Post-Operative Instructions: Bone Grafting

After Your Surgery

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. The bone graft material has a small, grainy consistency, and it is normal to lose some of the graft while the extraction site is healing. It typically takes 1-2 weeks for the gum tissue to heal over the extraction site.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. You can control excessive bleeding (where your mouth fills up rapidly with blood) 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. Remove gauze when it is no longer needed. If excessive bleeding continues, please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice pack (or a plastic bag or towel filled with ice) on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 24–36 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 acetaminophen) may be taken every 6 hours (no more than 4000 mg/24-hour period). Ibuprofen (also known as 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/24-hour period). For severe pain, the prescribed medication should be taken as directed. Norco (325 mg Tylenol/acetaminophen and hydrocodone) is typically adequate for moderate to severe post-operative pain control. Please note: this prescription has Tylenol^® [Acetaminophen] in it, so do not take additional Tylenol if already taking Norco. 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

Be sure to take the prescribed antibiotics as directed to help prevent infection.

Oral Hygiene

Good oral hygiene is essential to good healing. Warm salt water rinses (a 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 Peridex^™ 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.