Bone Grafting for Ridge / Socket Preservation

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Most of the time a “plug” is placed into the tooth socket over the bone graft.  It may look white or like a blood clot.  It is not unusual for this to protrude and eventually get dislodged in the next few days following the surgery.   Also small amounts of the bone graft may work themselves out of the tooth socket.  Patients may feel these particles on their tongue or between their teeth.  These have a consistency similar to sand.  Spitting or using straws while drinking produces negative pressure inside the mouth which can lead to loss of the bone graft.

Bleeding

A certain amount of bleeding is to be expected following surgery for 24 hours. Slight bleeding, oozing, or redness in the saliva is common.  Bleeding should never be severe.  If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical areas. Try repositioning the packs and bite firmly for 30-45 minutes. Repeat if necessary.  If bleeding persists or becomes heavy you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels.  To minimize further bleeding, do not become excited, sit upright, and avoid exercise.  If bleeding remains uncontrolled, please call our office.

Swelling

Swelling is often associated with oral surgery. It will not become apparent until the day following surgery and will not reach its maximum until two to three days after the surgery. Swelling can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed.

Diet

  • Chew away from the surgical side.
  • Eat any nourishing food that can be taken with comfort.
  • Avoid extremely hot foods.
  • Do not use a straw for the first few days after surgery and try chewing away from the surgical site(s).
  • It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, smoothies, mashed potatoes, etc.)
  • It is best to avoid foods like nuts, sunflower seeds, popcorn, chips, pretzels, etc., which may get lodged in the socket areas.
  • Over the next several days you may gradually progress to solid foods.
  • It is important not to skip meals.
  • If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster.
  • Prevent dehydration by taking fluids regularly.
  • If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.

Pain

Unfortunately most oral surgery is accompanied by some degree of discomfort.  You will usually have a prescription for pain medication.  If you take the first pill before the anesthetic has worn off, you should be able to manage any discomfort better.  Some patients find that stronger pain medicine causes nausea, but if you precede each pain pill with a full glass of water or a small amount of food, chances for nausea will be reduced.  The effects of pain medications vary widely among individuals.  If you do not achieve adequate relief at first, you may supplement each pain pill with an analgesic such as ibuprofen (Advil, Motrin) or naproxen (Aleve).  Some patients may even require two of the pain pills at one time.  Remember that the most severe pain is usually within three days after the surgery; after that your need for medicine should lessen.  If you find you are taking large amounts of pain medicine at frequent intervals, please call our office.  If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours. Please keep in mind pain medications cannot be called into the pharmacy. You need to pick up a prescription at our office during weekday business hours.

When taking prescription or over the counter medications, always follow manufacturer’s recommended dose. Do not take any medication if you are allergic or have been instructed by your doctor not to take. If you are not sure or have any questions, please contact your doctor, the pharmacy, or our office.

Antibiotics

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

Oral Hygiene

MOUTH RINSES:  Keeping your mouth clean after surgery is essential.  Use 1/4 teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful.  Repeat as often as you like, but at least two or three times daily.

BRUSHING:  Begin your normal oral hygiene routine as soon as possible after surgery.  Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort.

Remember: A clean wound heals better and faster.

Activity

  • Keep physical activities to a minimum immediately following surgery.
  • Stay away from heavy exercises and lifting for the initial five days following your surgery to avoid complications.
  • If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising.
  • Be aware that your normal nourishment intake is reduced.
  • Exercise may weaken you.
  • If you get light headed, stop exercising.

Wearing Your Prosthesis

Many patients may elect to have a prosthesis to immediately replace their extracted tooth.  This is especially true for the upper front teeth.  This prosthesis can be made by your restorative dentist prior to the tooth extraction, and then placed right after the tooth is extracted.  This way the patient will have a replacement tooth right away.  The prosthesis should not put any pressure on the tissue; otherwise bone may melt away prematurely.  Bring your prosthesis to your surgery appointment so that Dr. Vahadi can make any necessary adjustments to avoid this pressure.