Post-operative Instructions

These instructions apply to the surgical procedure just completed. They are designed to help you minimize post-surgical discomfort and inform you of any situation that may require special attention.

Discomfort and Medication

Periodontal surgery, like other surgical procedures, may be associated with varying degrees of discomfort. This depends on the procedure involved and individual differences.

IF analgesics have been prescribed, it is usual to take the first dose while the surgical site is still anesthetized (“numb”). All medication should be taken strictly as prescribed. The interval between taking the medications and the total length of time that you are to remain on your medications has been carefully determined to give you the maximum benefit with the minimum use of drugs. Variation from the prescribed regime can affect healing and the success of your procedure.   Please take your medications as directed. It is advisable to not take pain medication on an empty stomach (take with a small amount of soft food), as nausea may result.

As an alternative to prescription medications, some patients have found taking a combination of over-the-counter Ibuprofen and Tylenol to be effective. You may take the combination in either of the following dosages: 3 Advil Liqui-Gels and 2 Regular Strength Tylenol or 3 Advil Liqui-Gels and 1 Extra Strength Tylenol, every 4-6 hours as needed.

Note: When taking any prescribed medication containing Acetaminophen (Tylenol), i.e.; Percocet, Hydrocodone, Vicoden or Tylenol with Codeine, you should not take additional Tylenol so as not to exceed the safety level of Acetaminophen. Please contact the office with any questions you may have.

Antibiotics

Please alert the office to any allergies or sensitivities that you might have to antibiotics.

An antibiotic may be prescribed following your surgical procedure. Take as directed until gone.   It is advisable not to take these medications on an empty stomach, as nausea may result. For women taking birth control pills, be advised that antibiotics may interfere with their effectiveness.

Swelling

Some slight swelling of the operated area is not unusual and may begin after the surgery. An ice pack may be used to minimize swelling. Ice should be placed in a plastic bag and then wrapped in a thick cloth towel and applied directly over the surgical area. You should keep the towel-wrapped ice pack in contact with the skin as much as possible for the first 24 hours after surgery. You should also keep your head elevated above the level of your heart during the first 24 hours after surgery. This may necessitate the use of several pillows to support your head and upper body while sleeping. If swelling occurs, it usually disappears after several days. Applying moist heat to the swollen area will help the swelling resolve; however, heat should not be applied until at least 1-2 days after surgery.   It is not uncommon to see a peak in swelling on Day 3, this is normal.  Any unusual or large swelling should be reported to your periodontist at once.

Bleeding

You may notice slight bleeding from the surgical site. This type of minor bleeding for one or two days is not unusual and is not a major concern.

If excessive or continuous bleeding occurs:

• Do not rinse your mouth.
• Elevate your head when lying down.
• Apply moistened gauze to the immediate area with moderate pressure for 20 minutes; repeat if necessary.
• Enclose a moistened tea bag in a gauze square and apply pressure for 20 minutes.
• Call the office if bleeding persists.

If at any time you notice the formation of large blood clots or any obvious flow of blood which is more than a light ooze, notify your doctor at once.

Sutures/Dressing

SUTURES: Sutures (“stitches”) are placed to hold the gingival tissues in the proper position for ideal healing. Sutures will start to dissolve (fall out) within the first seven to ten days.

Do not disturb the sutures with your tongue, toothbrush, or in any other manner since displacement will impair healing.  

DRESSING: A periodontal dressing is often used to cover the surgical site for one to two weeks after surgery. The dressing is placed around your teeth to protect the surgical area and should not be disturbed. If small pieces become lost, and you have no discomfort, there is no cause for concern. If large pieces break off or the entire dressing becomes loose in the first 2-4 days, please contact the dentist.

Sharp Edges

If you feel something hard or a sharp edge in the surgical site, it is likely you are feeling the bony walls, which once supported the extracted teeth. Occasionally small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.

Diet

Until comfortable, avoid chewing on the side where surgery was completed. Avoid hot foods and liquids for approximately 1 hour following the surgery so as not to soften the dressing. A soft diet is recommended. Remember, adequate nutrition is essential for feeling better as well as for healing.  Please see the YES list below for recommendations.

 Please do NOT use a straw for the 1^st 7-10 days.

 

Smoking

• Do not smoke for at least 2 weeks following your surgical procedure. It will significantly slow healing and can compromise results.

Alcohol

• Do not drink alcohol while taking prescription pain medications.

Oral Hygiene

Continue to brush and floss the teeth that were not involved in the surgery (or covered by the periodontal dressing). The surgical area should not be disturbed for the first week post-operatively. However, you may rinse gently with an over-the-counter mouthwash or one prescribed by your doctor.   

Do NOT spit, just tilt your head to the side and let the mouthwash dribble out.

Recap –  DO NOT for the next several days, do NOT spit, smoke, rinse vigorously, drink through a straw, create a “sucking” action in your mouth, or use an oral irrigating device.

Suture Removal

You may notice increased discomfort 3-4 days after the surgical procedure. As the tissues begin to heal, they may pull against the sutures and dressing. You may choose to take some form of pain medication one hour prior to your suture removal appointment to minimize tenderness.   If you are a patient for whom Antibiotic Pre-Medication is required, take the prescribed antibiotics 1 hour prior to your suture removal appointment.

Physical Activity

Avoid strenuous physical activity during your immediate recovery period, usually 2 to 3 days.