Post-Operative Instructions:
Bone Grafting

Patients who have undergone IV anesthesia should be carefully monitored by a responsible family member or friend for the first 6 hours after leaving our office. The patient cannot drive for 24 hours or while taking prescribed narcotic pain medication.

PAIN: A certain amount of discomfort is to be expected with any surgical procedure. This varies with the amount of surgery required. Discomfort is usually well-controlled by the prescribed medications. Make sure to eat before taking any narcotic pain medication to prevent nausea, the most common side effect. Take all prescribed pain medication as directed by Dr. McPhillips.

Do not pull on the cheek or lip to inspect the surgery site. Do not probe the surgery site with your fingers or tongue. This can pull the incision open and cause loss of the graft. It will also cause discomfort.

BLEEDING: Bleeding follows any surgical procedure and should not alarm you unless it is excessive or persistent. To control bleeding, we will place a gauze dressing over the surgical site(s) and have the patient apply firm pressure. This pressure will stop the bleeding.

• The gauze will need to be changed every hour for the first few hours after surgery while it is bleeding. It will be important to ensure the gauze is directly over the surgical site and the patient has firm biting pressure applied.
• If the bleeding is brisk, place a tea bag under cold water and remove excess water. Place the tea bag over the extraction site and have the patient bite down on the tea bag for 30 minutes. The tannins in the tea will help stop bleeding quicker.
• Remove the gauze or tea bags when eating or drinking to avoid choking.
• Make sure to remove all gauze and tea bags from the mouth before taking naps or going to bed.
• Once bleeding has stopped, remove all gauze and tea bags from the mouth. This will minimize the risk of choking.

ORAL HYGIENE: Do not use any mouth rinse unless prescribed by Dr. McPhillips or cleared to do so.

• To clean the surgery site, use a dampened Q-tip^® or gauze to gently wipe the incision line and clean the adjacent teeth.
• Do NOT directly brush the surgery site. You can damage the incision, cause the sutures to come out early, and cause the incision to open prematurely causing loss of the graft, in addition to pain and bleeding.
• Do NOT use a Waterpik^® or toothpick in the surgery site.
• Brush your other teeth normally using regular toothpaste.
• If prescribed a mouth rinse, use this as directed.
• If prescribed an antioxidant gel, use this as directed.

DIET: For your comfort, start with clear cool liquids after surgery. Your diet can be advanced as tolerated once the numbness wears off. Do not use a straw or drink carbonated beverages and avoid alcohol for at least the first 3 days after surgery.

• Do NOT directly chew on the surgery site! This can cause the incision to open and the graft can be compromised. The incision should remain as undisturbed as possible for the first 2 weeks.

SWELLING & DISCOLORATIONS: These are a normal part of the healing process and, unless extreme, are of no significant concern. Early application of ice can be helpful in decreasing the amount of swelling, which peaks 72 hours after surgery. Place an ice pack to the surgery side of face in 20-minute intervals for the first 24–36 hours as you feel up to it. Do not continue the ice overnight. Keep your head elevated on additional pillows. This will also help to reduce the severity of swelling.

TOBACCO: Please avoid all tobacco products for the first 72 hours after surgery. Nicotine adversely affects normal healing.

CALL THIS OFFICE REGARDING ANY CONCERN OR COMPLICATION. These can include but are not limited to a fever over 101.3, discomfort not controlled by prescribed pain medications, prolonged or excessive bleeding, or excessive swelling. After regular business hours, contact Dr. McPhillips by calling our office answering service at (254) 965-2541 for any concerns. Contact Dr. McPhillips as soon as possible if you notice the surgery site is open. Failure to do so can compromise the graft.