After Bone Grafting Procedure

DO NOT:

• DO NOT rinse, spit, or brush teeth for 24 hours after surgery
• DO NOT smoke for 48 hours after surgery
• DO NOT drink alcohol for 48 hours after surgery
• DO NOT eat or drink hot temperature food for 24 hours
• DO NOT eat  spicy, or acidic foods for seven days after surgery
• DO NOT exercise vigorously for 3 – 4  days after surgery
• If there is no bleeding you DO NOT need to apply the gauze.
• DO NOT probe the surgical site with your tongue, any objects, or your fingers

BLEEDING: 

• Bite with continuous pressure over the site with a moist folded gauze until gauze becomes saturated.
• Change gauze every hour until bleeding stops.
• Remember, it is common to have slight oozing for the first day after surgery. Pressure from biting on gauze almost always helps.
• PLACING GAUZE: During the day if you are awake and alert use the 2x2’s provided for you. Dampen and fold into quarters and place at the surgical site(s), with the excess placed toward the cheek. When sleeping during the day replace the 2x2’s with the 4x4’s, dampening and folding one end and allowing the excess to hang out of your mouth to prevent accidental swallowing of the gauze. Never sleep overnight with the gauze in your mouth.
• Discontinue the gauze after bleeding has stopped.
• You may have sutures placed. If you do, they are dissolvable and should dissolve on their own in approximately 7-10 days. 

DISCOMFORT:

• The local anesthesia (numbing medicine) administered during your surgery normally has a 4 - 6 hour duration for the upper surgery sites, and can last up to 12 hours for the lower sites.  It may be difficult to control the discomfort once the anesthetic wears off. Therefore supplemental medication for relief of discomfort is usually necessary. 
• Take the prescribed antibiotic pills as directed.  The directions will be printed on the bottle.  It is extremely important to make sure you finish the whole prescription. Discontinue antibiotics if a rash develops or if an upset stomach persists.  Report this immediately. 

SWELLING & BRUISING:

• It is extremely important to apply ice packs 30 minutes on and 30 minutes off the cheeks, until bedtime, to decrease the inflammation and minimize swelling. We recommend a zip lock bag of crushed ice or a bag of frozen peas.
• Following your bone grafting, you will need to keep the pressure dressing in place for the first 24 hours.   Sleep with your head elevated with pillows for two days following surgery.  This will help reduce swelling and the appearance of bruises.
• Remember, swelling and bruising is very common after surgery. It will reach its maximum at 72 hours post–surgery and will gradually resolve over the week.  Everyone heals at a different rate.  Some will swell more or less than others.
• Keep lips moist with cream or Vaseline to prevent cracking or chapping.

DIET:

• If you have had general anesthesia please refer to the general anesthesia sheet for more details.
• We recommend cold foods (such as Shakes/Pudding/Ice cream/Jello) for the first 24 hours after surgery.
• After your surgery, maintain a soft diet, such as soup, scrambled eggs, mashed potatoes, soft chicken or fish. At your continued care appointment we will give you further instructions. 
• It is imperative that you do not bite down on anything near your surgical site, as this will cause the tissue to breakdown and result failure of the bone graft.
• Avoid crunchy and chewy foods, like popcorn, nuts, sunflower seeds, rice, or taffy. As it may take 4-6 weeks for the area to completely heal.
• If you are a diabetic, maintain your normal diet as much as possible and follow your doctor’s instructions regarding your insulin schedule.

ORAL HYGIENE AND CARE:

• Brush your teeth gently, carefully avoiding the surgical sites, beginning the day after surgery.
• Start rinsing your mouth with salt-water rinses (1 tsp salt in one quart of water) after every meal beginning the day after surgery.
• It is extremely important to keep your mouth clean, beginning the 2nd day after surgery, and continuing for one week, since an accumulation of food or debris may promote inflammation/infection.

* You may wear your temporary prosthesis after the proper adjustments have been made by Dr. Alijanian.

If you have any questions about your recovery or the above recommendations, please call our office at (925) 934-7888.  During business hours, a member of our team will be happy to assist you.  If this is a life threatening emergency, please contact 911.  After hours, you may call our number and press 9 and leave a detailed message with a call back number and Dr. Alijanian will be paged and  return your call as soon as possible.

We are committed to making your surgical experience a comfortable one.