After Biopsy

Post-operative care is very important. Unnecessary pain and complications can be minimized if the instructions are followed carefully.

Bleeding

A certain amount of bleeding is to be expected for a day or two (2) following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first rinsing with cold water and wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty (30) to sixty (60) minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty (30) to sixty (60) minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. The swelling may not become apparent until the day following surgery and will not reach its maximum until two (2) to three (3) days after surgery. However, the swelling may be minimized by the immediate use of cold compresses and keeping your head elevated above your heart.

Diet

Good nutrition is extremely important for healing. Start off with clear liquids after general anesthesia or IV sedation. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. Once you are able, you may eat anything soft by chewing away from the surgical site(s). You may want to confine the first day’s intake to bland liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.). Avoid foods like nuts, sunflower seeds, popcorn, etc, which may become lodged in the surgical site(s).

Pain

Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for pain medication, but it may take up to several hours for the pharmacy to prepare your prescribed pain medication. Taking over-the-counter pain medication (two [2] tablets Extra Strength Tylenol and three [3] tablets Ibuprofen 200mg) before the numbness wears off will help you be able to manage any discomfort better. Effects of pain medicines very widely among individuals. For ongoing moderate discomfort, one (1) or two (2) Tylenol or one (1) Extra Strength Tylenol may be taken every four (4) hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol, unless you are also on Coumadin/warfarin. Ibuprofen bought over the counter comes in 200mg tablets. Two (2) to three (3) 200 mg tablets (400 – 600mg total) of Ibuprofen may be taken every four (4) hours as needed for discomfort.

For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. If you do not achieve adequate relief from your prescription, you may supplement your prescription with two (2) to three (3) 200 mg tablets of Ibuprofen every four (4) hours, if you are NOT also on Coumadin/warfarin. Some people may even require two (2) of the prescription tablets at a time during the early stages, but that may add to the risk of upset stomach. The more severe discomfort is usually experienced within the first three (3) days after the surgery. Pain or discomfort following surgery usually subsides more and more each day after that, and your need for medicine should lessen as well. Sometimes, the pain increases as the swelling increases over the next two (2) to three (3) days. If significant pain persists for more than three days, 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 by your doctor not to take it.

Oral Hygiene

Mouth cleanliness is essential to good healing. No vigorous rinsing should be performed the day of surgery. You may brush your teeth the night of surgery, but rinse gently. The day after surgery, you should begin gently rinsing after meals and additionally, for a total of four (4) to six (6) times a day, with an 8oz. glass of warm water mixed with one-half teaspoon of salt. Continue this procedure for one (1) week.

Nausea & Vomiting

Nausea may occur after surgery, and is sometimes caused by stronger pain medications. Nausea may be reduced by preceding each tablet with a small amount of food, then taking the tablet with a large volume of water. In the event of nausea and/or vomiting following surgery, do not take anything by mouth for a least an hour, including the prescribed medicine. You should then sip on tea or ginger ale (after stirring out carbonation). You should sip slowly over a 15-minute period. If you are not on Coumadin/warfarin, you may also try Alka-Seltzer or Pepto Bismol. When the nausea subsides, you can begin taking solid foods and the prescribed medicine. If nausea persists for more than four hours, call the office.

Sutures

Sutures may be placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. In most cases, sutures will dissolve unnoticed within a week. Occasionally, sutures require removal after one week. The removal of sutures is a quick procedure that requires no anesthesia or needles and is usually associated with minimal to no discomfort.

Activity

Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Be aware that your normal nourishment intake may be reduced. Exercise may weaken you. If you get light-headed, stop exercising.

Other Complications

• If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, it is important to be especially careful when eating because you could bite your lip or tongue and not feel the sensation. Call the office if you have any questions, or if the numbness persists for more than a week.
• A slight elevation of temperature immediately following surgery is not uncommon. Tylenol may be taken to reduce the fever. If a temperature of 101°F persists for longer than a day after surgery, notify the office.
• You should be careful going from the lying-down position to standing. Since you may not have been able to eat or drink prior to surgery, and it may be difficult to take fluids after surgery, your body may be low on fluid. Because of this, you could get light-headed if you stand up suddenly. Taking pain medications can also make you dizzy. Before standing up, you should sit for one minute and then get up slowly.
• Avoid smoking for at least three days after your surgery.

Finally

It is very important that you return to our office for your scheduled post-operative visit, so that Dr. Burns may review pathology results with you and evaluate the healing of the surgical site(s).

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, call the office location where you had your surgery. Please try to call during office hours in order to obtain a quicker result. A 24-hour answering service is available if necessary. The after-hours telephone number is 317-823-4260 or 866-823-4260.