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Patients with Infections

Bleeding : It is normal to have some bleeding after oral surgery.  In order to help minimize bleeding you should bite on gauze for the next 2-3 hours changing the gauze every 1/2 - 1 hour.  If the bleeding persists you may use additional gauze or a tea bag (regular tea, not decaffeinated or herbal).  Just dip the tea bag into warm water, place it over the surgical site and bite.  Do not chew the tea bag so as to avoid getting tea leaves into the open wound.  Redness in the saliva or on the gauze is not necessarily active bleeding.  Active bleeding is oozing at the surgical site.  Do not be alarmed if, upon wakening, you find blood on your pillow as this is not uncommon and is usually caused by drooling saliva that contains a small amount of old blood.  
    No rinsing, spitting, or drinking through a straw for 24 hours. This will prevent dislodgement of the blood clot and excessive bleeding.
Swelling : Some swelling is to be expected.  The degree of swelling varies depending upon the amount of surgery, how your body reacts to the surgery, and how much swelling you had before surgery.  You can expect your swelling to increase after surgery.  As long as you feel better than you did before the surgery you need not to be concerned about swelling.  Do not use ice.  Rather use warm compresses on your face/neck over the surgical area or swelling every 2 hours.  After 24 hours alternate warm compresses with warm salt water rinses (1/2 tsp salt in 8 ounces of warm water) every other hour.  An easy way to prepare a warm compress is to place a moist wash cloth in a microwave oven for 10-15 seconds on high.  Be careful not to burn your skin.
Diet : Your diet will vary depending upon the degree of surgery you have had.  If you have had extensive surgery, maintain a clear liquid diet (e.g tea, jello, chicken or beef bouillon, apple juice) for the first 24 hours.  Avoid anything too hot, too cold, or spicy.  Thereafter, you may advance your diet first full liquids/pureed and then to soft foods and finally a regular diet as you feel able.  After less extensive procedures you may start with full liquids and advance your diet more quickly.  It is important for you to take in an adequate number of calories and sufficient liquids, but do not overdo it when is comes to chewing.  Liquid nutritional supplements (e.g. Ensure) are often helpful and can be included in a clear liquid diet.
Hygiene : Since you cannot rinse or spit for the first 24 hours do not brush your teeth either.  Starting 24 hours after surgery, begin rinsing your mouth with warm salt water (1/2 tsp salt in 8 ounces warm water) 4-5x/day and especially after meals.  You should also resume your normal oral hygiene regimen, but avoid brushing/flossing in the immediate surgical area.  By keeping the rest of your mouth clean you will aid healing. Do not use any commercial mouthwashes.
Nausea : Nausea after oral surgery can be caused by several things.  Swallowed blood may lead to nausea, as can some medications.  If you do throw up and the emesis is dark brown and looks like coffee grounds the nausea was caused by swallowing blood.  You should have immediate relief.  If the nausea persist it may be caused by medication, especially if you are taking a pain medication containing a narcotic.  Warm, flat coca or ginger ale will often help with nausea.  If nausea is persistent and severe please call our office.

Pain :  Some discomfort is to be expected after surgery.  Throbbing is not unusual.  Take your medication as soon as you feel pain and before the pain becomes severe.  You can minimize your discomfort by treating it early.  If pain worsens or persists after several days apply ice to temples and jaw 4 x /day and do gentle mouth opening stretches.  If you do not obtain relief please contact our office.
Medications : Take all medications as prescribed.  Antibiotics should be taken until the bottle is empty, not just until you feel better.  If you are taking a pain medication containing a narcotic does not drive, operate machinery, or drink alcohol while taking it.  If you are taking birth control pills be aware that there is some evidence that some antibiotics may interfere with their effectiveness; therefore, if you are taking birth control pills and an antibiotic you should consider the entire cycle high risk for pregnancy and use additional form of birth control.
Smoking : Smoking is one of the worst things you can do to your mouth after oral surgery. Please refrain from smoking for 2 weeks after extensive procedures. For less extensive surgery 1 week will probably suffice. The longer you do not smoke the better.
Sutures : If you have sutures, you may notice one or more loosen or fall out over the next several days. This is not unusual and by itself should not be cause for concern.
Questions : If you have any questions or concerns please call our office. We are always available to help you and can be reached 24 hours a day for emergencies.
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