1. Do not blow your nose.  Avoid things that will make you sneeze or cough.  Do not blow your nose hard or vigorously inhale.  If you have to cough or sneeze, do it with your mouth open.  This will allow the pressure to go out the mouth, not the nasal sinuses.
  2. Take the prescribed Motrin or ibuprofen every 8 hours, for a minimum of one day.  Take stronger pain medication as needed.  Discontinue as discomfort subsides.
  3. Take antibiotics as prescribed, finishing prescribed dose.
  4. Apply ice to site 20 minutes on, 20 minutes off.
  5. Avoid extremely hot beverages for the first 48 hours, cold is encouraged.
  6. Do not create positive pressure in mouth (for example, drinking through a straw or SMOKING).
  7. Expect minor bleeding.
  8. Expect a minor nose bleed.
  9. Rinse with Peridex as instructed.
  10. Do not exercise for the first week.
  11. You may be aware of small granules in your mouth for the next few days.  This is not unusual, as your graft is mainly made of particles and some excess particles will be lost.
  12. If you feel congested, you may need to use antihistamines or decongestants.  If you do, use over the counter product such as Sudafed, Tavist-D, or Dimetapp.  I would also suggest that you avoid nasal sprays unless they are saline.


ACTIVITY:  After leaving our dental office today, we suggest you consider relaxing or at least limiting your activity as much as possible for the remainder of the day.  Avoid strenuous activity or aerobic exercise for the next 2-3 days.

DISCOMFORT:  Some discomfort may be present when the anesthesia wears off.  You may have been given a prescription for an anti-inflammatory (NSAID) analgesic.  Please take this every 4-6 hours or four times per day for at least the first day.  This drug will greatly decrease the possibility of post-surgical swelling and pain, and has shown to accelerate healing.  Should more significant discomfort occur at any time after the surgery, please take the narcotic medication (if one has been prescribed for you), as directed.  You may take both the narcotic and NSAID together.  Their analgesic effect will be synergistic.

INFECTION:  Please continue taking your antibiotic until gone.  If you notice that after a few days, pain or swelling are increasing, or that you are experiencing an elevated temperature, or after one week are seeing yellow or green discharge from your nose, please call our office.

ANTIHISTAMINE USE:  Antihistamines should be taken every 6-8 hours, or 2-3 times per day for a least the first 4-5 days, particularly if you are having any symptoms of “stuffiness” or tendency to sneeze.  Antihistamines can make you drowsy.  If this is the case, then reduce the dosage, i.e., take them twice a day instead of three times a day.  Continue to use saline nasal spray, one puff every 6-8 hours for the first three days, or longer, if symptoms of “stuffiness” and difficulty breathing through your nose are present.

SWELLING:  It is normal to experience some facial swelling after surgery.  To minimize this, apply an ice bag wrapped in a light tea towel or handkerchief to the outside of your face over the operated area.  This should be left on your face for about 20 minutes, then removed for 20 minutes, or alternated from side-to-side, between operated areas, for 2-3 hours after surgery.  The use of both ice and the NSAID analgesic as described above will reduce facial swelling.

BLOWING YOUR NOSE:   Do not under any circumstances,  blow your nose for the next 4 weeks.  This may be longer if indicated.  You may sniff all you like, but NO BLOWING.
Do not blow or sneeze holding your nose.  Sneeze with your mouth open.  Do not drink with straws and do not spit.  Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided.  Decongestants such as Drixoral, Dimetapp, or Sudafed will help reduce pressure in the sinuses.  Avoid “bearing down” as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure.  Smoking must be stopped.

BLEEDING:  It is common to have slight bleeding for a few hours following surgery.  Most of the blood you may see in your mouth is actually a little bit of blood mixed with a lot of saliva – blood is a very strong “dye” and a little bit of blood will color your saliva dramatically.  If bleeding persists, apply a tea bag to the surgical site with gentle pressure for 15-20 minutes.  Let yourself rest for 15 minutes then repeat the application of the tea bag for a second time if you still have slight bleeding.  If excessive bleeding continues, please call our office or the doctor after normal office hours.  You may experience some blood discharge from your nose.  If so, lie down, with your head slightly elevated and apply an ice pack over your midface-nasal area.  If this bleeding does not stop within 30 minutes, telephone our office.

ORAL HYGIENE:  Brushing and oral hygiene procedures should be done as usual in all untreated areas.  The exposed operated areas will be cleansed by rinsing with Peridex (Chlorhexidine) at bedtime and again in the morning after breakfast.

EATING AND DRINKING:  High protein foods and liquids are desirable for 3-5 days following surgery.  Semi-solid foods may be eaten as long as this may be done comfortably.  Eggs, custard, yogurt, pasta, steamed vegetables, casseroles, cooked cereals are some thing that you might consider eating during the first few days following your surgery.  Avoid spicy, salty, acidic, very hot or very cold foods or liquids.  Also, avoid nuts, chips or other crunchy or fibrous foods which may become caught between your teeth.  Please refrain from drinking alcoholic beverages the day of surgery.

USE OF REMOVABLE DENTAL APPLIANCES:  If you normally wear a removable appliance which replaces missing teeth, and it rests on the operated area, it is best to minimize use of this appliance as any pressure on the surgical site could be detrimental to healing and cause discomfort.

Dr. Britten is genuinely concerned about your well being and postoperative healing.  If you experience any symptoms, which you feel are unusual, please feel free to contact us any time.
After hours, Dr. Britten can be reached at  his emergency number listed on our office voicemail message 727-586-2681.

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