Sometimes the after-effects of endodontic surgery are quite minimal, so not all of these instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office at any time.
Day of Surgery
Bite down gently but firmly on the gauze packs that have been placed over surgical areas, making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. If active bleeding persists after one hour, place enough new gauze to obtain pressure over the surgical site for another 30-60 minutes. The gauze may be changed as necessary and may be dampened for more comfortable positioning.
Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any object or fingers. You may brush your teeth gently. DO NOT SMOKE for at least 48 hours, since it is very detrimental to healing.
Intermittent bleeding or oozing is normal. Placing fresh gauze over the surgical areas and biting down firmly for 30-60 minutes may control it.
Small amounts of blood during the first twenty-four (24) hours after surgery is common and should not be of great concern. 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 repositioning fresh packs. If bleeding remains uncontrolled, please call our office.
Often there is some swelling associated with endodontic surgery. It may persist for several days but is no cause for alarm. You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 12 to 24 hours after surgery. Cold water with ice chips is also recommended the entire day of the surgery. The colder you keep the surgical site the less swelling you will experience. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. After 24 hours, it is usually best to switch from ice to moist heat to the same areas.
Unfortunately, most endodontic surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, and if you take the first pill before the anesthetic has worn off, you will be able to manage any discomfort better. Effects of pain medication vary widely among individuals. If you do not achieve adequate relief, you may supplement each pill with advil or tylenol. Remember that the most severe discomfort is usually within the first six hours after the anesthetic wears off. After that your need for pain medicine should decrease.
Normal healing after surgery should be as follows: The first day of surgery is usually the most uncomfortable and there is some degree of swelling and stiffness. The second day you will usually be far more comfortable and, although still swollen, you can usually begin a more substantial diet. From the third day on GRADUAL, STEADY IMPROVEMENT should mark the remainder of your post- operative course. If you do not see steady improvement during the first few days after surgery, don’t suffer needlessly. Call the office and report symptoms so you can be seen as soon as possible.
You may experience some facial bruising. This typically happens in fair skinned patients. Yellowing or even black and blue under the eyes or chin in area of treatment can be seen and will disappear as you heal. Please call us if you have any concerns.
Nausea is not an uncommon event after surgery, and it is sometimes caused by stronger pain medicines. Preceding each pill with a small amount of soft food, then taking the pill with a large amount of water may reduce the nausea. Try to keep taking clear fluids and minimize the pain medicine, but call us if you do not feel better or if repeated vomiting is a problem. Ginger ale or Cola drinks that have less carbonation may help with nausea.
Eat any nourishing food that can be taken with comfort. Temperature of the food doesn’t matter, but avoid extremely hot foods. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids or pureed foods (creamed soups, puddings, yogurt, milk shakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc., that may get lodged in the surgery site. Over the next several days you can progress to solid foods at your own pace. It is important not to skip meals. If you eat 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 primary care physician regarding your insulin schedule.
Keeping your mouth clean after surgery is essential. DO NOT RINSE the day of the surgery. Warm salt water rinses can be started the following day. DO NOT SWISH VIGOROUSLY but gently tilt your head to the surgical side and allow the rinse to bathe the teeth in the area for a minimum of 60 seconds twice a day. Brush the other areas of your mouth as usual but avoid the surgical area.
Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean your teeth within the bounds of comfort.
After the first 24 hours you may apply warm moist 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. This will also help decrease swelling and stiffness.
Infection of surgical sites can occur due to the bacteria in the mouth. In order to minimize the chances of infection remember to utilize the oral mouth-rinse, take any prescribed antibiotic and resume brushing as directed.