Post-Op Instructions Following Bone Grafting
A bone graft is typically made up of many small particles of bone. You may occasionally discover some small granules of this bone in your mouth during the first several days after the procedure and as healing progresses. Do not be alarmed, as this is normal and to be expected. There are several things you can do to minimize dislodging a bone particle:
- Do not disturb or touch the wound.
- Avoid vigorous rinsing or spitting to allow stabilization of the blood clot and bone graft.
- Do not apply pressure with your tongue or fingers to the surgical site, as the bone graft material may move during the initial healing stage.
- Do not lift or pull on your lips to look at the sutures. This can cause damage to the wound site and tear the sutures free.
- Do not smoke. Smoking has been proven to increase the chance of bone graft failure.
If your bone graft procedure was performed in the sinus cavity:
- Do not blow your nose. If necessary just wipe, dab, or sniff until your return visit. Do not sneeze holding your mouth or nose closed. Sneeze with your mouth open.
- Use an over-the-counter decongestant (Dimetapp/Sudafed) as needed to reduce sinus and nasal congestion.
- Avoid anything that causes increased pressure in your nasal cavities, sinuses, or mouth such as playing a musical instrument, blowing up balloons, scuba diving, etc.
- Do not be alarmed if you experience bloody drainage or the discharge of a bone graft particle from your nose.
- Notify the office if you experience the unexpected flow of air or fluid between your mouth and nose.
A certain amount of bleeding is to be expected following a bone graft. Slight oozing or blood-tinged saliva is not uncommon for the first 12 to 24 hours. You may be asked to keep a gauze pad over the surgical site with firm biting pressure for one (1) hour. After this time, remove and discard the gauze pad. It does not need to be replaced unless bleeding continues or recurs. If bleeding continues, you may bite on a moistened tea bag in the same manner. Tannic acid in tea helps blood to clot. If bleeding does not subside, please call the office for further instructions.
Swelling is normally expected after most surgical procedures and is usually proportional to the extent of surgery performed. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal and healthy reaction to surgery. Most swelling will not become apparent until the day following surgery and will not reach its maximum until 48 to 72 hours post-operatively. However, swelling and discomfort may be minimized by the immediate use of ice packs. Ice packs should be applied to the outside of the face over the area where surgery was performed for the first 24 to 48 hours. Ice packs should be left on for 30 minutes and then left off for 30 minutes while awake. After 48 hours ice has no beneficial effect. Instead, the application of heat may be helpful in reducing the size of swelling more quickly. On occasion, some residual swelling may last a week or longer.
Take the prescribed pain medication before you begin to feel discomfort. This usually coincides with the start of the local anesthetic wearing off. Taking pain medication on an empty stomach may cause nausea, so it is recommended to take the pills with food or drink. Pain medication may make you groggy and slow down your reflexes. Do not drive an automobile or work around machinery while medicated. It is also best to avoid alcoholic beverages. Aspirin or other over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil/Motrin) may be used when appropriate.
Antibiotics may be prescribed for certain patients after bone grafting to help prevent infection. If you have been placed on an antibiotic, take the tablets or liquid as directed until gone. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction, and notify our office immediately.
It is best to wait until after the local anesthetic has completely worn off before beginning to eat. It’s understandable that your food intake will be limited for the first few days after your procedure. Start with plenty of fluids (juice, tea, water) during the first 24 hours. You may eat anything soft and cool the first day by chewing away form the graft site. Do not drink hot fluids or eat hot food the first day. Do not use straws as this may encourage more bleeding. Avoid hard, crunchy foods and foods with seeds that may harm the area. It’s best to progress to more solid foods and return to your normal diet as soon as possible.
Good oral hygiene is essential for good healing and to reduce the risk of infection. Our doctors may prescribe an antibiotic mouth rise (Peridex) to begin the night of surgery and continue as directed on the label. Begin warm salt-water rinses (1/2 teaspoon of salt in a glass of warm water) the day after surgery, and rinse four to five times a day, especially after meals. Rinse very gently to avoid disturbing the bone graft. Continue to brush your teeth as best you can – remembering to stay away from the surgical site.
You will most likely have sutures in the area of the bone graft. Our doctors will tell you if your sutures are dissolvable or if you will need to have them removed. Even if your sutures are dissolvable, a follow-up appointment seven to ten days after the procedure may still be scheduled to check your healing.
If you regularly exercise please be aware that your normal caloric intake may be reduced and you may be dehydrated after surgery. Exercise may further weaken you. It is best to avoid strenuous activity for two to three days following your procedure.
WEARING YOUR PROSTHESIS
Your removable dental prosthesis (partial denture, full denture, or flipper) should not be worn immediately after your bone graft unless specifically instructed otherwise. Your prosthesis may need to be properly adjusted at the time of your procedure so that it does not cause tissue irritation and interfere with the healing of your bone graft. Please check with our doctors about your personal needs concerning wearing your removable prosthesis.
Please notify the office if you have any of the following:
- Uncontrollable pain
- Excessive or severe bleeding
- Marked fever
- Excessive warm swelling occurring a few days after the procedure
- Reactions to medications, especially rash, itching or breathing problems