelling from settling in the cheeks and neck.  Stiffness of the jaw muscles may cause difficulty opening the mouth fully (this situation will improve with the use of moist heat after 3-7 days, but may take one month to resolve).  Bruising on the head and neck is not uncommon (It will improve in a few days).

 

Pain Control – Individuals that undergo this procedure may have a dull, abnormal feeling in the area for up to one week (reaction to the healing graft).

- Non-steroidal anti-inflammatory drugs (NSAIDS) are a good way to control post-operative pain and swelling (assuming you are not allergic or intolerant). Start taking Motrin (Ibuprofen) as prescribed immediately after surgery and as often as allowed during the first three days after surgery. It can be taken during the same time as prescribed narcotics and will often work better when combined with either the narcotic or Tylenol. Since Ibuprofen can also help prevent swelling it is recommended to continue this for mild discomfort after narcotic use has ended (use the NSAID for at least three days, unless it is upsetting to the stomach or contraindicated).

- Prescribed Narcotic Pain Medicine: If the Motrin does not control the discomfort alone, take the prescribed narcotic as well. The two drugs can be taken during the same time (usually alternating drugs every three hours). Tylenol (Acetaminophen) is usually in the prescribed narcotic and should not be taken at the same time (it can be used as an alternative). You should not drive, use motorized equipment, or make important decisions while taking the narcotic pain medicine. Common side effects of narcotic pain medicine include nausea and vomiting, constipation and dizziness (please take with something in your stomach).

- If dizziness occurs, sit or lie down, place a cool towel on your forehead, recline with your legs up.

- If you experience nausea, then consuming a small amount of carbonated soda (7-up, ginger ale) followed by eating a salted cracker may help.  If the nausea continues, please notify our office (Motion sickness medications like Meclizine or Dramamine could be considered).

- Do not drive a motor vehicle, engage in dangerous activity or drink alcoholic beverages for 24 hours after narcotic use.

 

Eating - It is important to drink lots of fluids to replenish your body after fasting or during healing.  A liquid (soup, yogurt, milk shakes) diet should be utilized the evening after the procedure.

- Soft foods will be more comfortable while you are healing during the first few days after the procedure: eggs, soups, soft pasta, mashed potatoes, cooked soft vegetables, ice cream, shakes, etc.

- Avoid placing any substance in the mouth that is excessively hot (i.e. coffee, hot chocolate) during the first 72 hours.  Avoid spicy or acidic food.  Avoid hard liquor during the first week of healing.

- Please chew on an unaffected location for one Month during the healing period.

 

Oral hygiene/Wound care - Start brushing normally 24 hours after surgery.  Flossing should also be resumed.  Be gentle in the area of the wound.  No straws (sucking action) for one week.

- Not Smoking or using tobacco is always recommended.  Use delays healing and substantially increases complications.  If you cannot quit tobacco use, we ask you not to utilize tobacco and cigarettes for one week.  Smoking depressants (Nicoderm – over the counter) may help.

- A minor increase in body temperature can be expected.  The office should be notified if your temperature is above 100.5.  Irritation during swallowing can be addressed with chloraseptic spray.  Difficulty to or inability to swallow or pooling saliva in the oral cavity is an emergency.

- Do not disturb the stitches.  Light irrigation (either an antibiotic mouthwash like Peridex or saltwater solution – ½ teaspoon of salt in a 12 oz. glass of warm water) can be used over the surgical wound and stiches (using a syringe may be helpful).  Please do not use any commercial mouthwash with a high alcohol concentration (i.e. Listerine – avoid for 10 days).  The stitches are dissolvable, they will fall out on their own within 10 days (usually one week).  Please notify the office if the sutures come out in the first 3 days.  Black silk suture or thin silver wire are often used to attach the gold wire (from the bonded tooth) to the surrounding teeth (brackets).  Please notify the office if the chain or bracket lose their bond or break. 

- Due to the location of some procedures, the corners of the mouth may be stretched.  Occasionally, they become dry and cracked.  Please keep your lips moist with lip balm or Vaseline.

- Do not engage in highly physical activity for one week after the procedure (walking, similar activity is ok).

 

Numbness – Local anesthetics are used during the procedure to numb the site and increase your intra-operative and post-operative comfort.

-If you are numb (have decreased sensation in your mouth or surrounding skin) after 24 hours (from the procedure), the office must be notified.  You may need to be started on a steroid.

 

IV Sedation (if applicable) – You must have a responsible adult with you until the anesthetics have completely worn off (this may take 12 to 16 hours).  Do not drive a motor vehicle, use alcoholic beverages, use non-prescribed drugs, engage in dangerous or highly physical activity, use alcoholic beverages for at least 24 hours (identical to narcotic use).  Do not wear contacts or place anything in your eyes (non-prescription) for 24 hours.  If you are lightheaded, please see the section above.  Rest is strongly recommended during this time.

 

General – Swelling, minor discomfort, and some initial restriction of jaw function are expected so there is no cause for alarm.  These conditions should be minimalized if the instructions listed above are followed.  If you are uncertain about anything at any time, give our office a call (618-628-1800).  The answering service (same number) will direct your call from 5 pm till 8 am and on weekends/holidays. 

- If there is an emergency, please call 911.

 

 

 

 

Thank you for choosing Oral Surgeons of Southern Illinois, we appreciate having the opportunity to serve you!!

© Oral Surgeons of Southern Illinois

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