After Surgery Care

Dentoalveolar Procedures

This information is designed to help you understand what to expect after your dentoalveolar surgery (including wisdom tooth surgery) and how to care for yourself during the recovery period. Following these instructions will help minimise discomfort and promote healing.

Expected Recovery:

  • Initial 24 Hours:

    • Some bleeding is normal. You will likely be provided with gauze to bite on.

    • Swelling and discomfort are expected.

    • You may experience some numbness from the anaesthetic.

  • 2-3 Days:

    • Swelling typically peaks during this period.

    • Bruising may become visible.

    • Discomfort can be managed with prescribed or over-the-counter pain medication.

  • 1 Week:

    • Swelling and bruising should begin to subside.

    • You should be able to gradually return to a normal diet.

    • Some residual soreness may persist.

  • Several Weeks/Months:

    • Complete healing of the gums can take several weeks.

    • The bony socket where the tooth was removed will continue to fill in over several months.

Aftercare Instructions:

  • Bleeding:

    • Bite gently on the provided gauze for the recommended time.

    • If bleeding persists, replace the gauze and apply firm pressure.

    • Avoid spitting or rinsing vigorously.

  • Swelling:

    • Apply ice packs to the outside of your face for 20 minutes on, 20 minutes off, for the first 24-48 hours.

    • A bag of frozen peas wrapped in a towel works well.

  • Pain Management:

    • Take pain medication as prescribed by your surgeon.

    • Over-the-counter pain relievers, such as paracetamol or ibuprofen, may also be used. (Avoid Aspirin)

  • Oral Hygiene:

    • Avoid rinsing for the first 24 hours.

    • After 24 hours, gently rinse with warm salt water several times a day, especially after meals.

    • Brush your teeth carefully, avoiding the surgical site in the initial days.

  • Diet:

    • Eat soft foods for the first few days, such as soup, yoghurt, mashed potatoes, and smoothies.

    • Avoid hot, spicy, or hard foods that could irritate the surgical site.

    • Avoid using straws.

  • Rest:

    • Get plenty of rest for the first few days.

    • Avoid strenuous activity.

    • keep your head elevated with extra pillows when resting.

  • Smoking and Alcohol:

    • Avoid smoking and alcohol for at least 72 hours, as they can impede healing.

When to Contact Your Surgeon:

  • Excessive bleeding that does not stop with pressure.

  • Severe pain that is not relieved by medication.

  • Signs of infection, such as increased swelling, redness, fever, or pus.

  • Numbness that persists beyond the expected time.

  • Any concerns that you may have.

If you have any concerns, please contact your surgeon.

Sinus Precautions

This information explains sinus precautions following dentoalveolar surgery. These precautions are crucial to prevent complications involving your sinuses and ensure proper healing.

When are Sinus Precautions Necessary?

Sinus precautions are necessary when:

  • There is a known oroantral communication (OAC).

  • An oroantral communication (OAC) is suspected.

  • Following a repair of an oroantral communication (OAC).

What Do Sinus Precautions Involve?

The goal of sinus precautions is to minimise pressure and disruption to the sinus area. Here's what you need to do:

  • Avoid Blowing Your Nose: Do not blow your nose for at least one week, or as directed by your surgeon. Sneeze with your mouth open.

  • Avoid Creating Sinus Pressure: Do not use straws, play wind instruments, or engage in activities that create pressure in your sinuses. Avoid heavy lifting or straining.

  • Nasal Hygiene: Use prescribed nasal decongestants and saline nasal spray as directed.

  • Medication: Follow your surgeon's instructions regarding prescribed medications.

  • Diet: Eat soft foods, avoiding very hot foods.

When to Contact Your Surgeon:

Contact your surgeon immediately if you experience:

  • Increased sinus pain or pressure

  • Discoloured nasal discharge

  • Persistent bleeding

  • Signs of infection

Jaw Surgery

This information outlines the aftercare procedures and expected recovery following your jaw surgery. Following these guidelines will help ensure optimal healing and minimise complications.

Hospital Stay:

  • For a single jaw operation, you will typically stay in hospital for one night.

  • For a double jaw operation, a two-night hospital stay is usually required.

  • In some simpler procedures, such as maxillary expansion (upper jaw widening surgery), you may be discharged on the same day.

Diet:

  • You will be on a strict non-chew diet for up to six weeks following surgery. This will allow your jaw to heal properly. Your surgeon and/or a dietician will provide instructions on appropriate foods and nutritional intake.

Recovery and Healing:

  • Plates and screws have been used to secure your jaw in its new position. These are placeholders. Your body will need to fuse the bones together, which takes 6-12 weeks. During this period, the strength in your bones will gradually return.

  • It is crucial to avoid any activities that could cause trauma to your jaw during this healing phase.

  • Caution with contact sports is required for 3 months.

Follow-up Appointments:

  • You will need to attend regular follow-up appointments with both your surgeon and orthodontist every 1-2 weeks for at least the first six weeks after surgery. These appointments are essential to monitor your healing progress and make any necessary adjustments.

Time Off Work/School:

  • You will need to take up to two weeks off work or school to allow for initial recovery.

TMJ Surgery

This section outlines essential aftercare instructions following your Temporomandibular Joint (TMJ) surgery. Please adhere to these guidelines to ensure optimal healing and recovery.

Hospital Stay:

  • TMJ Arthrocentesis/Arthroscopy: Typically, these procedures are performed as day surgery, meaning you will be discharged on the same day.

  • TMJ Arthroplasty: An overnight hospital stay is usually required to monitor your initial recovery.

  • TMJ Replacement: This more extensive surgery generally necessitates a hospital stay of 3-4 nights.

Diet:

  • Following your surgery, a soft diet is crucial for approximately one week. This minimizes stress on the healing joint. Examples of suitable foods include:

    • Smooth soups

    • Mashed potatoes

    • Yoghurt

    • Pureed fruits and vegetables

    • Scrambled eggs

  • It is important to commence physiotherapy as soon as possible after your surgery. You should mobilise the jaw as much as possible, as directed by your physiotherapist, without causing excessive pain.

Follow-Up Care:

  • TMJ Arthrocentesis and Arthroscopy:

    • Successful recovery relies heavily on consistent non-surgical management. Therefore, diligent follow-up appointments with your oral medicine specialist, physiotherapist, and other allied health professionals are paramount.

    • The surgical procedure serves to facilitate the effectiveness of these ongoing therapies.

    • It is very important to continue your non surgical management as that is the most important part to the road to recovery, the surgery only helps these other things do their work.

  • TMJ Replacement:

    • Post-operative care following a TMJ replacement is primarily managed by your surgical team.

    • However, your physiotherapist and oral medicine specialist will play a vital role in your rehabilitation and long-term care.

Time Off School/Work:

  • TMJ Arthrocentesis and Arthroscopy:

    • You should anticipate needing 2-3 days off from school or work.

  • TMJ Replacement:

    • A more extended recovery period is necessary, typically requiring 2-4 weeks off from school or work.

General Post-Operative Instructions:

  • Follow your surgeon's specific instructions regarding pain management, wound care, and any prescribed medications.

  • Apply cold compresses to the affected area as directed to reduce swelling.

  • Maintain good oral hygiene.

  • Avoid strenuous activities and excessive jaw movements during the initial healing phase.

  • Attend all follow up appointments.

  • Contact your surgical team if you experience any concerning symptoms, such as increased pain, excessive swelling, fever, or signs of infection.

Medications

You will likely be prescribed several medications to aid in your recovery and prevent complications. These may include:

  • Antibiotic:

    • A common antibiotic prescribed is amoxycillin 500mg.

    • Take one tablet three times a day, with food, as directed by your surgeon.

  • Analgesics (Pain Killers):

    • We strongly recommend taking regular paracetamol (two 500mg tablets) and ibuprofen (one to two 200mg tablets) every six hours.

    • To maximise their effectiveness, space the doses three hours apart (e.g., paracetamol, then three hours later, ibuprofen).

    • Your surgeon may prescribe stronger pain medication for certain procedures. This should be taken in addition to, not as a replacement for, the regular paracetamol and ibuprofen regimen.

  • Antibacterial Mouthwash:

    • An antibacterial mouthwash, such as chlorhexidine (available over the counter as alcohol-free Savacol), will be recommended.

    • Use as directed by your surgeon.

It is crucial to follow your surgeon's instructions regarding medication dosages and frequency. If you have any questions or concerns about your medications, please contact our office.

Diet

Proper nutrition is essential for healing after oral surgery. Initially, you'll need to follow a soft or liquid diet, gradually transitioning to more solid foods as your comfort and healing progress. Your surgeon and/or a dietician will provide specific dietary instructions.

Suitable Foods:

  • Liquids: Smoothies (without seeds or chunks), broths (strained), yogurt (smooth, no chunks), apple sauce (smooth), clear juices (no pulp).

  • Soft Foods: Mashed potatoes, scrambled eggs, well-cooked, mashed vegetables (carrots, sweet potatoes), pureed soups, soft cooked pasta, soft ripe fruit, tofu (mashed or blended).

Foods to Avoid:

  • Hard or Crunchy Foods: Nuts, chips, popcorn, raw vegetables, hard breads or crusts.

  • Spicy or Acidic Foods: Hot peppers, citrus fruits (initially), tomato-based sauces (highly acidic).

  • Foods with Small Seeds or Grains: Sesame seeds, poppy seeds, rice (initially).

  • Sticky or Chewy Foods: Caramel, chewing gum, steak or other tough meats.

Important Considerations:

  • Maintain adequate hydration by drinking plenty of fluids.

  • Eat small, frequent meals to ensure you receive sufficient nutrients.

  • Avoid using straws, as the suction can disrupt healing.

  • Follow any specific instructions given to you by your surgeon or dietician.