Introduction: Post Operative Care
In majority of cases, surgery to the mouth, jaw and face heals quickly and with few side effects. Individuals respond after surgery differently and knowing what to expect after surgery and how to identify and take care of these side effects have been outlined. As the surgery involves the mouth, jaws and face, it is involved in function immediately after the surgery and this can cause discomfort during the healing period. You should endeavour to keep your mouth clean with frequent oral rinses and use of a small soft toothbrush, avoiding the surgical site or extraction socket. Smoking increases your chance of having an infection as well as “poking” the wound area with your fingers or objects. After surgery, often you will have a numb lip from the local anaesthetic, please avoid hot food and drinks to prevent injury to the lips, cheeks and tongue.
Are You Experiencing The Following Warnings?
Swelling is normal after surgery. Maximum swelling occurs around 24 to 48 hours after surgery and generally subsides rapidly afterwards. The more complex the surgery the greater the swelling. Due to the swelling you may have difficulty in closing your mouth in the first few days. To reduce the amount of swelling, ice packs should be used straight after the surgery. Ice packs should be used for the next 1- 3 days, apply intermittently 15 min on and 15 min off. Ice packs are available at pharmacies. Ice cubes held in the mouth can also be used to reduce the swelling.
This is dependent on the complexity of the surgery. This discomfort is the worse during the first 2 to 4 days after surgery and then should gradually subside. Long acting local anaesthetic is used at the time of surgery to make you comfortable immediately afterwards. Strong painkillers are prescribed for you. You should take them as soon as you get home before the local anaesthetic wears off. For most people over the counter painkillers would be sufficient. Your surgeon may prescribe a stronger painkiller if you need it. Make sure you take these tablets with some substantial food in your stomach. The need for pain killers usually stops about 7 to 10 days after surgery. If you develop a rash, nausea or vomiting, or if your pain increases after 48 hours, please contact your surgeon for further advice.
Although rare, hemorrhage may occur. This may be caused by too much exertion or by vomiting. More commonly, a slight pink ooze results from the wound site. This just enough to pink your saliva. If there’s continued bleeding after surgery then you should take the following steps:
- RINSE out any existing blood clots with salt water or mouthwash.
- APPLY a piece of gauze over the wound or a small folded handkerchief over the wound and applying pressure by biting gently on the gauze for 30 minutes.
- SIT STILL and maintain this pressure for 30 minutes. Keep your head elevated with at least 2 pillows when lying down, this decreases the blood rushing to your facial area.
- AVOID exercising for at least 2- 3 days after surgery.
- AVOID hot foods/ drinks in the next 2 days as it may make the wound prone to bleed.
If the above methods do not stop the bleeding, you should contact your surgeon immediately for further advice.
Wound Care
Do not brush the area near the wound for 3-5 days. Use a chlorhexidine based mouthwash (Savacol or Curasept are available from pharmacies and supermarkets), after meals to keep the wound clean. The rinse should be diluted 1:1 with water. Alternatively, salt water rinses (1 teaspoon in warm water) can also be used. The stitches will start to dissolve 7 to 10 days following surgery. The stitches should be totally dissolved after 2 weeks. Sometimes, your surgeon may use non dissolving stitches to keep the wound tight. This will be removed on your follow up visit.
Infection
An infection in the gum or bone is usually treated with antibiotics. If a course of antibiotics is prescribed for you, take the complete course. Please tell your surgeon if you are allergic or had any adverse reaction to any antibiotics. All surgery has a risk of infection, especially in patients with diabetes. Antibiotics are often prescribed at the time of surgery to prevent infection. If infection does occur after surgery, the symptoms appear with increased pain, swelling, raised temperature and a bad taste in the mouth. Rarely, the wound site may need to be re-opened, cleaned and restitched. If infection occurs, it can make things worse by spreading to adjacent areas or make the wound healing difficult. Please call your surgeon immediately for further advice and management.
