After Biopsy

Bleeding

It is normal to experience some redness in your saliva or bleeding 24 hours after the procedure. If you experience excessive bleeding, place a moistened gauze pad directly on the wound and bite down for at least 30-45 minutes. If the bleeding persists, bit down on a moistened black tea bag. Black tea contains tannic acid, which contracts blood vessels and helps form a clot. Call for further instructions if bleeding persists after 5-6 gauze changes. 

Once the bleeding stops and a clot forms do not:

• Spit
• Use a straw
• Rinse vigorously 
• Smoke for 4 weeks
• Drink alcohol for 72 hours

Doing any of the above will dislodge the clot and slow the healing process. 

Swelling

Swelling is our body’s natural reaction to surgery and eventual repair. The amount of swelling you experience will depend on the extent of the surgery. It is normal to experience swelling of the cheeks, eyes, sides of the face, and around the mouth. Swelling will not be visible until the day after surgery and will not reach its maximum until the second postoperative day. Swelling can be minimized by applying ice packs immediately following surgery. Apply ice packs continuously during the first 48 hours, 20 minutes on, 20 minutes off, and sleep with your head elevated. After 48 hours, the ice is no longer beneficial. 

If swelling and jaw stiffness persists for several days, do not be alarmed, this is a normal reaction to surgery. Forty-eight hours after surgery, you may begin to apply moist heat to the outside of your face, this will help to further reduce swelling. 

On the day of surgery, begin aggressive oral stretching and manual massage to the sides of the face. This will help with muscle tightness and reestablish a normal oral opening. Sleep with your head elevated at a 30-degree angle for the first two days after surgery. Following these instructions will ensure a quick recovery with less swelling and post-operative pain.

Diet

Take only fluids until the feeling in your mouth has completely returned. Chewing foods while your mouth is numb can lead to tongue and cheek biting which will form painful ulcers. Eat soft foods and chew away from the surgical sites. Avoid hot liquids and food. Drink plenty of fluids and eat a nutritious diet of soft foods on the day of surgery. Start eating a regular diet as soon as possible unless otherwise directed.

Caution: You may feel dizzy or faint when standing up from a lying or sitting position. If you are lying down after surgery, sit up slowly and place your feet on the ground.  Stay seated with your head elevated for one minute before standing. On occasion, a patient may faint following sedation/anesthesia due to a lack of blood flow to the brain. If the escort witnesses the patient fainting, please elevate the patient’s legs above their head for 30 seconds. This will allow oxygenated blood to return to the patient’s brain and restore consciousness. Staying well hydrated following surgery will help prevent fainting. 

Pain

As with any surgery, some degree of discomfort is to be expected. You will usually be given a prescription for pain medication. We recommend taking pain medication before the numbing medication has worn off for the best pain management. You will experience the most severe pain within 6 hours of the anesthesia wearing off. After that, your need for pain medication should decrease.

For moderate pain, take a dose (400-600mg) of Ibuprofen (Advil or Motrin) every 4-6 hours as needed for pain. Do not exceed the maximum daily dosage suggested on the bottle.

Do not take Ibuprofen if you:

•  Have an intolerance to it
•  Take blood thinners 
•  Have a history of stomach ulcers 
•  Have a history of kidney disease 

For severe pain, the prescribed medication should be taken as directed. To avoid stomach upset, take the pain medication after a meal or with a small snack. If you have allergies to any medications above, do not take them. If your doctor has advised you not to take any of the medications mentioned above, do not take them.

While taking pain medication, do not:

• Operate a motor vehicle
• Operate machinery (lawn mower, etc.) 
• Drink alcohol 
• If you had I.V. anesthesia, do not drive for the first 24 hours after surgery.

If you still experience significant pain that is not improving 3-5 days after surgery, notify the clinic. Prescription pain medication has the potential to be addictive, so it’s very important that you only take it if you are experiencing significant post-operative pain. If you do not finish all your prescription medication, take the unused medication to the police station or a pharmacy, and they will dispose of it responsibly. Never leave unused medication in your medicine cabinet at home. 

We recommend the following protocol for optimum pain management:

Take each medication with a small snack and a full glass of liquid.

Immediately Following Surgery: 1 Prescription pain pill

3 Hours Later: Ibuprofen dosage

3 Hours Later: 1 Prescription pain pill

3 Hours Later: Ibuprofen dosage

NOTE: The dosage of the prescription pain medication can be increased to 1 1/2 to 2 pills if needed for pain management.

Nausea and Vomiting

Nausea and vomiting are common side effects of anesthesia and pain medication. To reduce nausea, eat a small snack before taking the medication and drink a large amount of fluids when you take the medication. If you are nauseous and/or vomiting after surgery, avoid eating, drinking, or taking pain medication for at least one hour. After the hour has passed, sip ginger ale, tea, or coke. Sip slowly over a period of fifteen minutes. Do not use a straw. You may begin taking solid foods and the prescribed medication when you no longer feel nauseous. To help with nausea and vomiting, do not take medication on an empty stomach.

Oral Hygiene

Keeping your mouth clean following surgery is essential to good healing and is one of the best ways to avoid infection. You should brush and floss your teeth the night of surgery, avoiding the surgery site. Brush carefully when cleaning the surgical areas. You can mix 50% hydrogen peroxide/50% water. Dip a Q-tip in the solution and gently wipe over the surgery site. This will ensure plaque doesn’t accumulate on the sutures or teeth surrounding the area. Do not rinse your mouth until the day after surgery. 

The day after surgery, rinse with warm salt water at least 5-6 times a day, especially after eating. To make the salt water rinse, mix one teaspoon of salt with a cup of warm water. begin using it the night of surgery after brushing and flossing. You will be given a bottle of Chlorhexidine mouth rinse from the hospital, begin using it the night of surgery after brushing and flossing. This mouth rinse should be used twice daily, after breakfast and before bed, until gone. Rinse for at least 30 seconds before spitting it out. Do not drink or eat food for 15 minutes after using the mouth rinse. 

Healing

What to expect following surgery:• Day.1 & 2: Usually the most uncomfortable. Expect some swelling. Swelling will peak on the second day.• Day.3: You should start feeling more comfortable and notice a reduction in your swelling. You will be able to eat a more substantial diet.• After day three, you should start to feel better and see steady and gradual improvement. If you do not see steady improvement, call our office for further instructions.

Stitches (Sutures)

You may notice some sutures in your mouth. Do not be concerned if you lose a suture before your post operative appointment. Do not cut or trim the sutures.

Smoking

DO NOT SMOKE for a minimum of 4 weeks following surgery. The toxic chemicals and heat in cigarette and marijuana smoke increases the likelihood of implant failure and are harmful to the healing of wounds.

Activity

Keep physical activity to a minimum for the first few days following surgery. Exercise can cause an increase in blood pressure and result in throbbing and bleeding. After oral surgery, your food intake is often reduced, which can lead to feeling weak and limit your ability to exercise.

Wearing Your Prosthesis

Flippers or partial dentures should not be used immediately after surgery and as little as possible for the first two weeks following surgery. When not required for function or social engagements, try and leave your prosthesis out of your mouth to allow the soft tissue to heal.