Post-Operative Instructions: Bone Grafting

It is important to review and follow these instructions to promote proper healing and avoid post-surgical complications.

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 in order to maintain all graft material at the surgical site. Do not play with the site with your tongue.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (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. Change the gauze pad every 30 minutes as needed. If excessive bleeding continues, please call for further instructions. (In general, use as little pressure as is needed.) Remove gauze when it is no longer needed.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag (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 2–3 days after surgery 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 foods away from the surgical site for at least 2 weeks after surgery to avoid disruption and loss of graft material.

Pain

You should begin taking pain medication prior to the local anesthetic wearing off. For moderate pain, one or two Regular Strength Tylenol^® (325 mg) may be taken every 6 hours (no more than 2600 mg/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/24-hour period). For severe pain, the prescribed medication should be taken as directed. (Please note: if this prescription has Tylenol [APAP] in it, do not take additional over-the-counter Tylenol). 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 saltwater 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. You may gently brush the tooth surfaces of the adjacent teeth the day after surgery, as long as the bristles don’t disturb the graft site. You may floss normally, starting the day of surgery, if comfortable, but avoid the areas that have stitches between the teeth.

If sutures (stitches) were placed, they are almost always the type that will dissolve and fall out within the first week or so after surgery. You will only have to have sutures removed if you were told that they must be removed and were scheduled for an appointment to remove them.

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 put pressure on the graft site.