After Surgery Care
Dentoalveolar Procedures
Proper care following oral surgery is essential to reduce the risk of infection and ensure a smooth recovery. Please follow these guidelines closely.
Immediate Recovery (First 24 Hours)
Bleeding: Bite firmly on the provided gauze pack for 30 minutes to stop bleeding. If bleeding persists, replace with a fresh pack.
Clot Protection: Do not rinse your mouth, spit forcefully, or use a straw for the first 24 hours. This protects the blood clot, which is vital for healing and preventing "dry socket."
Numbness: Local anaesthetic will last for several hours. Take your first dose of pain medication before the numbness wears off. Be careful not to bite your lip or tongue.
Swelling & Bruising
Expectation: Swelling is common, particularly for impacted wisdom teeth, and typically peaks 2–3 days after surgery.
Management: Apply ice packs to the cheek (20 minutes on, 20 minutes off) for the first 48 hours to minimise swelling.
Diet & Nutrition
First 24 Hours: Stick to cool, soft foods (e.g., yoghurt, ice cream, smoothies). Avoid hot foods and drinks while your mouth is numb.
Days 2–7: Gradually introduce soft foods (e.g., pasta, eggs, mashed potato). Chew away from the surgical site.
Avoid: Hard, crunchy, or spicy foods, and seeds/grains that could get trapped in the socket.
Oral Hygiene
First 24 Hours: Do not rinse or brush near the extraction site.
After 24 Hours:
Salt Water Rinses: Gently rinse with warm salt water (1 teaspoon of salt in a cup of warm water) 4 times a day, especially after meals.
Brushing: Brush your teeth gently, but avoid the surgical site for the first few days.
Implant Care: If you had an implant, avoid applying pressure to the implant site with your tongue or fingers.
Activity & Lifestyle
Rest: Rest for the remainder of the surgery day. Avoid strenuous exercise or heavy lifting for 3–5 days, as elevated heart rate can cause bleeding to restart.
Smoking & Alcohol: Strictly avoid smoking and alcohol for at least 3 days (preferably longer). Smoking significantly increases the risk of infection and dry socket.
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
Recovery from orthognathic surgery is a gradual process requiring patience. While the initial phase involves some discomfort, adherence to these guidelines is crucial for a smooth recovery and optimal results.
Hospital Stay & Immediate Recovery
Duration: Expect to stay in the hospital for a 1–3 days. Day stay for a surgically assisted maxillary expansion
Swelling: Facial swelling is normal and typically peaks 3–4 days after surgery before gradually subsiding.
Numbness: Temporary numbness in the lips, chin, and cheeks is common as nerves recover.
Elastics: Small rubber bands may be placed to guide your bite into its new position. Do not remove these unless specifically instructed.
Diet & Nutrition
Your jaw needs time to heal without the pressure of chewing.
Weeks 1–6 (Non-Chew Diet): You must adhere to a strict liquid or pureed diet (e.g., soups, smoothies, yoghurt). Ensure you maintain high calorie and protein intake to aid healing.
After Week 6: You may gradually introduce soft foods (e.g., scrambled eggs, soft pasta) as advised by your surgeon.
Hydration: Drink plenty of fluids to prevent dehydration.
Oral Hygiene
Keeping your mouth clean is vital to prevent infection.
Brushing: Use a soft baby toothbrush to gently clean your teeth, avoiding the surgical sites and gums initially.
Rinsing: Use warm salt water mouthwashes or the prescribed antiseptic rinse several times a day, especially after eating.
Activity & Lifestyle
Rest: Plan to take 2–3 weeks off work or school/university.
Physical Activity: Avoid strenuous exercise and heavy lifting for 4–6 weeks.
Contact Sports: strictly avoid contact sports for at least 3 months to prevent jaw injury.
Smoking: distinct prohibition on smoking as it severely compromises bone healing and increases infection risk.
Follow-Up
We will schedule regular appointments to monitor your healing, remove sutures (if necessary), and adjust elastics. Full bony healing takes approximately 6–8 weeks, though residual swelling and numbness may take several months to fully resolve.
TMJ Surgery
Hospital Stay & Immediate Recovery
TMJ Arthrocentesis (Joint Washout): Typically a day procedure. You will return home once the anaesthetic wears off.
Arthroplasty & Alloplastic Replacement: Expect a hospital stay of 1–3 nights for monitoring and initial pain management.
Swelling:
Arthrocentesis: Mild swelling for 24–48 hours. Ice packs applied for 20 minutes on/off will help.
Open Surgery (Arthroplasty/Replacement): Significant swelling is normal, peaking at day 3–4.
Nerve Function: For open surgeries, temporary weakness in the forehead or eye closure (facial nerve) or numbness in the earlobe is possible but usually resolves with time.
Diet & Nutrition
Resting the jaw is critical to allow inflammation to subside and the joint to heal.
Arthrocentesis: Soft diet (pasta, eggs, fish) for 2–5 days, then gradual return to normal.
Arthroplasty & Replacement:
Weeks 1–6 (Non-Chew Diet): Strict liquid or pureed diet. Do not chew.
After Week 6: Gradual introduction of soft foods as advised.
Long-term: Patients with total joint replacements may need to permanently avoid very hard or chewy foods (e.g., steak, toffee).
Physiotherapy & Jaw Exercises
Unlike some jaw surgeries where the jaw is immobilised, TMJ surgery often requires early movement to prevent stiffness (ankylosis), especially for joint replacements.
Exercises: You will be prescribed specific jaw opening and excursion exercises. Perform these strictly as directed to maintain mouth opening.
Therabite/Motion Devices: If prescribed a mechanical motion device, use it exactly as per the protocol provided by your surgeon.
Activity & Lifestyle
Rest:
Arthrocentesis: 1–2 days off work.
Open Surgery: 2–3 weeks off work/study.
Physical Activity: Avoid heavy lifting and strenuous exercise for 4–6 weeks for open surgery cases.
Ice & Heat: Ice is beneficial for the first 48 hours to reduce swelling. After this, moist heat packs can help relax muscles and aid movement.
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.