The following information applies when bone grafting material has been placed into extraction sites to help preserve your jawbone in preparation for future implant replacement.

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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:

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• Do not disturb or touch the wound.

• Avoid vigorous rinsing or spitting for 7 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 period.

• 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, use through a straw, or split for at least 48 hours.

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Bleeding

Some bleeding or redness in the saliva is normal. In order to decrease bleeding and form the necessary blood clot for healing, please bite on (do not chew) the provided gauze for approximately 30 minutes.  Repeat as necessary. Additional gauze is provided in the instance the initial gauze becomes saturated.  To place a new gauze dressing, fold it in half then half again, place it over the surgical site and bite down with firm pressure.  A small amount of blood may ooze overnight - do not sleep with gauze packings.  

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Swelling

Swelling is a normal after surgery. Swelling peaks in 48–72 hours and then gradually decreases.  To minimize swelling, apply ice packs to the area of surgery, 20 minutes on and 20 minutes off, for the first 24-36 hours.  After 36 hours ice is ineffective. 

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Discomfort

Some discomfort after surgery can be expected.  You should begin taking pain medication prior to the local anesthetic wearing off.  For moderate discomfort, 2-3 Advil (400-600mg Ibuprofen), may be taken every 5-6 hours.  For greater discomfort, the prescription medication can be taken as directed.   Do not take any of the above medication if you have an allergy to it.  Do not drive, operate machinery, or drink alcohol if taking prescription pain medication.

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Diet

Drink plenty of fluids. Do not drink anything hot for the first day. This tends to dissolve the blood clot and burn the anesthetized tissue. Please eat a normal healthy diet but avoid hard foods such as popcorn and nacho chips.  Soft foods and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

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Oral Hygiene

Good oral hygiene is essential to good healing. The night of surgery, you may gently rinse with warm salt water (1/2 teaspoon salt in 8 oz. water) 8 hours after surgery. Continue the rinses 4-5 times a day for the first few days.  The day after surgery, the prescription mouth rinse (if prescribed) should be used twice daily, after breakfast and before bed. Be sure to gently rinse for at least 30 seconds then let it roll out of your mouth. Do not swallow or spit vigorously.  You may also gently brush your teeth being extra careful around the surgical site.

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Discoloration / Bruising

In some cases, discoloration of the skin follows swelling. The development of yellow, green, or blue discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively.

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Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed.  Antibiotics will be given to help prevent infection.  Call the office if you have any questions.

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Activity

Please rest and engage in minimal activity for the first 2-3 days.  Starting the third postoperative day, you may begin resuming normal activity.

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If you have any questions regarding these instructions please ask Dr. Silva or one of our staff.  If any questions arise after leaving our office do not hesitate to call our office at (831) 649 - 1388