What to expect after surgery:
o Significant swelling is expected during the first week following alveolar cleft bone grafting because of the inflammation associated with the bone graft material.
o Avoid vigorous rinsing or spitting during the first 48 hours.
o You may have a numb lip or cheek for 6-10 hours, so take care not to accidently bite yourself or burn yourself with hot foods/liquids.
o Start taking the pain medications as prescribed when you get home. It’s important to start taking them before the numbing medicine wears off.
o Avoid vigorous activity for 1 week.
o Use ice packs or bags of frozen peas during the first 24 hours over the areas where the surgery was performed
o Sometimes some tiny pieces of bone work their way through the incision site. This is generally ok and doesn’t mean the bone graft is having a major problem.
o We wait 6 months before we take an x-ray to see how much of the bone graft was successful.
o You will have a follow up appointment about 1 week after surgery.
Diet:
o First week: Non-chew diet, liquids and pureed foods ONLY.
Protein shakes, Boost, Ensure, Carnation Instant breakfast, etc.
o Second and Third week: Soft foods, scrambled egg consistency.
Yogurt, Puddings, well cooked vegetables, pureed foods.
o Be very careful with forks and spoons. You want to avoid poking or bumping the bone graft site.
o It’s important to be well hydrated, so focus on drinking a lot of fluids. Sharp, crunchy foods can hurt the site and should be avoided.
o Avoid sucking strongly on a straw (i.e. thick milkshake).
o If you have a lot of nausea and vomiting, then focus on clear liquids and maintaining hydration. If the nausea and upset stomach is persistent, please contact our office. We will prescribe an anti-nausea medication.
Antibiotics:
o Antibiotics MUST be taken as prescribed. Typically, the course of antibiotics is for 7 days. If you develop a rash or other side effect, stop the antibiotic and contact our office.
o Use the antibiotic mouth rinse (Peridex) twice daily for three weeks. Start this evening after surgery.
Bleeding:
o Some oozing of blood is expected after surgery. A small amount makes a lot of saliva look pink/red.
o Sometimes there is some bleeding inside your nose, too.
o The oozing may persist for up to 24 hours. Avoid any strenuous activity as this may worsen bleeding.
o If there is persistent bright red bleeding, then please contact our office.
Pain Management:
o Some discomfort is expected after surgery. The goal is to minimize the discomfort so that it is tolerable. It is unrealistic to expect zero pain after surgery, but we will work with you to minimize the discomfort as much as possible.
o Consistently taking ibuprofen and Tylenol has been shown to be very effective at controlling pain.
o Very few people actually need to take a narcotic pain medicine. Narcotics have real risks and side effects such as nausea and vomiting, constipation, drowsiness and addiction. However, if there is severe pain that is not well controlled with ibuprofen and Tylenol, then we can prescribe a small amount of prescription pain medication. Take the narcotic pain medication exactly as prescribed to avoid a complication.
o Never exceed the maximum daily dose that is described in the over-the-counter instructions.
o Ice packs the first day can also help reduce the need for pain medication.
Swelling:
o Swelling is normal after surgery. It is normal for swelling to increase for the first 2-3 days after surgery and then reach its peak and start to lessen.
o Ice packs during the first 24 hours can help. You can also keep your head slightly elevated when you sleep. Spending more time sitting upright and on your feet, rather than lying flat will help reduce the swelling. If you sleep all night on one side of your face, it will be more swollen the following day, but should even out during the day when you are upright.
o Sometimes there is bruising that can take days to weeks to resolve.
Brushing/Rinsing:
o Gentle saltwater rinses can begin the day of surgery. It helps to gently rinse after any snacks or meals.
o You should brush and floss your teeth, but be careful and gentle in the areas of the surgery.
Activity:
o Avoid strenuous activity and exercise for 1 week. You can usually return to school or work the day after surgery, but you might be swollen and sore. Some people need a couple days off from work/school.
o If you have bone taken from your hip, then no sports or intense physical activity for 6 weeks.
o You should not drive a car, operate machinery or sign legal documents if you are taking narcotic pain medication.
Sutures:
o Sutures placed at the surgical site, will dissolve/resorb on their own after about 7-14 days. It’s ok if you accidentally swallow them as they will simply dissolve in your stomach.