Postoperative Care Instructions


 Our goal is to provide you with the information that you will need to have the best experience possible. Your compliance with these instructions will have a significant impact on your recovery. Sometimes the after-effects of oral surgery are quite minimal, so not all the instructions will apply to you. 


All patients undergoing IV sedation are required to have a responsible adult, 18 years old or older, as escort them to and from their appointment. It is recommended that the escort visually monitors the patient for 24 hours after the procedure for their safety. ESCORTS ARE REQUIRED TO STAY IN THE OFFICE DURING THE PROCEDURE. Escorts are also responsible for driving the patient home, picking up medications, and making sure the patient is following these instructions. 


  1. Change the gauze packs only when saturated with blood and saliva. When saturated, gently remove the gauze pack and replace it with a fresh gauze pack.
  2. Make sure gauze is directly over the surgical site. Bite gently but firmly on the gauze pack and avoid talking.
  3. Do not rinse your mouth between gauze changes because this will cause more bleeding. Remove dried blood from cheeks, lips, and tongue using a damp paper towel or gauze around your fingers if needed. Do not spit the blood out. Don’t disturb the surgical site.
  4. For persistent bleeding you can use a damp tea bag wrapped in gauze and apply it to the site.
  5. You can stop using gauze when the gauze is mostly pink after 20-30 minutes.
  6. A little bleeding at night after your procedure is not uncommon. Use gauze as described above to control the bleeding.
  7. Do not sleep with gauze or any other type of packing in your mouth as it is a choking risk.
  8. Contact the office ASAP for bleeding that is not controlled with these measures.



  1. You can eat anything soft that can be mashed with a fork.
  2. Avoid foods that are hard, crunchy, with seeds or nuts that can get stuck in the surgical site.
  3. Advance your diet as you feel more comfortable chewing.
  4. Avoid carbonated drinks and alcohol for the first 48 hours.
  5. Nausea can be experienced if you take medications on an empty stomach and persistent nausea may indicate an emergency.  If you have persistent nausea or nausea with vomiting after your surgery, you should contact the office immediately.



  1. You should perform normal oral hygiene including brushing and flossing.
  2. Cheeks, lips, tongue, and roof of mouth that are not involved as part of the surgical site can be brushed and/or flossed like normal.
  3. Do not use a water pick at the surgical site. Avoid the area around the site.
  4. Do not rinse, flush, or spit out toothpaste residue for the first week as rinsing during this time can affect healing of the site and cause bleeding.
  5. Toothpaste residue can be managed by soaking the mouth for a minute and letting the water fall out of the mouth over the sink. This can be repeated as needed.


  1. A few days of achy soreness is to be expected.
  2. Over the counter medications are effective in controlling most postoperative pain.
  3. NSAIDs such as Motrin, Ibuprofen, and Advil are recommended first line medications and 800mg every 8 hours is a good dosing regimen.
  4. Tylenol Extra Strength can be coupled with or taken in between Ibuprofen to optimize your pain relief.
  5. If you were prescribed a pain reliever, follow the dosing instructions on the prescription bottle
  6. If a narcotic was prescribed for pain relief use it sparingly and only if NSAIDs and Tylenol are insufficient.
  7. Requests for refills of narcotic pain relievers are only approved after an office visit with a clinical examination that clearly demonstrate a medical necessityfor a refill.



  1. Avoid smoking, vaping, chewing tobacco, nicotine lozenges, and nicotine gum for two weeks as these cause healing problems.
  2. Avoid the use of a straw for the first week.
  3. Swelling is normal and may take some time to resolve.
  4. Bruising is not uncommon and may take some time to resolve.
  5. For the first 24 hours, apply ice or cold packs wrapped in a towel to protect your skin to your face over the surgical site every hour for 20 minutes on and 20 minutes off to reduce swelling.
  6. After 24 hours switch to warm, moist compresses and massage. Apply compresses and gently massage the site a few times a day to stimulate blood flow.
  7. For the first 48 hours sleep elevated with your head above your chest as sleeping flat can worsen swelling
  8. Soaking your mouth with warm salt water (1/4 teaspoon in 8 ounces water) 3-6 times a day is advisable to encourage the site to heal. Do not rinse your mouth, just soak your mouth.
  9. Dissolvable stitches, if placed, start to unravel around the 3rd to 4th day and can take as many as 7-14 days to come out completely
  10. For extraction sites, it is normal to feel a hole which will close from the bottom to the top over time and can take about a month to close completely
  11. Sharp edges around the extraction site may be felt and tend to come out on their own with gentle brushing and time.  If they do not or are painful call the office for a follow up to address it
  12. Dried or cracked lips can be managed by keeping them moist with a lubricant like Vaseline
  13. If you were sedated with and IV and have discomfort or bruising at the IV site, warm compresses with massage and limb elevation can help with these symptoms and it can take some time to resolve.  If they worsen please inform the office ASAP
  14. If you were feeling better and then start to feel worse please call the office to follow up ASAP



  1. All implants and bone grafts must be left undisturbed in order to heal.
  2. Food restrictions must be followed closely or implants can experience micromovement and fail to fuse to bone
  3. A Q-tip and salt water can be used 2 times a day to gently clean the buildup off of the stitches.
  4. Make sure you keep your mouth clean and brush your mouth regularly
  5. When stitches begin to come out, a few extremely light and gentle brushes of the surgical site can be performed each time you brush.
  6. Do not forcefully brush the surgical site.
  7. Some small particulates of graft material may come off the surface, however if you notice more than this please call the office
  8. If a denture or a temporary tooth were delivered with implant placement, your bite has been adjusted so you won’t be able to chew forcefully over them, but you also need to avoid chewing anything hard over them
  9. If anything feels sore or achy after getting better call the office for a follow up ASAP


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, please call the office at 808-649-5099. You can reach Dr. Rotwein on his cell phone with any questions or concerns not addressed on this form.

Click the link below for printable postoperative care instructions:

Abbreviated Post Op Instructions PDF

Are You in Need of Oral & Maxillofacial Treatment?

You can trust Dr. Rotwein to provide you with outstanding care. Contact us to learn more about your treatment options.