Care of your mouth after surgery has an important effect on healing. Swelling, discomfort, restricted jaw function, and skin discoloration is to be expected. However, following these instructions closely will help to insure a rapid and uneventful recovery.
Pain Management Overview
Baseline Pain Control Regimen
If Additional Pain Control is Needed
- 650 mg Tylenol (Acetaminophen) 2 x 325 mg tablets 4 times per day. Breakfast, lunch, dinner, and right before bed. (Avoid Tylenol if you have been told not to take this medication or have liver failure)
- 200-600 mg Advil (Ibuprofen) 1-3 x 200mg tablets 4 times per day. Breakfast lunch, dinner, and right before bed. (Avoid ibuprofen if you have been told not to take this medication or if you have a history of stomach ulcers, kidney disease, or take a blood thinning medication)
- 2.5 – 5 mg Oxycodone ½ – 1 x tablet up to 4 times per day if needed for additional pain control.
- Do not stop taking the baseline pain control regimen if you need the oxycodone
- Postoperative pain control is of paramount importance to us and our patients after surgery. We want you to be as comfortable as possible as you recover from your surgery. When you return home and the local anesthesia (numbing medicine) wears off, you will transition to oral pain medications to assist in pain control. The goal of postoperative pain management is to use oral pain medications to reduce pain to a tolerable level while the body heals and reduces pain naturally overtime. This may result in a maximal oral medication regimen which can be progressively decreased over the recovery process.
- Modern medicine uses three common classes of medications to achieve this goal, Acetaminophen (e.g. Tylenol), Non-Steroidal Anti-Inflammatory Drugs (NSAID e.g. Ibuprofen/Advil), and opiates (e.g. Oxycodone). Each act on different pain pathways within the body which allows them to all work synergistically at the same time. Using different classes of pain medications allows us to maximize the potential benefits of any one class while minimizing their respective side effects. During the postoperative period we want to maximize your pain control while minimizing any potential side effects.
- All pain medicine should be used in an “as needed” fashion. If you are not in pain, you do not need to take pain medicine. However, the baseline pain control regimen outlined above can be more effective if taken on a “scheduled” basis, regularly spaced time intervals, during the postoperative period where significant pain is anticipated. The baseline pain control regimen is more effective if taken on a “scheduled” basis rather than waiting for significant pain before taking the pain medicine. This “scheduled” strategy allows you to maintain a constant level of pain control in your blood which ultimately results in more effective pain control. If you would like to take the baseline pain control regimen on a “scheduled” basis to maximize its effectiveness we recommend taking these medications ~ 4 times per day, convenient times for most patients are breakfast, lunch, dinner, and right before you go to bed. The baseline pain control regimen can be taken together as instructed above for up to 1 week without concern for significant side effects in a healthy patient. However, if you find yourself continuing to need a “scheduled” baseline pain control regimen after 1 week, please let us know so we can make sure that you are healing appropriately.
- Opiate derived pain medications, like oxycodone, have rightfully received a lot of attention in the media recently due to their addictive potential. While this class of medication can be addictive it is important to note that addiction occurs when these medications are used for prolonged durations for chronic pain, not for acute postoperative pain. As such, these medications are safe to use as prescribed for a short duration after your surgery. However, they have other side-effects as well such as nausea, constipation, and drowsiness which are undesirable. As a result, we still reserve this class of medication for as needed additional pain control if the baseline pain control regimen above is insufficient.
- We hope all our patients recover as painlessly as possible. However, recovering from surgery is typically uncomfortable. The strategies and philosophies outlined above will not make the recovery from surgery painless, but they should serve to reduce the pain to a tolerable level while the body heals and subsequently reduces pain naturally. If you ever feel that the pain is unbearable despite these medications, please let us know so we can make sure that you are healing appropriately.
Diet With While You Are Numb
For the first few hours after returning home your lips will still be numb from the local anesthesia given during surgery. While your lips and tongue are numb it is safe to eat and drink, but best to not chew to avoid inadvertent injury when accidently biting or burning your lip or tongue. Examples of foods you can eat without chewing include any liquid, smoothies, milkshakes, ice cream, yogurt, creamy soups etc.
Diet With After The Numbness Wears Off
Numbness of the lips and tongue may persist through the first evening. Once the numbness begins to wear off you can advance your diet to more substantial foods, but it is still important to chew away from the grafted site to protect it. We would recommend you stick to softer foods and chewing away from the surgical site until it is more comfortable which can take up to 2 weeks.
Starting tomorrow you will gentle rinse with a topical antibiotic mouth rinse called Peridex twice a day, after you brush your teeth.
You will also have a prescription for several days of antibiotic pills. After you pick these up at the pharmacy take them as directed on the bottle until they are gone.
Protect The Implant
Your implant will either be covered completely by gum tissue or visible only as a low-profile screw head during the time it is integrating with your bone, 3-6 months depending on the type of implant. During the first two weeks you have your implant it is important to generally avoid chewing where the implant was placed if possible. After those two weeks the soft tissue around your implant should be healed and your sutures have fallen away on their own, you should no longer need to consciously avoid chewing in that area.
It is important to resume your normal dental routine after 24 hours. This should include brushing and flossing your teeth twice a day. However, be gentle around the implant site until the soft tissue in that area has healed, typically 2 weeks. The surgical site heals best next to clean teeth.
The sutures in your mouth will dissolve on their own. This typically takes 3-10 days, however, if a suture comes out early it is not a problem. Leave the sutures alone if possible and they will take care of themselves. Often, they will come out when you are eating food and you will swallow them, that is not a problem.
Smoking has been proven to directly decrease the rate of implant success. You have invested a lot into your implant. Not smoking during the integration period can increase the success rate of your implant.
Mild activity is fine on the day after your extraction; see how you feel but don’t push yourself.
If you develop hives or a rash, discontinue all medications and immediately contact our office.
Post-surgical follow-up is an important part of your care. We want you to have a successful and comfortable recovery. Please call the office if you have any questions or concerns about your procedure or postoperative healing.