Patient Instructions Following Oral Surgery
1 Packs:
In the event that the patient goes home with gauze packs in the mouth, these are to be removed 1 hour after surgery. Ice packs may be applied to help decrease pain and swelling (packet of frozen peas may be substituted).
2 Swelling:
This is quite a normal response and usually reaches its peak 24 – 30 hours following surgery. It often varies from one side of the face to another depending on the degree of difficulty of surgery. The swelling will start to decrease after 4 – 5 days.
3 Brusing:
Bruising may occur as the swelling starts to subside and is again not unusual.
4 Bleeding:
Bleeding may occur after oral surgery and responds well to direct pressure. If it occurs, use a clean rolled handkerchief to apply direct firm pressure to the bleeding site for one hour. If bleeding persists, please contact the surgeon.
5 Pain:
Always occurs with varying intensity. Initially, it is important to take the painkillers regularly. This may reach a peak after 3 – 4 days but should decrease after 5 – 7 days with a decrease in the need for painkillers. There may be limitation in mouth opening. This is normal and will pass as the swelling subsides.
6 Nausea:
Nausea and/or vomiting following oral surgery is common and may relate to medication or swallowed blood. It is wise to have clear fluids only for the first 12 hours. If vomiting persists, please contact the surgeon.
7 Infection:
Infection is uncommon following oral surgery and if it does occur, it will show itself by a late increase in swelling and/or discomfort and/or the onset of a discharge. Antibiotics are not routinely prescribed following surgery.
8 Stitches:
Dissolving sutures will be used in almost all cases. These will fall out or dissolve in approximately 7 – 14 days following surgery.
9 Oral Hygiene:
DO NOT RINSE YOUR MOUTH UNTIL THE NEXT DAY AFTER SURGERY. Rinsing in the early stages will cause bleeding. Rinsing with a mouthwash is suggested (a teaspoon of salt in a glass of warm water is recommended) and this should be done after food intake until healed. Tooth brushing should be recommenced as soon as possible.
10 Diet:
Your diet will need to be restricted to fluids and soft foods initially. A gradual return to a normal diet is recommended.
11 Smoking:
It is advisable that you refrain from smoking for at least 3 days after the surgery as this increases the risk of infection.
12 Local Anaesthetic:
Local anaesthetic is almost always used, even if treatment is carried out under General Anaesthetic, as it reduces post operative pain. It is very important that you do not bite your lip or tongue while it is numb.
13 Problems:
If problems arise, do not contact your own Dentist or Doctor, please contact the surgeon on: ROOMS: (03) 5975 6087 or After Hours Pager: (03) 9483 8570
In the unlikely event that you cannot contact your Surgeon,
Please call the Emergency Department of your local public hospital.
Pain Relief Following Oral Surgery
Once severe pain is established it is harder to relieve, it is therefore important to try to take analgesics regularly if pain is present.
Most pain following oral surgery responds well to Paracetamol (eg Panadol). The adult dose is normally one or two tablets every four hour (maximum dose 8 tabs per day). Paracetamol is available in combination with other analgesics.
Nurofen (Ibuprofen) can be used in addition to paracetamol for more severe pain. Persons with some medical conditions such as a history of gastric ulcers cannot take Nurofen. The adult dose of Nurofen is usually one or two tablets three times daily. Nurofen does not require a prescription. If you have had treatment either under a general anaesthetic or intravenous sedation you are usually given a drug similar to Nurofen intravenously and should not commence Nurofen until 24 hours after your surgery.
For pain not relieved by paracetamol and Nurofen a prescription medication may be required; for example Panadeine Forte. Panadeine Forte is a mixture of paracetamol and codeine therefore, if Panadeine Forte is taken, no other paracetamol should be taken. Panadeine Forte and Nurofen can be taken simultaneously.
Ideally, analgesics should be commenced before the effects of the local anaesthetic have worn off.
It is important to follow the manufacturers directions with analgesics and not exceed the maximum recommended doses.