Instructions After Socket Bone Grafting

These instructions apply when bone grafting has been performed to preserve or rebuild the jawbone, often in preparation for future dental implant placement.

Different types of bone graft material may be used depending on your individual situation. The graft may also be covered by a membrane or other material to protect it during the early stages of healing. Avoid disturbing the surgical area unless your surgeon has instructed you otherwise.

Bleeding

Some bleeding or blood-tinged saliva is normal after surgery. If bleeding is more significant, place a gauze pad directly over the surgical area and bite with firm, continuous pressure for approximately 30 minutes.

Avoid vigorous rinsing, spitting, or touching the grafted area on the day of surgery.

If bleeding remains heavy or your mouth is rapidly filling with blood despite firm pressure, please call our office for further instructions.

Swelling

Some swelling is normal after bone grafting. Apply an ice pack to the cheek near the surgical area for approximately 20 minutes on and 20 minutes off, as often as comfortable, during the first 24 to 36 hours.

Swelling may increase during the first few days before beginning to improve.

Pain

Some discomfort is normal following bone grafting. If you are able to take nonsteroidal anti-inflammatory drugs (NSAIDs), good options include one of the following:

Aleve (naproxen): 1-2 over-the-counter tablets every 12 hours
Advil (ibuprofen 200 mg): up to 3 tablets every 6 hours

Choose either ibuprofen or naproxen. Do not take both together.

If you are able to take NSAIDs, use one of the above options on a scheduled basis for the first 3 days following surgery, even if discomfort is mild. Staying ahead of postoperative discomfort often provides better pain control.

If ibuprofen or naproxen alone is inadequate, you may add 1-2 Regular Strength Tylenol (acetaminophen 325 mg each) every 6 hours.

If you are unable to take NSAIDs, 1 Extra Strength Tylenol (acetaminophen 500 mg), or 1-2 Regular Strength Tylenol (325 mg each), every 6 hours is often sufficient when started before the local anesthetic wears off.

Be aware that acetaminophen is also contained in many prescription pain medications and over-the-counter cold and flu products. Do not take additional acetaminophen without considering the total amount you are taking from all medications. If your surgeon has prescribed or recommended a different pain medication regimen, follow those instructions.

Antibiotics

If you were prescribed an antibiotic, take it as directed by your surgeon. Please contact our office if you have questions or develop a reaction or other problem while taking the medication.

Oral Hygiene

Keeping your mouth clean after surgery is important for healing. Avoid rinsing your mouth on the day of surgery.

Beginning the day after surgery, gently rinse with warm salt water several times each day, especially after eating. Mix approximately one teaspoon of salt into a cup of warm water. Avoid vigorous swishing or spitting.

Do not brush directly over the surgical area for the first 48 hours. After that time, resume brushing carefully around the area while being gentle with the graft and surrounding tissues.

If Peridex or another chlorhexidine rinse was prescribed, use it according to your surgeon’s instructions. It is commonly used in the morning and at bedtime. Do not eat, drink, or rinse immediately after using the medicated rinse.

Bone Graft Particles

Occasionally, you may notice a few small particles of graft material in your mouth during healing. This does not necessarily mean that the bone graft has failed.

Do not pick at, probe, or attempt to remove material from the grafted area. If a significant amount of graft material appears to be coming from the site, the wound opens, or you are concerned about the appearance of the graft, please contact our office.

Diet

Drink plenty of fluids after surgery. Begin with soft foods and avoid very hot, hard, crunchy, or sharp foods that could irritate the surgical area.

Avoid chewing directly over the grafted area during the early healing period. Gradually advance your diet as directed by your surgeon.

Smoking, Vaping & Nicotine

Do not smoke or vape for at least two weeks after surgery. Smoking, vaping, nicotine, and other tobacco products can interfere with healing and increase the risk of complications following bone grafting.

Ideally, avoid these products for as long as possible during the healing period.

Partial Dentures, Flippers & Nightguards

Partial dentures, flippers, full dentures, and other removable appliances should not be worn immediately after surgery unless your surgeon has specifically instructed you otherwise.

If you have a temporary flipper, do not place it until the numbness has resolved. When worn, the appliance should not place pressure on the grafted area or surgical wound. Pressure from an appliance can irritate the tissues, disrupt the incision, and interfere with healing.

If your flipper, partial denture, complete denture, or nightguard contacts the surgical area or does not fit comfortably, do not force it into place. Please contact your general dentist or our office for evaluation or adjustment.

Activity

Rest on the day of surgery and limit strenuous physical activity during the early recovery period. Exercise can increase throbbing, swelling, or bleeding. Gradually return to your normal activities as you feel able.

When to Call Our Office

Please contact our office if you experience heavy bleeding that does not respond to pressure, pain or swelling that is worsening rather than improving, a suspected medication reaction, opening of the surgical wound, significant loss of graft material, or any other symptoms that concern you.

Your surgery and recovery are individual. If the instructions provided specifically by your surgeon differ from these general recommendations, please follow your surgeon’s instructions.