Open and frank discussions about the risks of surgery are obligatory for every health professional who provides surgical services. It is not meant to frighten, but to fully inform patients who ultimately must decide whether to proceed with their surgery based on the balance of information about the risks vs. benefits provided by the surgeon.
Fortunately, surgical risks have significantly diminished over the years because of improved surgical techniques, instruments, materials and training which have made Surgery very safe.
Surgical risks are uncommon but real possibilities so it is important that you ask questions during your consultation.
Below is a short list of general risks associated with Oral & Maxillofacial Surgery procedures:
During your consultation, your Surgeon will discuss the potential risks that are associated with your particular surgery and more detailed information will be provided to you during your visit.
The following information is a general guide about what to expect following surgery. Please note that the extent and nature of the post-operative points discussed below depends on the type and complexity of your surgery.
For minor surgical procedures, such as the extraction of wisdom teeth, you will only be in hospital for a few hours following surgery. Overnight admission will only be required if there is persistent bleeding, severe nausea and vomiting, or the patient has experienced an adverse reaction to medication or the anaesthesia that will require overnight observation. For major surgical procedures, such as jaw reconstruction, the hospital stay will vary from 1-5 nights.
Bleeding from the wounds may persist for up to 24 hours following surgery. It is essential that you avoid spitting or touching the wounds with your fingers. Eating hot foods and exercise will stimulate further bleeding. To help minimise bleeding get plenty of rest and sleep with your head elevated on several pillows. Avoid smoking, alcohol and mouth rinses for the first 12 hours following surgery. Direct pressure over the wound with a clean gauze or handkerchief for 20-30 minutes will help reduce any persistent bleeding. Repeat the procedure with a new gauze if necessary, making sure it sits directly over the wound.
Swelling is quite normal after surgery and will depend on how difficult your surgery was. Maximum swelling is usually 24-48 hours following surgery and gradually subsides after that. During the period of maximum swelling you will have difficulty in closing your back teeth together, so stick to a soft, non-chewing diet. Any swelling that arises 1-2 weeks after surgery indicates an infection.
Bruising may occur in some people as the swelling subsides and is a not too uncommon occurrence as it will eventually disappear after 7-10 days.
Pain & Discomfort
The degree of pain will depend on the difficulty and complexity of the surgery. Pain and discomfort is highest in the 2-3 days following surgery and gradually subsides thereafter. Excessive talking and chewing will make the pain worse so jaw rest is essential. For simple surgical procedures such as simple tooth extractions and dental implants, 1-2 doses of paracetamol or ibuprofen is all that is required. For more complex surgery, stronger pain killers will be provided and should be taken at regular intervals for the first 3 days. For intense pain, you can take paracetamol based analgesics followed 3 hours later by ibuprofen based analgesics on alternate basis every 3 hours, to maintain analgesic effectiveness. The need for analgesics usually stops after 7 days.
Nausea & Vomiting
This may occur after a general anaesthetic for which the nursing staff will provide you with medication to stop the nausea. If the nausea and vomiting persist after discharge from hospital, stop all medication and drink plenty of clear fluids, such as lemonade to build up your blood sugar levels which may be low due to your limited diet following surgery.
For those who have had a general anaesthetic, difficulty in swallowing, sore, dry throat and generalised muscle pain may arise but usually disappear by the following day. If the sore throat and swallowing difficulties persist for more than 48 hrs then try Cepacol lozengers or Difflam mouthwash from your local pharmacy.
Limited Mouth Opening
Limited mouth opening is initially due to swelling and soreness especially following difficult and complex surgery, including wisdom teeth. This will spontaneously resolve in 1-4 weeks depending on the surgery.
Loss of Feeling
Loss of feeling (sensation) may occasionally occur as a result of the surgery when the sensory nerves may have been stretched or bruised. With Oral Surgery, the chin, lower lip, lower teeth and tongue are the most common sites affected. Fortunately, in the vast majority of cases, sensation returns to normal in due course although the time frame is very hard to predict. The more major the surgery, and the older the patient, the longer it takes for the feeling to return. Tingling and itching of the affected areas are promising signs for full nerve recovery. Make sure you avoid biting your lips or placing hot food and drink next to the numb areas until return of full sensation is complete.
Stitches in the mouth are almost always dissolving and gradually disappear after 5-7 days. If they fall out earlier, do not worry. Provided there is no persistent bleeding, then the stitches have done their job. Stitches on the face, neck, and other parts of the body where grafts have been taken are usually not dissolving, and will need to be professionally removed between 5-10 days following surgery.
Meticulous care and cleanliness is VITAL to rapid healing and prevention of wound infections. For operations done in the mouth, tooth brushing will be difficult in the first week so rinse your mouth with warm salt/water mouthwashes and Chlorhexidine (SAVACOL) mouth rinse 3 times daily, particularly after meals. Do not begin mouthwashes for at least 12 hours after surgery. For surgical wounds on the face and other parts of the body, some of the dressings will be changed while you are still in hospital and then removed about 1 week later. You can shower 2-3 days following surgery. After the stitches are removed, apply antiseptic ointments over the skin wounds for another week and protect from direct sunlight for about 6 months.
Following tooth extractions, you can wear your denture immediately after surgery but be sure to rinse your mouth and thoroughly clean your denture the next day after surgery with SAVACOL mouthwash. However, if you have had a bone graft to your jaws it is best to keep your dentures out for the first 2-3 days. You may need to see your Dentist to adjust your denture if it does not fit properly.
Your diet will be restricted to soft foods (e.g. eggs, pasta, rice, soup) for 5 days, where little chewing is required, until the swelling and discomfort subsides. If weight loss is a problem or you can only tolerate fluids, then consider milk fortified with eggs, skim milk powder as well as Sustagen from your local pharmacy. For those that are undergoing major jaw surgery, a hospital dietician will provide you with more detailed dietary advice.
Please call Dr Dimitroulis 0409 505 146 if you encounter:
All other queries should be directed to 03 9654 3799 during business hours.