Oral cavity surgery

The tooth row is closed on both sides by third molar or wisdom teeth, which most commonly erupt at the age of 17 to 24. Wisdom teeth often create problems; since there is not enough space for them in the mouth, they grow sideways and extraction is required. If the wisdom tooth grows sideways, it can cause problems for the adjacent tooth, for instance, risk of inflammation.

This tooth may cause problems while completely embedded into the bone, or covered with the gum and invisible in the oral cavity. If the wisdom tooth has erupted partially and a small part of the tooth is visible, bacteria enter the space between the tooth and the gum, which causes inflammation, pain, swelling, difficulty moving the jaw and swallowing saliva. Even if a wisdom tooth has completely erupted, it is susceptible to dental and gingival infections, because it is difficult to access with a toothbrush and clean properly. If a defect of a wisdom tooth is detected, the most commonly made therapeutic decision is removal of the tooth, not the preservation thereof, because treatment is complex, time-consuming and expensive; furthermore, it is highly likely that the tooth will continue to cause problems.

If a wisdom tooth with a defect or incorrect growth direction is detected, the preferable therapy is removal of the tooth, before symptoms of pain have occurred.

To remove a wisdom tooth, opening of the gum or removal of the surrounding bone tissue may be required, and the wound must be closed by suturing afterwards. If the removal of the wisdom tooth was performed using local anaesthesia, there should be no problems returning home or going to work immediately. Abstaining from excessive load would be preferable for at least the first three days.

The patient must be aware that, after the manipulation, the patient will have swelling and minor discomfort or they could have problems opening their mouth completely or swallowing saliva. A skin haemorrhage can also be expected.

For better success of the recovery process, you are recommended to apply ice compresses and to avoid excessive loads, as well as consume easily digestible food (porridge, yoghurt, etc.).

Your physician may apply a course of antibiotics at their own discretion.

Bleeding
Minor bleeding is possible 24 hours after artificial bone implantation or bone graft transplantation. Saliva may turn pinkish. Most often the bleeding stops within a couple of hours.
If the bleeding continues at home, roll a piece of gauze into a swab, apply it on the wound, close your teeth firmly and hold them closed for 30 minutes; Apply a cold compress from the outside.

Numb lower lip
After extensive bone graft surgery, the lower lip may temporarily become numb. The sensation of numbness can last for up to 6 months.
If the general health status deteriorates several days after the surgery, which manifests as a general feeling of weakness, rising body temperature, development of severe swelling at the site of implantation, pain when swallowing saliva or difficulty opening your mouth, call the reception desk of the clinic on +371 67 339 300 or your attending physician.

In the first days

Physical load
Physical work is not recommended, it is advisable to mostly stay in a sitting position. When lying down, it is important to keep the head as high as possible. It is advisable to use two pillows. Sleep on the unoperated side.

Diet
On the first day after surgery, do not rinse your mouth and eat hot food or consume hot drinks. It is not advisable to drink with a straw. It is recommended to have warm and soft food.

Oedema
To reduce swelling, put a bag with ice folded in a towel on the cheek and hold for 20 minutes. Pause for 20 minutes and put the ice on the cheek for another 20 minutes. Repeat this procedure until the evening. If sinus lift surgery was performed in addition to bone transplantation, it is prohibited to forcefully blow your nose or suppress sneezing.

Medications
All medicine and/or nasal drops prescribed by the doctor should be used from the first day of surgery.

Antibiotics
Use exactly as prescribed.

Painkillers and anti-inflammatory medications
Any painkiller prescribed by your doctor can be used to relieve pain. Take the medicine 2–3 times a day for 2–5 days as required. All other prescribed drugs should be taken as usual.

Drain
If a drain was inserted during the surgery, on the second day after surgery it can be removed with your fingers.

During the first week

Oral hygiene
The next day after the surgery, start brushing your teeth 3 times a day with toothpaste, then rinse your mouth with 0.2% chlorhexidine solution.

Removable prosthesis
The prosthesis, which you have been using, will no longer fit after the surgery, as the anatomy of the oral cavity has changed.
You have two options:

• To rebase the old prosthesis because the wearing thereof without readjusting can cause opening of the stitches, which can lead to loss of bone volume;
• To produce a new prosthesis. Preparation can begin 1 week after removing the stitches.

Physical load
Attending sports classes, being in a bent over position is not recommended and taking a hot shower or bath should be avoided. It is not recommended to stay in dusty rooms.

Diet
To avoid trauma of the postoperative wound it is advisable to have light, warm food. Due to temporary numbness of the lip, it is not recommended to have hot meals and drinks to avoid possible burns.

Sutures
Sutures are removed on day 7–14 after surgery.

Smoking and alcohol
Smoking can adversely affect healing of the postoperative wound and successful integration of the bone. We recommend avoiding smoking for two weeks after the surgery.
Do not drink alcohol for 7 days after surgery.

During the first month

Diet
From the second week, when the sutures are removed, you can eat any consistency of food. However, it is not recommended to chew on the affected side until the wound is completely healed.

Medications
From the second week, there is no longer any need to use any medicine.

Oral hygiene
Perform oral hygiene as usual, replacing chlorhexidine with water or any mouthwash.

Bleeding
Minor bleeding is possible for 24 hours after the sinus lift operation. Saliva may turn pinkish. Most often the bleeding stops within a couple of hours. Nose bleeding is also possible.
If the bleeding continues at home - roll a piece of gauze into a swab, apply it on the wound, close your teeth firmly and hold them closed for 30 minutes. Apply a cold compress from the outside.

Swelling
Facial swelling may occur on day 2–3 after the surgery. It may be almost unnoticeable but it may also be very pronounced. Sometimes a bruise may appear on the cheek or under the eye.
If the general health status deteriorates several days after the surgery, which manifests as a general feeling of weakness, rising temperature, the head becomes heavy, especially when leaning forward, there is a discharge from the nose with an unpleasant odour, call the reception desk on +371 67 339 300 or your attending physician.

In the first days

Physical load
Physical work is not recommended, it is advisable to mostly stay in a sitting position. When lying down, it is important to keep the head as high as possible. It is advisable to use two pillows. Sleep on the unoperated side is recommended.

Diet
On the first day after surgery, do not rinse your mouth and eat hot food or consume hot drinks. It is not advisable to drink with a straw. It is recommended to have warm and soft food.

It is forbidden
It is prohibited to smoke, forcefully blow your nose or suppress sneezing. Sneeze with an open mouth.

Oedema
To reduce swelling, it is best to put a bag with ice folded in a towel on the cheek and hold it for 20 minutes. Pause for 20 minutes and put ice on the cheek for another 20 minutes. Repeat this procedure until the evening.

Nasal drops
It is recommended to use nasal drops before going to bed. They must be used from the first day of the surgery 3–4 times a day for 5 days.

Antibiotics
Use exactly as prescribed.

Painkillers and anti-inflammatory medications
Any painkiller prescribed by your doctor can be used to relieve pain. Take the medicine 2–3 times a day for 2–5 days as required. All other prescribed drugs should be taken as usual.

During the first week

Oral hygiene
The next day after the surgery, start brushing your teeth 3 times a day with toothpaste, then rinse your mouth with 0.2% chlorhexidine solution.

Nose
Nose bleed may occur on the first days after sinus lift. Breathing through the nose can be hindered due to swelling of the nasal cavity. The prescribed nasal drops should be used for no longer than 4–5 days in order not to provoke a runny nose. Do not blow your nose for two weeks after the surgery. Sneeze with an open mouth. It is important to avoid getting a cold.

Physical load
For the first week after surgery it is not recommended to attend sports classes, be in a bent position, and you should not take a hot shower or bath. It is not recommended to stay in dusty rooms. It is forbidden to dive. If possible, avoid flying.

Diet
In the first week, in order not to traumatise the postoperative wound it is advisable to have light, warm food.

Sutures
Sutures are removed on day 7–14 after surgery.

Smoking and alcohol
Smoking can adversely affect healing of the postoperative wound and successful integration of the bone. We recommend avoiding smoking for two weeks after the surgery.
Do not drink alcohol for 7 days after surgery.

During the first month

Diet
From the second week, when the sutures are removed, you can eat any consistency of food.

Nasal drops
From the second week there is no longer any need to use the nasal drops.

Oral hygiene
Oral hygiene must be performed as usual, replacing chlorhexidine with water or any mouthwash.

Physical activity
It is not advisable to lean forward for two weeks after surgery. From the third week, all types of sports can be restarted. Diving and flying can be restarted one month after surgery.

Bleeding
The possibility of bleeding is normal after tooth extraction. Saliva may turn pinkish. For 30 minutes after the extraction, it is advisable to gently bite a cotton swab in the mouth.
If the bleeding continues at home, repeat this procedure - roll a piece of gauze into a swab, apply it to the wound, close your teeth and keep them closed for 30 minutes. Apply a cold compress from the outside.

Smoking and alcohol
Do not smoke for at least two hours after tooth extraction. Smoking can adversely affect healing of the wound.
Do not drink alcohol for 24 hours after surgery.

Rinsing
Do not rinse your mouth for 24 hours after surgery. It is allowed to have warm drinks, but do not rinse and spit, as it can rinse out the blood clot that must form in the wound. On the next day you can start to rinse your mouth with a weak salt solution (1/4 teaspoon of salt per 200 ml of water) or 0.2% chlorhexidine solution. Continue rinsing for several days.

Pain
Any painkiller prescribed by your doctor can be used to relieve pain. All other prescribed drugs should be taken as usual.

Diet
For the first 24 hours, light, soft consistency and warm food is best. Do not drink hot drinks.

Oral hygiene
Careful oral hygiene will help the wound to heal faster. In the first days after surgery, when brushing your teeth, be careful not to touch the wound. Brush your teeth gently, rinse your mouth often.

Physical load
Nursing regimen is recommended for 3 days.
If the general health status deteriorates several days after tooth extraction, which manifests as a general feeling of weakness, rising temperature, severe swelling at the site of extraction, pain when swallowing saliva or difficulty opening the mouth, call the reception desk on +371 67 339 300 or your attending physician.

Bleeding
Occurrence of bleeding after tooth extraction is normal. Your saliva may turn pinkish as a result. For 30 minutes after the extraction, it is advisable to gently bite a cotton swab in the mouth.
If the bleeding continues at home, repeat this procedure - roll a piece of gauze into a swab, apply it to the wound, close your teeth and keep it intact for 30 minutes. Apply a cold compress from the outside.

Smoking and alcohol
Do not smoke for at least two hours after tooth extraction. Smoking can adversely affect healing of the wound.
Do not drink alcohol for 24 hours after surgery.

Rinsing
Do not rinse your mouth for 24 hours after surgery. It is allowed to have warm drinks, but do not rinse and spit, as it can rinse out the blood clot that must form in the wound. On the next day you can start to rinse your mouth with a weak brine (1/4 tsp of salt per 200 ml of water) or 0.2% chlorhexidine solution. Continue rinsing for several days.

Swelling
To avoid swelling, it is advisable to put an ice bag folded in a towel on the cheek. Hold this cold compress for 20 minutes, then pause for 20 minutes. You can repeat the procedure several times.

Pain
Any painkiller prescribed by your doctor can be used to relieve pain.

Diet
For the first 24 hours, light, soft consistency and warm food is best. Do not drink hot drinks.

Sutures
Sutures are usually removed 7-10 days after surgery, because food residues may collect around them causing a feeling of discomfort in the mouth. If self-absorbent sutures are used, their removal is not necessary.

Oral hygiene
Careful oral hygiene will help the wound to heal faster. Be careful not to touch the wound and the suture, when brushing your teeth during the first days after surgery. Brush your teeth gently, rinse your mouth often.

Physical activity
Nursing regimen is recommended for 3 days.

NB! Complications

If the general health status deteriorates several days after tooth extraction, which manifests as a general feeling of weakness, rising temperature, severe swelling at the site of extraction, pain when swallowing saliva or difficulty opening the mouth, call the reception desk on +67 339 300 or your attending physician.