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Post-Operative Instructions: Tooth Extraction and Bone Graft

Surgical wounds usually heal quickly and without complications if simple precautions are taken. You should reduce your activities for several hours after surgery. This helps reduce bleeding and permits the formation of a clot, which is necessary for healing. ABSOLUTELY NO MOUTH RINSING, HOT DRINKS, OR STRAWS ON THE DAY OF THE SURGERY! Starting the day following surgery, the mouth may be rinsed with warm salt water after each meal and at bedtime. Continue this for the week following your surgery as well. The teeth should be brushed as usual, but the site of surgery should be avoided until it can be gently brushed without discomfort. 

MEDICATIONS

You have been given an antibiotic to prevent infection. Please begin taking this as directed until all the medication is finished. The pain medication that you have been given should be taken as directed and with a full stomach, otherwise you may experience nausea and vomiting. If your doctor has given you PeridexTM (Chlorhexidine), begin rinsing 2 days following your surgery twice daily, and do not eat or drink anything 1 hour after rinsing. 

SWELLING

It is normal to experience mild to moderate swelling, peaking at 48 hours. You can help decrease swelling by applying an ice bag to the affected area for 20 minutes and then 10 minutes off. Do this for the remainder of the day of surgery and continue the day after for as much as possible. Sleeping with your head elevated also helps reduce swelling.

DIET

We recommend sticking to a cool, soft food diet. To help the healing process, be sure to keep yourself hydrated by drinking plenty of liquids, and be sure to eat foods high in vitamins and proteins the week following your surgery. Limit your diet to soft foods such as yogurt, soups, puddings, pasta, and soft cooked eggs. Chew all foods on the opposite side of your mouth from where the bone graft was placed. If you wear a denture or a partial that will cover the site, leave it out during eating to prevent pressure on a bone graft—your doctor will give you special instructions for your needs.

CARE FOR YOUR BONE GRAFT SITE

There may be some bleeding or oozing at the site, which is normal for 24 hours following the surgery. You may also experience grafting particles in your mouth after surgery. This is normal and not an indication that the graft has dislodged itself. If you leave the office with a gauze pack, keep firm, steady pressure on the gauze for approximately 1 hour following the surgery. Studies have shown a decrease in both short and long-term success rates of bone grafts in patients who smoke. If you have thought about quitting smoking, now is a good time to do so. Ask the doctors how they can help. 

RELIEF OF PAIN

Some discomfort is to be expected following oral surgery. Immediately upon returning home, and before the local anesthesia wears off, take two 200 mg ibuprofen tablets (Advil®, Motrin®) with one extra strength Tylenol® tablet (500 mg). We have found this reduces the amount of narcotic-based pain medication required. Please note you may not exceed 4000 mg of Tylenol per day for a maximum of 7 days (note: the narcotic-based pain medicine contains 325 mg of Tylenol). Some nausea is not uncommon while taking pain relievers. Taking your medication with a light snack and sipping small quantities of carbonated soda can minimize this. If you are taking a narcotic-based medication, please note that the medication may make you drowsy. 

CAUTION: Refrain from operating a motor vehicle while taking a prescribed narcotic pain medication (ex: Hydrocodone, Tylenol with codeine, Vicodin®, Percocet®, and Vicoprofen®). Do not take more than one prescribed narcotic at a time. Please consult with your doctor if you are unsure about taking ibuprofen or Tylenol, or if you have had previous allergic reactions to these medications.

CAUTION

Patients who were asleep for their procedure MUST NOT DRIVE FOR 24 HOURS.

SMOKING AND DRINKING

Studies have shown that oral surgical wounds take more time to heal if the patient smokes or vapes following surgery. AVOID SMOKING & VAPING FOR 1 WEEK. Absolutely no alcoholic beverages for 24 hours after surgery, or while taking prescription pain relievers.

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