After sinus lift surgery
General – After any surgical procedure performed in the mouth, one can expect some bleeding, some swelling, some discomfort. Those occurrences will be minimized if these instructions are followed carefully. Sometimes the after effects of oral surgery are minimal, so not all instructions apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office anytime for clarification.
Instructions for the First Day of Surgery
- First Hour – Bleeding – After surgery, you’ll be asked to bite on a piece of gauze for about 20 minutes to put pressure on the area for the blood to clot. Before getting concerned, remember that the mouth and its wounds are constantly washed by saliva. What may appear to be excessive blood loss is more likely to be a lot of saliva tinged with a small amount of blood. Do not change the gauze for the first hour unless the bleeding is not being controlled. If active bleeding occurs after the first hour, place a rolled tissue or gauze, or a Lipton teabag over the bleeding area. Keep firm, constant pressure on the area for at least 15 minutes. If it continues, call the office. Bleeding is minimized by not spitting, talking or rinsing. Place a bath towel or plastic bag over the pillow, as drooling is likely while sleeping. Don’t disturb the clot that forms on the wound.
- Nose Bleeds – Nose bleeds are normal and may occur up to several days following surgery. Treat by leaning head back, apply ice and direct pressure. Do not be alarmed by the presence of bone granules. Some drainage is normal from the nose and mouth, just wipe away. bath towel or plastic bag over the pillow, as drooling is likely while sleeping. Don’t disturb the clot that forms on the wound.
**Remember it is normal to have mild oozing for the first 24 hours**
- Avoid – To prevent loss of the clot, you should exercise extreme caution and observe the following. Do Not Disturb the surgical area today. Do Not Rinse vigorously or probe the area with any objects or your fingers. Do Not Smoke for at least 48 hours, since it is very detrimental to healing. Do Not Drink through a straw or spit after surgery for 2 weeks. These actions can pull the blood clot out of the hole where the tooth was, that can lead to a dry socket. It is most common when lower back teeth are removed and happens more often in smokers and women who take birth control pills. A sure sign of a dry socket is persistent, acute pain in the jaw.
- Oozing – Intermittent bleeding or oozing is normal for as long as 2 weeks following surgery. It may be controlled by placing fresh gauze over the surgical area and biting down firmly for 30-60 minutes. Make sure the gauze is pressing on the surgical site not just between the teeth.
- Steady Bleeding – Bleeding should never be severe. If it is, it usually means that the packs are being clenched between your teeth rather than exerting pressure on the surgical areas. Try replacing fresh packs. If bleeding persists or becomes heavy, you may substitute a tea bag (soaked in cold water, squeezed damp-dry and wrapped in moist gauze) for 60 minutes. If bleeding remains uncontrolled, please call our office.
- Swelling – Arnica and Vitamin C – available over the counter to take starting 2 weeks before surgery. Often there is some swelling associated with oral surgery. Severe cheek swelling is also normal following this procedure. If eyes swell shut, please call our office or the phone number below. You can minimize swelling by using a cold pack or ice bag wrapped in a towel, and apply firmly to face or cheeks adjacent to the surgical area. This should be applied 20 minutes on and 20 minutes off during the first 12-24 hours of surgery. After 24 hours, it is best to switch from ice to moist heat. Remember most swelling occurs on the second and third days after surgery
- Pain Medication – If you do not have medical interferences, over the counter medication should relieve your discomfort. Ibuprofen (i.e. Advil, Motrin) 600-800 mg every 6 hours usually will provide sufficient pain and swelling relief. Another good pain reliever (not for swelling) is acetaminophen (Tylenol). Be sure to take this medication with food. No alcoholic beverages should be consumed while taking these medications.
- Nausea – Nausea is not an uncommon event after surgery, and it is sometimes caused by strong pain medications. Nausea may be reduced by preceding each pill with small amounts of food, and taking the pill with a large volume of water. Try to keep taking clear fluids to minimize pain medication, but call us if you do not feel better or if repeated vomiting is a problem. Cola drinks that have less carbon may help.
- Diet – Please avoid hot liquids or foods during the first 2 days. A light soft diet with plenty of liquids is recommended. Examples include cereals, milk shakes, ice cream, mashed potatoes, pasta and fish. Chew food on the opposite side of the surgical area. Be sure to drink plenty of water (8 glasses/day). Avoid foods like nuts, sunflower seeds, popcorn, etc. that may get lodged in the socket areas. Over the next several days, you can progress to solid foods at your own pace. It is important not to skip meals! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. If you are diabetic, maintain your normal eating habits as much as possible and follow instructions from your doctor regarding your insulin schedule.
Instructions for the Second and Third Days
- Oral Hygiene – Keeping your teeth clean after surgery is essential. Do not brush the teeth in the extraction area for 1 week, but do start to gently rinse as directed after 24 hours. Continue to brush and floss as usual outside the surgical area. A glass of warm water mixed with 1 teaspoon of salt is a good rinse for healing. You can do this every 3-4 hours, especially after meals. The cleaner you keep the surgical area, the faster it will heal. Do not use mouthwash for 2 weeks.
- Warm Applications – After 48 hours, you may apply warm compresses to the skin overlying areas of swelling (hot water bottle, moist hot towels, heating pad) for 20 minutes on and 20 minutes off to help soothe those tender areas.
- Antibiotics – Antibiotics may be prescribed for infection. All of this medication should be taken as directed unless an allergic reaction develops. If there are signs of an allergic reaction (i.e. rash, itching, unusual swelling), stop taking the medication immediately and call the office. If the reaction is severe (i.e. difficulty breathing), go to the nearest Emergency Room.
- Sneezes/Nose Blowing – Do not blow your nose. Blowing your nose could cause the bone-graft material to move, and loosen the stitches.
- Bone Chips – During healing, you may notice small bone fragments working their way through the gums. We can easily remove them if they are too annoying.
- Dry Socket – Occasionally this occurs after a tooth extraction, and results from the blood clot not forming properly during the healing time, so it is lost from the tooth socket. A Dry Socket can be painful, and should be treated by Dr. Ganti as soon as possible. He may clean the tooth socket, removing any debris from the hole, and fill the socket with a medicated dressing or special paste to relieve discomfort. You may have to come back to the office every day for a dressing change until the socket starts to heal and your pain lessens.
- Rest – Sleep works wonders for the body, so take it easy for the rest of the day. Go to bed earlier than usual with your head slightly elevated.
- Stitches – If stitches are used, the stitches are usually dissolvable and should disappear in 1-2 weeks. If indicated, they may be removed earlier at your follow up visit.
- Bandage – If a bandage has been placed, it may tend to break loose, or pieces may break off, as the week progresses. It is important that the bandage stay on the area. Please discuss with your doctor.
If any of the following occur, contact our office immediately (469-596-7722)
- Any swelling or pain gets worse over time. (It should decrease after the first two days or so.)
- The bleeding does not stop after one to two days.
- You think the bony material may have been dislodged after sneezing or blowing your nose.
- Pain does not decrease over time.
- You develop a fever greater than 101F