Bone Graft Post-Operative Instructions

Bone grafting prepares the jaw for a dental implant or supports teeth after an extraction. The graft material needs an undisturbed environment to integrate with your bone. The instructions below are organized day by day so you know exactly what to expect and what to do at each stage of recovery.

Day of Surgery

• Do NOT spit, rinse, or use a straw for 24 hours. These actions create suction or pressure that can dislodge the blood clot and disturb the graft material. This is the single most important rule on Day 1.
• Gauze: Bite gently but firmly on the gauze placed over the graft site. Change it every 30 to 45 minutes as needed. If oozing continues, fold fresh gauze and hold with steady pressure. Light pink-tinged saliva is normal and does not require gauze.
• Keep your head elevated. Sit upright or recline with your head above your heart. If resting, use an extra pillow. This reduces bleeding and swelling.
• Ice pack protocol: Apply a cold pack or ice wrapped in a cloth to the outside of your cheek -- 20 minutes on, 20 minutes off. Continue this through the day of surgery and into the next morning.
• Rest. Avoid any physical activity. Increased heart rate raises blood pressure and can cause bleeding at the surgical site.
• Begin pain medication before the anesthetic wears off. Do not wait until you are in pain. Take ibuprofen 400 mg and schedule it every 6 hours. If prescription pain medication was provided, follow those instructions instead.

Days 1 and 2

• Swelling is normal and expected. Swelling typically peaks at 48 to 72 hours and then gradually improves. Continue ice packs on Day 2 if helpful.
• Pain management: Alternate ibuprofen 400 mg (every 6 hours) with acetaminophen 500 mg (between ibuprofen doses) to maintain steady coverage. These dosages are for healthy adults without kidney or liver conditions. Follow prescription instructions if provided.
• Antibiotics: If antibiotics were prescribed, begin taking them as directed and complete the full course even if you feel fine. Stopping early allows bacteria to recolonize the graft site.
• Chlorhexidine rinse: If a chlorhexidine (Peridex) rinse was prescribed, begin using it starting Day 2 as directed -- typically 30 seconds twice daily. Do not eat, drink, or rinse with water for 30 minutes afterward.
• Soft diet only. Eat on the opposite side of the graft. Chewing near the graft can move the material before it has had any time to stabilize. See the diet section below for specific food guidance.

Days 3 through 7

• Warm salt water rinse begins Day 2 (or as directed): Gently let a warm salt water solution (1/2 teaspoon salt in 8 oz warm water) rest in your mouth and allow it to fall out -- do not swish forcefully. Repeat after meals and before bed. This helps clean the area and supports healing.
• Swelling should be improving. Some residual swelling or bruising may remain through Day 5. After the first 48 hours, a warm moist cloth applied to the face (not directly over the incision) can help circulation if bruising is present.
• Continue soft diet. The graft is not structurally stable during this window. Resist the temptation to eat on that side even if soreness has decreased.
• No smoking. Smoking significantly reduces blood flow to the graft site, interferes with the body's healing response, and is one of the leading causes of graft failure. This restriction applies throughout the entire healing period.
• Sutures: Dissolving sutures typically begin loosening around Day 5 to 7 and will fall out on their own. Do not pull at them. If non-dissolving sutures were placed, your follow-up appointment is scheduled for their removal.
• Pain should be decreasing. If your pain is increasing after Day 3 rather than improving, call our office. This is a warning sign that should not be ignored.

Week 2 and Beyond

• Gradual return to normal foods: By Week 2 you can typically reintroduce softer regular foods. Avoid hard, crunchy, or chewy foods directly over the graft site for 4 to 6 weeks or until cleared at your follow-up.
• Suture dissolution timeline: Most resorbable sutures are fully gone within 2 to 3 weeks. Some may take slightly longer. Contact us if you see anything that concerns you.
• The graft site continues to mature. Bone graft integration takes several months. Your implant placement appointment will be scheduled once imaging confirms adequate bone density -- typically 3 to 6 months after grafting.

Diet Guidelines

Good choices (soft and gentle):

• Yogurt, pudding, applesauce, smoothies (no straw)
• Mashed potatoes, soft scrambled eggs, soft-cooked oatmeal
• Soft fish such as tilapia or salmon, soft pasta with mild sauce
• Soup broth -- lukewarm, not hot; avoid chunks near the graft side
• Cottage cheese, soft-cooked vegetables, bananas

Avoid for at least 2 weeks:

• Hard or crunchy foods: chips, crackers, raw vegetables, nuts, hard candy
• Chewy foods: bagels, tough meats, gummy candies, crusty bread
• Seeds and small particles that can lodge in the graft site: sesame seeds, popcorn, rice
• Hot foods and beverages -- heat increases swelling and can dissolve the blood clot
• Carbonated beverages -- the fizz creates pressure and suction similar to straw use
• Alcohol, which interferes with healing and interacts with medications

Warning Signs -- Call Our Office

• Fever above 101 degrees F -- especially combined with swelling or a bad taste -- may indicate infection.
• Excessive bleeding not controlled by gauze pressure after 60 minutes. Some oozing on Day 1 is normal; heavy or persistent bleeding is not.
• Pain that is increasing after Day 3 rather than gradually improving. Steady worsening pain is not a normal part of recovery.
• Foul taste or smell from the surgical site that does not improve with salt water rinsing.
• Graft material coming out. Seeing small granules in your mouth is not uncommon and does not always mean there is a problem -- but call us so we can assess the situation.

Questions at any stage of your recovery are welcome. Our team at Smile Science Dental Spa is here to help. Call us at (480) 530-3663 or visit us at 20118 N 67th Ave Ste 308, Glendale, AZ 85308.