PERIODONTAL SURGERY - POST OPERATIVE INSTRUCTIONS
Instructions following Periodontal Surgery, Free Gingival Graft,
Connective Tissue Graft, Block Graft
Apply cold compresses to outside of face in the area of surgery-15 minutes on, 15 minutes off-for 4-6 hours. Do not use after 36 hours. It is not unusual to have post-operative swelling. Swelling is a normal occurrence after surgery. Some swelling should be expected. If it does occur, it will reach its maximum in 48-72 hours, and then it will start to decrease.
Take prescribed antibiotics as directed until all medication is consumed. Take pain relievers as directed but only as often as is necessary to manage the discomfort. Ideally, pain medication should be taken BEFORE numbness wears off. For light discomfort or moderate pain one or two 200 mg tablets of Ibuprofen (Nurofen, Rupan, Advil, Motrin) should be taken every three to four hours. Do not exceed 2400 mg per 24 hours. In addition you may use a very effective analgesic and antipyretic agent, Acetaminophen (Tylenol Extra Strength, Paracetamol), one or two every six hours. Some medications may cause an upset stomach. Taking these with food will lessen this side-effect.
Do not rinse your mouth for the first 18-24 hours. Begin the use of the prescribed rinse (special mouthwash - chlorhexidine gluconate 0,12% - or warm salt-water) after the first 24 hours and rinse gently after meals and between 6-8 times a day for at least one week.
A periodontal dressing has been placed around your teeth. It is comparable to the surgical dressing used in other types of operations. It serves a very useful purpose and should not be disturbed. The periodontal dressing will become semi-rigid within a few hours. It can then withstand some of the forces of chewing without breaking. The dressing should be permitted to remain in place as long as possible. Small particles may chip off during the week. Should a sizable portion become loose or fall off, please call the office. While the dressing is in place, you may notice a slight pain or soreness in the cheek or inside of the mouth. The edge of the dressing may be irritating the tissue. Please call the office if the soreness persists. It can be easily remedied.
Fluids should be consumed as soon as possible. It is recommended that you drink 6-8 glasses of water over the remainder of the day following surgery. Avoid using a straw as it may cause a suction, which may loosen clotting, causing bleeding.
For the first 24 hours, eat soft, cool foods that can be easily chewed or swallowed. Avoid eating or drinking hot or very cold foods or liquids (coffee, soup, tea). Avoid sharp, spicy, acidic or chewy foods for several days. Maintain a balanced diet.
Do not raise your lip or pull on the cheek to look at the surgical site. This might tear the sutures(stitches). Do not apply pressure with your tongue or fingers to the grafted area, as the material is movable during the initial healing. Do not touch surgical sites for the first week; you could dislodge the healing tissue and compromise the success of the graft.
The "look" of your graft will change over the next few weeks. It first turns white and then can turn pink. This is normal healing of the graft.
A little bleeding or redness in the saliva is normal after the surgery. If worried, place a wet teabag firmly against the area for 30 minutes or longer if necessary. If bleeding continues, please call the office.
Avoid brushing and flossing for the first six days in the surgical area. After 6 days, brush and floss very delicately. Begin to brush the NON-SURGICAL areas the day following surgery. Good oral hygiene is essential to good healing.
Do not spit, expectorate, or take any alcoholic beverages for the first 24 hours. These actions may delay healing, increase discomfort, encourage bleeding and cause complications. Smoking must be stopped. Anyways, do not smoke for at least two weeks after surgery, if at all. Smoking dramatically increases the risk of graft failure.
Rest quietly with your head elevated for the remainder of the day following surgery. Keep physical activities to a minimum immediately following surgery. Always get up slowing from a reclining position to prevent dizziness. To encourage rapid healing, please REST!
Please call our office if you have any questions or concerns.