Bone Graft care | Old Hook Dental

Bone Grafting : Post-Op care sheet

(A downloadable PDF version of this care sheet can be found by clicking the link here)

DO NOT DISTURB THE AREA: Extra care should be taken immediately following the surgery to minimize contact with the graft tissues. Normal hygiene is very important, however we do not want to disturb the treatment area. The following day you should resume brushing (with a soft brush and toothpaste) and flossing as normal with one exception, skip the teeth immediately next to the graft site on both sides to avoid accidental contact (keep roughly 1/2 inch away from the site if there are no teeth adjacent). You will be prescribed a medicated mouth rinse which should be used 3x daily. Follow a soft food diet and hygiene instructions above for the first 2 weeks. Do not touch the area and keep anything sharp from entering the wound (crunchy food, toothpicks, eating utensils).

Home care : The area of the graft must be kept clean to reduce chances of infection. We will provide you with a prescription for a medicated mouth wash, gently rinse 3x a day for 30 seconds. Do not swish vigorously, directly brush the area or use a water pick. In addition to the medicated rinse, you may also use a warm salt water rinse to provide some comfort (see mixture directions below). Do not touch the area with fingers or lift your lip to look at the area, doing so can open sutures or lead to infection. Do not drink through a straw, spit, smoke, blow your nose (or anything else that will create pressure). Do not drink alcohol, it will increase your risk of bleeding. Avoid unnecessary pressure in the area of the graft (such as direct chewing) and chew on the opposite side as much as possible for the first 7 days.

Warm salt water rinse : 1 tsp of table salt + 1 capful mouthwash + 8 oz warm water

Diet : DO please eat, having food will make you feel better, help you regain strength and heal faster. DO eat a diet of only soft foods for the first two weeks (mashed potatoes, eggs, pudding, jello, pancakes, cottage cheese, room temp soup, soft cooked veggies, baby food or any puree or blended food). Maintain a good, balanced diet, eat on the opposite side of the graft site and drink plenty of water or gatorade. DO NOT drink alcohol for 48 hours. DO NOT have foods that are hard, crunchy, or have small bits (Nuts, seeds, berries with seeds, rice, popcorn)

Prosthesis : Removable dental prosthetics (dentures, flipper, etc) should not be worn immediately after the bone graft procedure (unless we instruct you otherwise). The prosthetic may require adjustments following the procedure and before you can use it. This is to prevent tissue irritation that will delay healing and increase comfort.

Smoking : Smoking should be stopped following grafting altogether, but is mandatory for the first 4 days. The overall success of the surgery and healing will be substantially reduced by smoking and its chemicals. We can not stress this one enough. Smoking can lead to a painful infections, delayed healing and failure of the procedure, in addition to creating pressure that can dislodge the graft material.

Bleeding: Minimal bleeding is expected following bone grafting. We will have you biting on gauze to control bleeding when you leave the office. DO keep steady pressure on this gauze for at least 30 minutes. Do not change it or remove it during this time; it needs to remain undisturbed. When you get home, rest with your head elevated and remove the gauze. If bleeding still occurs, bite on fresh gauze and rest with head elevated for another 30 minutes. Repeat cycle until bleeding stops. Evaluate bleeding by looking directly at the surgical site, not saliva. Even a little blood in the saliva can make it appear quite red. This is considered normal, no cause for alarm and may be noticed a day or two after the procedure. Do not remove any sutures, they will either fall out on their own or will be removed after 2 weeks during a followup appointment.

Pain : Some discomfort is normal after surgery. To minimize pain, we recommend taking two Tylenol, Ibuprofen, or similar non-aspirin pain reliever before the anesthesia wears off and every 4-6 hours until bedtime to maintain comfort. If prescription pain medication is prescribed, take it as instructed on the label. NEVER exceed the recommended dose. Taking with food or crackers will help reduce upset stomach. If taken on an empty stomach they may have a sedative effect and make you drowsy. Do not drive, drink alcohol, take other sedative medications or operate heavy machinery while taking prescription pain medications.You may alternate the use of Ibuprofen with the prescription pain medications for the best result.

Note : Do not take Ibuprofen or Aspirin products if you are taking prescription blood thinners.

Nausea & Vomiting : Digestive discomfort is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pill with soft food (see diet section above for more info). Take the pill 30 minutes later with a large glass of water. Carbonated beverages (coke, ginger ale) may also help relieve nausea.

Antibiotics : Following bone grafting you will be given an antibiotic prescription, you must take them as directed until they are gone, do not stop taking them because you feel better.

Women : Some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months.

Swelling : Is considered the body’s normal reaction to any surgery and healing. DO apply an ice pack to the cheek over the procedure area immediately, it will minimize swelling even if none is present yet. Please do not put the ice pack in direct contact with skin, wrap it in a slightly moist hand towel. Apply for 20 minute intervals, then remove for 20 minutes.

Continue use of the ice pack for the first 24 hours only. Swelling, stiffness, bruising and discoloration of the skin, lip and cheek in the area is considered normal, expected, and can worsen over the first 48-72 hours before it begins to get better. While resting, be sure to keep your head elevated.
After 24 hours, switch to applying moist heat, it will help further reduce any symptoms at this point.
Slight fever following a surgical procedure is considered normal.

Numbness : The local anesthetic will cause you to be numb for several hours after you leave the office. Be very careful not to bite, chew, pinch, or scratch the procedural area as well as the rest of your mouth. Sometimes due to the nature of the grafting procedure, it may cause residual numbness or tingling in the area for six weeks or longer. A loss of sensation in the gum and the adjacent teeth feeling slightly loose near the surgical site is normal. The teeth may also be sensitive to temperature changes (hot and cold). These sensations will return to normal after a period of time.

Activity : Avoid any activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing. You should be able to return to work the following day, however avoid strenuous activity for the next 3 days.

Appointments : You may need to return to the office to have sutures removed or for a brief follow-up inspection for proper healing. If any complications occur, you can certainly return before then.

Your Bone Graft will require several months to heal.