After Bone Grafting
The following instructions are to be followed to optimize the healing of your bone graft, minimize discomfort and swelling, and ensure a speedy recovery.
Bleeding: You should bite on gauze and hold firm pressure at the surgical site for the first several hours following your procedure. Some bleeding or oozing at the surgical site is normal for several days following your procedure. Some blood may be present in your saliva, or you may notice while brushing your teeth. Gauze pressure or biting on a moist tea bag can help stop bleeding at the site. Significant active bleeding (copious bright red blood like a nose bleed) can be a problem. Immediately bite on gauze tightly to hold pressure, and contact your Doctor.
Swelling and Bruising: A slight amount of swelling and bruising is expected following oral surgery and can last for up to 2 weeks. Most swelling takes up to 3 days to peak, then begins to improve. The first 48 hours of care are crucial to reduce swelling. Apply cold compress to the cheek next to the surgery site on and off for 20 minutes during the first two days. Aim to keep your head in an elevated position. Do not lay flat, you may use extra pillows at night to maintain and elevated head position. Some bruising is normal. This may take several days to present and will dissipate spontaneously.
Discomfort/Pain: Following all types of surgery, a certain amount of discomfort is anticipated.
Take the prescribed medication for the first 5 days after surgery. It is always easier to prevent dental pain than to try to catch-up after the pain has started.
For mild pain: Ibuprofen 600-800mg every 6 hours
For moderate pain: Ibuprofen 600-800mg every 6 hours and Tylenol (Acetaminophen, prescribed or over the counter every 6 hours). Alternate the medications every 3 hours, do not take them together.
E.g: 9:00 AM take Prescribed Ibuprofen. 12:00 PM take Tylenol (Acetaminophen, prescribed or over the counter). 3:00 PM take Ibuprofen. 6 PM take Tylenol etc…
For severe pain: After alternating the ibuprofen and Tylenol for 2 rounds, you will then substitute 1 Tylenol tablet for 1 prescription pain killer (i.e. Hydrocodone) These can make you groggy and
slow down your reflexes. DO NOT DRIVE an automobile or work around machinery while taking these medications. Avoid alcoholic beverages.
Pain or discomfort following surgery is normal and should subside gradually each day. If pain persists, it may require attention and you should call our office.
Diet: Take in fluids immediately and avoid chewing on the operated area of your mouth. Soft foods must be eaten until you further instruction from your surgeon. The following require little pressure to chew and provide the necessary nutrients: protein shakes, bananas, cooked fish, cereals, pasta, mashed potatoes, and whole grain soft breads. You should continue your usual vitamin supplements. Returning to your normal diet and proper calorie intake will promote faster healing.
Fever: A slight fever or chills may occur. It is of no consequence unless it persists for more than 24 hours. A persistent low grade temperature or one above 102 degrees should be reported to our office.
Activity:
- AVOID strenuous physical activity and smoking for the first 48-72 hours following the procedure.
- Start the prescribed medications immediately and AVOID all alcoholic and carbonated beverages.
- Do NOT smoke.
Special medications: If you are taking other medications prescribed by your physician, be sure to inform your doctor and continue to take them as usual unless otherwise directed. Antibiotics or other medication(s) may be prescribed for you, please take these as directed on the label(s). Antibiotics especially need to be taken as prescribed and one should complete the full regimen as given. Female patients should also be aware that some antibiotics may interfere with the effectiveness of certain oral contraceptives. Antibiotic medications may be taken safely at the same time of other medications, including your prescribed pain medications.
Care for your Bone Graft site:
Depending on the specific surgery performed, your bone graft may be placed completely underneath the gums, or there may be a membrane placed to hold the bone. There may also be some stitches at the surgical site. Some stitches will dissolve, and stitches and/or membrane need to be removed by your surgeon. You may brush your teeth in other areas of the mouth as you normally would, but do not disturb the surgical site. Use a soft tooth brush. Gentle rinses with the prescribed mouthwash Peridex (0.12% Chlorohexidine) twice daily along with additional gentle rinses with salt water (1 Tsp table salt in 8 oz water) will help keep your surgical site clean.
It is normal for some bone particles to leach out, and the sensation of spitting out “sand like bone particles” is normal and expected. Extreme care should be exercised in avoiding placing any biting pressure on the surgical site. If a removable prosthetic appliance was placed it should not contact the implant or tissue in the area AT ALL. If you feel any pressure from a removable appliance on the surgical area, please contact the office immediately and schedule an appointment right away. Premature pressure on the site of healing may result in graft failure or healing complications.
