Bone Grafting After Care
Your bone graft is typically particulate bone and its consistency is near that of course sand. As a result, you may find some small granules in your mouth for the first several days. Do not be alarmed. It is normal to have some of these granules periodically come out of the graft site and into your mouth. However, you can do some things to mitigate this occurrence.
- Do not apply pressure with your tongue or fingers to the grafted area as the material is moveable during the initial healing.
- Do not lift or pull on your lip to look at the sutures. This can damage the wound, dislodge the membrane and possible tear the sutures.
- Do not disturb or touch the wound.
- Do not smoke for at least two weeks.
- Avoid rinsing or spitting for 2 days to allow proper blood clot and graft material stabilization.
Following the second day, you may gently rinse, but not vigorously, so not to disturb the bone graft granules. Please follow our instructions if you are wearing a full or partial denture.
Antibiotics
Please take all prescribed antibiotics as directed to help prevent infection.
Smoking
Do not smoke for at least two weeks after surgery, if at all. Smoking dramatically increases the risk of bone graft failure. If you feel it necessary, we can prescribe a Nicoderm patch.
Oral Hygiene
- Remember: A clean wound heals better and faster!
Wearing Your Prosthesis or Night Guard
Bleeding
- If bleeding does not subside, please call for further instructions.
Swelling
Swelling is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and will subside on its own. However, swelling is usually not apparent until the day following surgery and will not reach its maximum until two to three days postoperatively. The swelling may be minimized by the immediate use of ice packs applied to the areas of the face where surgery was performed. The ice packs should be left on for 20 minutes and then taken off for 20 minutes for the first 12-24 hours. After the first 36 hours, ice has no beneficial effect. If swelling or jaw stiffness persists for several days there is no cause for alarm, as this is a normal reaction to surgery. 36 hours after surgery, the application of moist heat to the sides of the face is beneficial in reducing swelling.
Pain
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours. Two to four Ibuprofen (Motrin or Advil) 200mg tablets (400-800 mg) may be taken every six hours. For severe pain, take the medication prescribed as directed (typically narcotic medication). The prescribed narcotic pain medication will make you groggy and slow down your reflexes, so you should not drive a motorized vehicle or work around machinery. Additionally, avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day.
- If pain persists it may require attention and you should call the office. Do not take any of the above medication if you are allergic or have been instructed not to do so by your physician.
Diet
Do not use a straw for the first 24 hours – instead, drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical site. A high calorie, high protein diet is very important – nourish your body regularly. You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days, and in turn you should compensate by increasing your fluid intake. Try drinking at least five to six glasses of fluid, and do your best to not miss meals. You will feel better, have more strength, feel less discomfort and heal more quickly if you continue to eat.
Discoloration and Bruising
In some cases, bruising, or discoloration of the skin, follows swelling. The development of black, blue, green or yellow discoloration is due to blood spreading beneath the tissues. This is rare but may occur postoperatively. Applying moist heat to the area may speed up the removal of the discoloration.
Other Complications
- If numbness of the lip, chin or tongue occurs, there is no cause for alarm, as this is usually temporary in nature. However, you need to be aware of the numbness as you could bite your lip or tongue and not feel the sensation. Please be careful and call with any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. Tylenol or Ibuprofen should be taken to reduce the fever. If your fever persists notify our office.
- Be cognizant of lightheadedness. The procedure, lack of fluids and medications can make you dizzy. Sit for a few moments before standing up.
- Due to stretching during the procedure, the corners of your mouth may dry out and crack. Lips can be kept moist with vaseline or another lip balm.
- Occasionally, a sore throat and painful swallowing can occur due to muscle inflammation. This usually subsides in 2-3 days.
- Stiffness of the jaw may cause difficulty in opening your mouth for a few days after surgery. This is normal and usually resolves itself in several days.
Sutures
Sutures are placed in the surgical area to minimize postoperative bleeding and to help healing. Dissolvable sutures typically fall out in five to seven days while non dissolvable sutures will require a return visit for removal one to two weeks post surgery. Sometimes the sutures become dislodged, but this is not a cause for alarm – simply remove the suture from your mouth and discard.
Exercise
Use common sense. If you exercise regularly and get lightheaded, reduce your exertion or stop. Do not assume upside-down positions for one to two weeks.
