Immediately Following Surgery

  • Dr. Hill will place a gauze pad over the incision sites in your mouth. Keep it in place for 30 minutes after surgery or until it becomes saturated, whichever happens first. Bleeding will slow and eventually stop 12-24 hours after surgery. You may need to replace the gauze and bite with firm pressure for several 30-minute cycles before this happens. Once the bleeding has stopped, you may remove the gauze.
  • Avoid trauma to the wound area or vigorous mouthwashing for at least 24 hours following surgery. Dislodging the blood clot (a condition known as dry socket) may prolong bleeding and impair healing.
  • To help keep you comfortable during recovery, we recommend starting any prescribed pain medication before the numbing medicine wears off.
  • Try to rest on the day of your surgery. Take it easy and restrict physical activities. Get back to your normal physical activities only when you feel able.
  • Use ice packs on your cheeks for up to 48 hours after surgery. When possible, keep your head elevated, which will also help minimize swelling. After 48-72 hours, we recommend applying heat therapy on the cheeks with a gentle massage 3-4 times daily to help further reduce swelling and soreness.

Following surgery, some slight bleeding or red saliva is normal and may continue on and off for 12-24 hours. Chapel Hill Oral Surgery will provide you with gauze packs to help manage the bleeding. Fold the gauze in half three times and bite down firmly with pressure against the gauze until the bleeding stops or until the gauze is saturated with blood. Usually, you should change the folded gauze dressing every 30 minutes and expect to do 4 or 5 dressing changes. If bleeding increases, resume biting down firmly on the gauze until the bleeding stops.

The gauze pack provided by Dr. Hill includes Xemax, a brand of gauze that comes with strings. These special gauze packs can be easily retrieved from your mouth while you are sleepy by pulling on the string. Do not sleep with regular gauze in your mouth. You should also sleep at a 30-degree to 45-degree angle during the night of surgery to further minimize bleeding.

Following your surgery, you can expect swelling around the mouth, cheeks, and even underneath the eyes. This symptom is the body’s normal response to surgery. Usually, the swelling does not become evident until the first day after surgery and will reach its peak on day two or three. You can help control swelling by using ice packs on the outside of your face over the surgical sites (30 minutes on and 30 minutes off) while you are awake. After 36-48 hours, switch the ice out for moist heat (e.g., a warm compress) with gentle cheek massage 3-4 times per day to help the swelling subside over the next week.

Your jaw may become stiff following surgery, especially during the second and third days of recovery. Stiffness is a normal response to surgery. Once swelling decreases, you may begin daily mouth-opening exercises to regain normal functionality. You may require 3-4 weeks of mouth exercises before returning to normal.

Dr. Hill recommends using the Comfort Care Clock™ to manage your comfort following surgery. The Comfort Care Clock™ is meant to be used on the day of surgery and the first two days afterward. By the second day after surgery, you will start to taper off the Comfort Care Clock™. By your third day after surgery, you may not need the Comfort Care Clock™ anymore.

The Comfort Care Clock™ recommends alternating 600mg of Motrin with 500 mg of Tylenol. Alternate these two drugs every 3 hours. When you go to bed, take one dose of Motrin and one dose of Tylenol (regardless of which one you would be due for) and sleep through the night. If you are reading this as the parent or caregiver of a patient, please do not wake up the patient; let them sleep through the night. This approach still puts you below the maximum daily dose of both Motrin (3200mg max daily dose) and Tylenol (4000mg max daily dose). 

Chapel Hill Oral Surgery is proud to be a near-opioid-free practice, and we strive to prescribe opioids for emergency use only. During an emergency situation, Dr. Hill may prescribe narcotic pain medications for more severe pain. Narcotic pain medications can cause you to feel groggy, and they may also slow your reflexes. We recommend not driving, operating machinery, or drinking alcohol when taking narcotic pain medicines.  

Pain should decrease each day following your surgery. If discomfort persists or intensifies beyond 72 hours post-operatively, contact our office.

Antibiotics can help prevent infection, so take them as prescribed. Do not continue using antibiotics in case of a rash or other adverse reactions. Contact our office if you have any questions.

You will need to modify your diet for the first two days after your surgery. On the day of surgery, after coming off of anesthesia or IV sedation, you will want to resume your diet with liquids first. Drink from a glass and avoid using straws (the sucking motion from the straw may dislodge your blood clot and cause more bleeding). Once tolerating liquids, you can enjoy soft foods that are easy to clean out of your mouth. We recommend chewing away from the surgical site when possible.

Seek nourishment regularly, and drink lots of fluids to avoid dehydration. Over the first few days, your food intake may be lower, so compensate by drinking more liquids and protein or nutrition shakes for calories and protein. Aim for a minimum of five to six glasses of liquid daily.

If you feel able, you may return to light physical activities (like walking or housekeeping) 3-4 days after surgery. If you exercise regularly or play a sport, be aware that you may not be able to intake your regular food and liquid amounts, so you may need to ease back into those activities slowly. If you become lightheaded, avoid exercising for several more days to give your body more time to recover.

  • Physical Activity/Gym: Avoid strenuous activities like heavy lifting, running, or contact sports for at least the first few days (typically 3-7 days). These activities can increase blood pressure and dislodge the blood clot at the operative site. Discuss your specific workout routine with our team for personalized advice.
  • Wind Instruments: Avoid playing wind instruments for at least 7 days after surgery.
  • Heavy Weightlifting & Contact Sports: Avoid for at least 7-10 days.

Day of surgery: You may gently brush your teeth at night to keep your mouth as clean as possible. Be sure to power off your electric toothbrush when brushing near the surgical site.

Day after surgery: Starting the day after your surgery, do a 30 second warm salt water rinse followed immediately by a 30 second StellaLife rinse. Do this routine 3-5 times daily.

In addition to swelling, you may experience some slight discoloration or bruising of the skin. Any black, blue, green, or yellow discoloration may be caused by blood spreading beneath the tissues. This bruising is normal and may happen within two to three days of your procedure. A warm compress can help manage this discoloration, but it may take 1-2 weeks to resolve fully.

Nausea and vomiting can result from medication intake, stress from surgery, or dehydration. If you experience nausea or vomiting the day after your surgery, begin taking fluid and foods slowly. Try sipping on ginger ale, tea, or Coke. Sip slowly and take any anti-nausea medication prescribed by Dr. Hill. You can try eating solid foods and continuing your medications once the nausea subsides. Prescribed narcotic medication can worsen nausea, and we recommend having some solid food in your stomach before taking any narcotics.

Sutures will minimize bleeding and expedite your healing. They will stay in place and self-dissolve in 3-10 days but may dislodge during the first couple of days. Simply remove the dislodged suture from your mouth and discard it.

Other Complications

  • Following surgery, you may notice numbness of the lip, tongue, or chin, which is normal and should be temporary. However, the numbness may cause you to bite your tongue or lip accidentally, so be extra careful as you eat.
  • You may have a slight temperature increase after surgery. This is normal and can be managed with Tylenol or Ibuprofen.
  • Be careful moving from a lying down position to standing. You will likely feel weak and a bit dizzy. To avoid lightheadedness, you should sit for one minute before you stand up.
  • After surgery, the lips and corners of your mouth might be dry and cracked. Use ointments such as Vaseline to keep your lips moist.
  • It is common to experience a sore throat, especially when swallowing. This symptom results from swelling in the throat muscles and should subside within a couple of days.
  • Stiffness in the jaw muscles may cause difficulty opening your mouth for a few weeks after surgery. This stiffness is normal and will resolve on its own. Applying a warm washcloth or heating pad to the cheeks and performing mouth-opening exercises can help facilitate your recovery.