After Bone Graft and Sinus Augmentation

Immediately Following Surgery

  • The gauze pad placed over the surgical area should be kept in place for a half hour. After this time, the gauze pad should be removed and discarded.
  • Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic becoming diminished.
  • Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.

Bleeding:  A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. If immediate dentures were inserted, do not remove immediate dentures unless the bleeding is severe. Expect some oozing around the sides of the dentures.

Swelling:  Use ice packs (externally) on the sides of the face where surgery was performed to help reduce swelling. Apply ice as much as possible for the first 36 hours.

Pain:  For mild to moderate discomfort use Ibuprofen/Motrin/Advil.  If you cannot take these medications you may use Tylenol (Acetaminophen). .  Ibuprofen, Motrin or Advil: Take 2 to 4 tablets every 6 hours as needed.  Tylenol:  Take 1 or 2 tablets every 6 hours as needed. 

For severe pain use the prescription pain medication if one was given to you. Add the prescription pain medication to the Ibuprofen, Motrin or Advil.  If you are taking Tylenol, remember that most prescription pain medications contain Tylenol and you should stop taking the Tylenol when you start the prescription pain medications. If the pain does not begin to subside in 2 to 3 days, please call our office. If an antibiotic has been prescribed, finish your antibiotic prescription.  If you are having trouble taking the antibiotics, please call the office for instructions.

Diet:  After surgery drink plenty of liquids.  Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. Diet:  Initially restrict your diet to liquids and soft foods, which are comfortable for you to eat. As the wounds heal, you can advance your diet as tolerated.

Keep the mouth clean:  Do not rinse your mouth for the first post-operative day, or while there is bleeding. You can brush your teeth gently as Tolerated. After the first day, use a warm salt water rinse several times a day and after meals to keep the extraction sites clean. (1/4 teaspoon of salt in a glass of lukewarm water).

 

Activity:  Limit vigorous physical activity for 24 hours.  This may increase blood pressure and cause more bleeding.  After a day or two, you will feel fine and can resume your normal activities. If you have heavy bleeding, severe pain, continued swelling for 2-3 days, or a reaction to the medication, call our office immediately.

Additional Bone Graft Information:

  • Your bone graft may be one solid piece of bone or many smaller particles of bone.
  • You may find some small granules in your mouth for the first several days. Do not be alarmed by this. It is normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:
  • Do not vigorously rinse or spit for 3-5 days.
  • Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
  • Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.
  • For the first day, we would suggest letting the blood clot stabilize and not even rinse your mouth. Following the first day, gentle rinsing would be advised but not too vigorously as you can again disturb some of the bone graft granules.
  • If you have received a block graft, and part of the graft becomes exposed, let Dr. Sarka know as soon as possible.  He will give you specific instructions to ensure the success of your bone graft.

Sinus Augmentation:  If you have had a sinus grafting procedure performed, the general postoperative instructions still apply, but we would like to emphasize a few important points about your particular procedure and remind you of some instructions:

  • Do not blow your nose.
  • If you must sneeze, do so with your mouth open to avoid any unnecessary pressure on the sinus area.
  • Do not smoke or use smokeless tobacco. Smoking greatly inhibits the healing, especially in the sinus graft.
  • Do not take liquids in through a straw.
  • Do not lift or pull up on your lip to look at the stitches, as this may actually create damage and tear the stitches.
  • Take your antibiotics as directed and until finished.
  • You may have some bleeding from the nose. This is not uncommon and should pass quickly.

If you have any questions or concerns, please call us at Portland Oral and Maxillofacial Surgery Phone Number (207) 387-2055.  After hours, you will reach our answering service and they will page the doctor and have him call you back.