Instructions Following Bone Grafting
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Be as gentle as you can around the bone grafting area. Try to maintain all graft material at the surgical site.
Bleeding: Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (where your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. In general, use as little pressure as is needed. Change the gauze pad every 30 minutes as needed. If excessive bleeding continues, please call for further instructions. Remove gauze when it is no longer necessary.
Swelling: Swelling is normal after surgery. To minimize swelling, apply an ice pack or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 24 hours. Swelling generally reaches a peak in 24–36 hours and then subsides over the next 3–5 days. If swelling begins to increase after the third post-operative day, please contact your doctor immediately.
Diet: Drink plenty of fluids. Avoid hot liquids or foods. Soft foods and liquids should be consumed on the day of surgery. Keep all solid food away from the surgical site.
Pain: You should begin taking pain medication before the local anesthetic wears off. For moderate pain, 1 or 2 regular strength Tylenol® (325 mg) may be taken every 6 hours (no more than 2600 mg per 24-hour period). Ibuprofen (Advil® or Motrin®) may be taken instead of Tylenol®. Ibuprofen bought over the counter comes in 200 mg tablets: 3–4 tablets may be taken every 4–6 hours as needed for pain (no more than 3200 mg per 24-hour period). For severe pain, the prescribed medication should be taken as directed. Please note that some prescription medications contain acetaminophen, which is the active ingredient in Tylenol®. Do not exceed a total of 2600 mg of acetaminophen per 24-hour period. If you need assistance managing your pain medication, consult with your doctor. Do not take any of the above medication if you are allergic or have been instructed by your doctor not to take it. This may include patients with liver or kidney disease.
Antibiotics: Always take prescribed antibiotics as directed to help prevent infection.
Oral Hygiene: Good oral hygiene is essential to good healing. Warm saltwater rinses (a 1⁄2 teaspoon of salt in a cup of warm water) should be used at least 4–5 times a day, especially after meals. If you are given a prescription for chlorhexidine oral rinse, rinse for 30 seconds and spit twice per day. Do not brush the 2 adjacent teeth on either side of the graft site for the first 7 days. After 7 days, you may gently brush the tooth surfaces of the adjacent teeth, as long as the bristles don’t disturb the graft site. You may floss normally starting the day of surgery, if comfortable.
Activity: Keep physical activities to a minimum immediately following surgery. If you are exercising, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing Your Prosthesis: Partial dentures, flippers, or full dentures should not be used immediately after surgery. You may wear these prostheses as soon as it is comfortable but only if the prosthesis doesn’t touch the graft site.