After Bone Grafting Surgery
The following information applies when grafting material has been placed into extraction sites to help preserve your jawbone in preparation for possible implant replacement of the extracted tooth.
Your bone graft is made up of many particles. You may find some small granules in your mouth for the first several days. Do not be alarmed by these. It’s normal to have some of them come out of the graft site and into your mouth. There are some things you could do to minimize the amount of particles that become dislodged:
- Do not disturb or touch the wound.
- Avoid rinsing or spitting for 2 days to allow blood clot and graft material stabilization.
- Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing.
- Do not lift or pull on the lip to look at the sutures. This can actually cause damage to the wound site and tear the sutures.
- Do not smoke.
PRESCRIPTION MEDICATIONS: It is essential that you get something soft and cold to eat or drink immediately after the surgery. Start the pain medication AFTER you get something to eat or drink but BEFORE the pain sets in. Start your next dose of antibiotics a couple hours after you start taking the pain medication.
For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed.
EATING: Drink plenty of fluids. Soft cold foods are best for the first 72 hours following surgery. However, do not eat any foods with small seeds, for example popcorn, nuts or berries. Make sure to AVOID ANY BITING ON THE SIDE OF THE GRAFT(s). Avoid chewing on that side for as long as possible. Avoid using any straws for a few weeks following the procedure.
GAUZE PACKS: You will have gauze in your mouth following surgery. Take the gauze out when you eat and replace with new gauze after. The gauze will help control the bleeding after the surgery. Apply firm pressure by biting down on the gauze. Place a couple pieces of the gauze folded up on the surgical site and bite down on it. Keep an eye on the gauze and replace when it becomes dark, red and saturated. It is normal to experience some bleeding following surgery throughout the first 24 hours after surgery, however there should be a trend that it will taper down. If bleeding continues after that, contact our office. Be sure to have the gauze removed before you go to sleep for the night.
MOIST HEAT: Apply warm moist heat to the OUTSIDE cheek area where the Graft(s) were placed. This will help provide better blood supply to the surgical site. Use a warm, damp cloth and continue to heat in the microwave or use a heating pad with a moist cloth over that.
SWELLING: It is normal following surgery for swelling to occur. It takes about 3 days for surgical swelling to peak. After 3 days the swelling should slowly decrease. Remember the use of warm moist heat will promote more swelling than average but will help with the implant area. Swelling that increases after the fourth day of surgery should immediately be brought to the attention of our office.
RINSING: Following the second day, very gentle rinsing would be allowed but not too vigorously as you can again disturb some of the bone graft granules.
BE SURE TO DO GENTLE RINSING SO THE BONE GRAFTING ISN’T DISTURED.
Warm Salt Water: Very gentle warm salt water rinsing is important to start the day after surgery. Mix just a little bit of warm water and some table salt to rinse around in your mouth for 30 seconds to 1 minute and then spit out. Do this as frequently as you can throughout the day (10-20 times a day if you can). Make sure to rinse after any meals or snacks throughout the day. The more rinsing you do, the cleaner the areas will be and help with the healing.
Peridex Rinse: We have prescribed you an antibiotic rinse to start using prior to surgery. Continue using again 1 day after surgery, using twice a day (once after lunch time and once right before bed). Try to use this rinse right before bed to ensure it stays on the tissue. Do not eat or drink anything 2 hours after you use the rinse.
After you return for your post-op appointment and are given further instructions, you still need to continue using the Peridex rinse however, you don’t need to fully rinse with it. Just apply some on a q-tip and dab around the graft area. Continue doing this around the graft area(s)
TOOTH BRUSHING: You may brush your teeth, but avoid the surgical areas until you return for a follow up appointment in the office. After that, you should GENTLY brush on the surgical areas to help with the healing and keeping the areas clean, but do so very softly to not disrupt the bone graft.
SMOKING: Smoking should be avoided after having grafting surgery to help insure the success of the graft.
SUTURES: A variety of sutures may have been used as a part of your treatment. These sutures will either dissolve on their own or be removed at the appropriate post-operative appointment. The sutures that need to be removed are usually done at the 2nd or 3rd post-operative appointment.
Keep physical activity to a minimum following surgery. If you are considering exercise, throbbing or bleeding may occur. If it does, discontinue exercise. Be sure to get plenty of nutrition including being properly hydrated.
If a partial denture or a flipper was placed in your mouth, you may have to see your restorative dentist to have it adjusted and learn how to remove and replace it appropriately.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. Please try to call during office hours; however a 24-hour answering service is available for after hours contact with a doctor. The after hours telephone number is (253) 770-1000.