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Post-Operative Instructions:
Bone Grafting

The following will cover important information regarding proper post-surgical care for a bone graft procedure.

Discomfort is normal after any surgical procedure. If this procedure involved a bone graft, you may experience some additional discomfort. If you are not allergic or intolerant to nonsteroidal anti-inflammatory drugs, start taking ibuprofen (also known as Advil® or Motrin®) as instructed by your doctor at the time of your surgery. If you are asthmatic, do not take ibuprofen unless you have tolerated it in the past.

Gauze pad(s) should be placed directly over the surgical site(s) and held in place with firm biting pressure. Replace the gauze pad(s) every 25 minutes. When the gauze pads have little or no blood on them, they are no longer necessary. The amount of bleeding will vary from person to person. Most of your bleeding will slow within 3–4 hours, but some bleeding is common for up to 24 hours. Please do not spit after surgery as it can prolong bleeding.

Do not rinse on the day of surgery; it may prolong your bleeding. Begin saltwater rinses the day after surgery and continue for 1 week. Rinse with warm salt water 3–4 times each day. To make the saltwater solution, dissolve 1 teaspoon of salt in a small glass of warm tap water. If you were prescribed an antimicrobial mouth rinse (known as Peridex™ or chlorhexidine), you should begin the day before the surgery and continue to use the day after your procedure, 3–4 times a day for 4 weeks.

Swelling is normal after surgery and is a major cause of post-procedure discomfort. Swelling typically peaks by the third to fourth day and then starts to resolve; it can be reduced by the use of an ice pack. Apply the ice pack to the side of your face for 10 minutes; transfer it to the opposite side for another 10 minutes. Continue icing the face for at least 24 hours. Do not freeze the skin. Ice packs are most useful for the first 24 hours. Also, keep your head elevated on 2 pillows for 3–4 days. These measures will not eliminate swelling, but they will help to reduce its severity.

To allow blood clots to form undisturbed, do not eat for 1 hour after surgery. Gradually ramp up your diet as tolerated. Always cool down any hot foods or liquids during the first 24 hours. You should eat only soft foods for the first week: for example, soups, eggs, mashed potatoes, and meatloaf are fine. Do not use a straw for the first 3 days after surgery.

Begin brushing your teeth the day after surgery. It is important to brush all of your teeth, even if the teeth and gums are sensitive. Bacterial plaque and food accumulation near the extraction site will delay healing. Do not smoke. Smoking will increase your bleeding, impair healing, or cause a graft failure. Smoking is contraindicated in patients receiving bone grafts.

Unless told otherwise, do no vigorous physical activity for 5 days following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may gradually increase your activity, such as jogging or tennis, 5–7 days after your surgery.