Post-operative Instructions Following
Extractions With Bone Grafting
The extent of post-operative pain and swelling will depend on the type of grafting that was done. If you had a tooth extraction with grafting into the tooth socket, there will be dissolvable sutures in place. Avoid chewing directly in this area. It is normal for some small pieces of the graft to dislodge. It will feel like small granules of sand. Do not be concerned, even if it seems like there are a lot of particles, the vast majority of the graft will be in place. You may also have a membrane placed which may be visible as a white material. Try not to disturb this, and keep it clean with gentle mouth rinsing.
Take care to minimize any sort of trauma to the area. Rinse very gently and brush very carefully on the adjacent teeth starting the night of the procedure. If you are wearing a temporary prosthesis over the grafted site, try to avoid any contact between the temporary and the grafted site. Do not eat with the temporary prosthesis in place. If you feel it is putting excessive force on the grafted site, please call us at 913-451-7680.
Immediately Following Bone Grafting
The gauze pack should be kept in place with firm pressure over the area. Remove the pack after 30 minutes. If there is continued excessive bleeding, replace with new gauze and bite gently again. Vigorous mouth rinsing or chewing in the areas of the bone grafting should be avoided. This may cause increased bleeding or damage to the bone graft.
Dissolvable sutures will be placed and likely begin to fall out in 3-5 days. If they begin to fall out sooner, do not be alarmed, this is normal. The graft will be held in place by the clot formed around the graft material.
A liquid or soft diet is recommended for the first 24 hours. After 24 hours, you may advance your diet, but take care to avoid any chewing directly on the surgical site. Avoid sucking through straws and eating hard or crunchy foods and spicy foods. Take the prescribed pain medication before the numbness from the local anesthesia wears off.
Swelling is normal after any surgical procedure. The extent of swelling varies and depends on the extent of the surgery and each individual patient. Swelling around the mouth, jaws, cheeks, and below the eyes is not uncommon. The swelling will usually reach its maximum 2–3 days after the surgical procedure. The swelling can be decreased by the immediate use of ice packs in the first 36 hours. Ice packs should be applied on the outside next to where the surgery was performed. Keep the ice on as continuously as possible. Discontinue ice after 36 hours and begin using heat. Sitting upright and not lying flat on the first day will help to decrease the amount of swelling. Taking ibuprofen as instructed will also help decrease swelling.
Pain medications are normally required after bone graft surgery. If you can take ibuprofen (Motrin® or Advil®), take 400–600 mg every 6 hours or as prescribed by your doctor. Ibuprofen will help with pain relief and swelling reduction as an anti-inflammatory. If you cannot take ibuprofen, then acetaminophen (Tylenol®) should be taken as instructed on the bottle. If you were prescribed a stronger pain medication such as Norco® (hydrocodone with acetaminophen) or Percocet® (oxycodone with acetaminophen), you can take that in addition to your ibuprofen if the pain is severe, but do not combine Norco® or Percocet® with any medication containing acetaminophen (Tylenol®). Follow the directions written on your prescription bottle. If you do take any of these medications, do not drive or work around machinery. Do not take more pain medicine than prescribed. Avoid alcohol while taking these medications. If you are uncertain how much pain medicine to take or how often, please call us at 913-451-7680.
Antibiotics will be prescribed following the procedure. Complete the prescription as directed.
Proper oral hygiene is important because it helps reduce chances of an infection. Very gentle rinsing should begin the day of bone graft surgery. Rinse gently with warm saltwater twice daily. You can brush your teeth the day of your surgery, but be careful not to traumatize the area where the bone graft was placed.
Smoking can inhibit the healing process and can cause more pain after surgery. To ensure the best post-operative recovery, refrain from smoking for as long as possible after surgery.
If you have any questions or concerns following your bone grafting procedure, please don’t hesitate to call our office 913-451-7680.