After Bone Grafting Surgery

General Instructions:

1. Do not brush your teeth, rinse your mouth or spit for 24 hours.
2. Do not drink through a straw for 7 days post-surgery.
3. Do not disturb the surgery site or over-exert yourself. It may cause bleeding, irritation, or infection.
4. The day after surgery, resume normal brushing & use a warm saltwater rinses (1/4 teaspoon salt in a glass of warm water) every 2-3 hours for 3 days.
5. Pain and swelling are normal and expected following surgery and may last 7-14 days. Do not be alarmed if the third day following surgery is the worst.
6. Take Ibuprofen 600mg and Tylenol 500mg every 6 hours OR Ibuprofen 800mg and Tylenol 500mg every 8 hours.
   • No more than 4,000mg of Tylenol should be taken per day. Be aware that some narcotic pain medications might contain Tylenol.
7. Medications: You may have been given the following medications.
   • Narcotic pain medicine: This should be taken as needed and only when Ibuprofen and Tylenol are not enough to control the pain. While taking prescription pain medication, do not drive or operate heavy machinery. Be sure to eat something prior to taking pain medication to prevent nausea.
   • Antibiotic: If prescribed, this should be taken as directed until gone. Be aware that some antibiotics can reduce the contraceptive effect of birth control pills. Please contact your gynecologist or pharmacist if you have concerns.
   • Mouth Rinse: Use according to the directions on the bottle. Start using the mouth rinse 24 hours after surgery.
8. Narcotic analgesics tend to cause constipation. Keep bowel movements normal by using a mild laxative if necessary.
9. If you were sedated, do not drive for 24 hours following surgery.
10. Following surgery, you should eat a soft diet for 3-4 days. Avoid chewing over surgical sites until instructed otherwise by your doctor. You should supplement your diet with plenty of fluids & gradually return to your normal diet as tolerated. Avoid spicy foods for two weeks.
11. No strenuous activity until recommended by your doctor. Avoid alcohol or smoking during the first week following surgery.
12. Ice packs may be used for the first 24 hours after surgery to reduce swelling. Rotate ice pack on & off or side to side every 20 minutes for 24 hours. Swelling is usually greater 3 days after surgery and may last about a week. If you continue to have swelling on the 5th and 6th days, or if the swelling goes down and then begins to worsen, you should call our office.
13. You may have sutures placed in your mouth to control bleeding and hasten healing. They will dissolve on their own over 1-2 weeks. Occasionally non-resorbable sutures are placed & will need to be removed in 1-2 weeks.
14. If bruising is present after 5 days, begin using a warm moist compress for the next 3 days. Do not use a warm compress during the first 4 days after surgery.
15. There is a doctor on call 24 hours a day. If a situation develops after our office hours that is a medical emergency, you may call our office, follow the prompts, and a doctor will be paged. It is only necessary to leave the patient name and phone number on the message. Please be aware that the doctor will return your call as soon as possible. Most calls are returned in 30 minutes, but if the doctor is in the emergency room or surgery, the response may be delayed.

Bleeding:

1. If you were given gauze, change it as directed every 30-40 minutes until active bleeding has subsided (usually 2-3 hours). Some bleeding may last for 24 hours. If it is excessive bleeding, follow these instructions.
2. Rinse mouth with cool water & gently wipe away blood clots with a clean piece of gauze or tissue.
3. Take a large amount of gauze, piece of sanitary napkin, or 2 black tea bags moistened with water and place over the bleeding area and close mouth, applying constant pressure.
4. Remain quiet and in a sitting position for 30-40 minutes.
5. Repeat steps 3 & 4 until bleeding is controlled.
6. After these directions have been followed in detail and excessive bleeding persists, you should call our office.

Specific Instructions:

• Leave immediate denture, partial, or flipper in mouth for 24 hours, then remove it & begin salt water rinses (1/4 teaspoon in a glass of warm water). Rinse every 2-3 hours for 3 days. Wear denture or partial as much as possible to reduce swelling from the surgical site. If you do not have a denture or partial, begin salt-water rinses 24 hours after surgery.
•  If you had a sinus lift, do not blow your nose for 2 weeks. Take a decongestant such as Dimetapp or Sudafed / Allegra D for two weeks after surgery to decrease sinus congestion.

No prescriptions will be called in after hours. If you anticipate the need for a refill on your medication or a new prescription, please contact our office during regular business hours. Please have your pharmacy phone number available before you call.