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. Optimal healing following periodontal surgery is dependent on proper post-operative care. It is very important to follow these post-operative instructions to facilitate optimal healing after periodontal surgery.

     Most surgeries involve repositioning of the gum tissues and re-contouring the bone around the teeth. In regenerative procedures, bone materials and barrier membranes may be used to “rebuild” tissues lost to disease.

After all surgeries, the most important factor which promotes healing is stabilization of the surgical site. Thus, the surgical site must remain undisturbed for at least 14 days. To evaluate your progress and healing, we will see you in two weeks following your surgery.

 

Antibiotics/ Pain Medications

An antibiotic may be prescribed following your surgical procedure. If so, you will have already started antibiotics prior to your surgery. After surgery, continue to take the remainder of your antibiotics as directed until gone. It is advisable not to take these medications on an empty stomach, as nausea may result.

     It is not unusual to have discomfort for at least the first week following your surgical procedure. The average patient experiences at least a moderate amount of pain and/or discomfort 1-3 days following periodontal surgery. This is normal, however, how much and how long it lasts depends on the type of surgery performed and your unique response to it.

     Do not take aspirin products unless instructed. (Aspirin increases bleeding). Do not take narcotic medications with alcohol or while driving or performing duties that require one’s full reasoning faculties. It is advisable not to take pain medication on an empty stomach, as nausea may result.

     You will be given a prescription for medication to help you tolerate the post-surgical recovery period. Please take your medications as directed. Take the pain medication before the numbness wears off and before you experience discomfort.

     If you choose not to use the narcotic pain medication prescribed, we recommend that you use over-the-counter Acetaminophen (Tylenol) and/or Ibuprofen/Motrin (Advil) for effective pain and inflammation management.

 

Swelling

Some swelling and/or bruising after certain surgical procedures is normal. This may occur following your surgical procedure and will typically increase 2-3 days after the procedure. To minimize the swelling, apply an ice pack to the outside of your face over the surgical area for 20 minutes on and 20 minutes off as needed during the first 24 hours following surgery unless otherwise instructed. Sleep with your head elevated for the first night. If swelling and/or bruising is still present after 72 hours, do not use ice packs. Instead use warm, moist compresses in 20 minutes on and 20 minutes off intervals. The gel pack that was sent home with you can be placed in the microwave. Just follow the directions on the gel pack.

 

Bleeding

A small amount of bleeding and/or slow oozing of blood is normal and expected, and you may notice blood in your saliva for 1-2 days. Do not rinse your mouth. Elevate your head when lying down and put a towel on your pillowcase in the evening to avoid staining linens.

     If you notice continued or excessive bleeding:   Do not panic. Locate the exact bleeding site.  Apply direct, moderate pressure to the surgical site with a moist tea bag or moist rolled up gauze with biting pressure or using your finger to apply moderate pressure for 20 minutes. Carefully remove the gauze or tea bag.  The bleeding should stop.  If there is still heavy bleeding, try a fresh tea bag or fresh gauze for an additional 20 minutes. If the bleeding does not stop, please call our office.

 

Rinsing

Begin your Stellalife or Peridex rinse (the medicated mouthwash that you were prescribed) the day after surgery. Gently swish 30-60 seconds, 2 times daily and expectorate. We recommend using it after breakfast and before bedtime. Continue the medicated rinse until post operative visit or until bottle is finished.

  *The medicated rinse can temporarily stain teeth. 

 

Food and Exercise

For the day of your surgery, please have cold, soft foods on hand. For the first 24 hours, keep all food and drink temperatures cold or lukewarm. Avoid any drinks that are carbonated (fizzy), anything with alcohol, or sucking from a straw for the first 72 hrs. after surgery. No excess spitting after surgery (this may dislodge regenerative materials).

 

 Avoid chewing on surgical sites for 14 days, or until your first post op appointment. No crunchy foods or small seeds (ex: chips, popcorn, pretzels, nuts, berries, etc.). You will be on a soft diet for several days until you feel that you can chew firmer foods. For your convenience, we have a list of suggested examples on our website under the “Surgery Instructions” tab, Soft Food Suggestions. Remember, adequate nutrition is essential for feeling better as well as for healing. If surgical areas are in the front part of your mouth, do not bite into any foods. Cut food into bite size portions and chew on non-surgical areas (this may dislodge regenerative materials).

    

No heavy activity/exercise for 72 hours after surgery. Keep blood pressure down!

 

Alcohol and Smoking

Do not drink alcohol while taking prescription pain medications, as it could cause an adverse effect on these medications and your health. Do not smoke for at least 2 weeks following your surgical procedure. It will significantly slow healing and can compromise results.

 

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. Never remove sutures or barrier membranes (this may dislodge regenerative materials). Sutures/membranes will be removed by the doctor at your first post op appointment. You may choose to take some form of pain medication one hour prior to your suture removal appointment to minimize tenderness.

 

Dressing

If a periodontal dressing (pink) is used, do not remove it intentionally. The dressing (which acts as a bandage) is used to protect the surgical site and help reduce discomfort. This dressing may chip off and fall out, even as early as the first day, but try to leave it undisturbed. If it does come out, do not worry, as it is only placed to ease the discomfort and temperature sensitivity after surgery.

 

Nausea

A common symptom (the day of surgery), due mainly to swallowing a lot of drainage (blood and saliva), but also a common reaction to many sedative, narcotic, and/or antibiotic medications. If you experience these symptoms, you may want to discontinue all milk products; drink clear liquids and/or take an over-the-counter Dramamine tablet at the first sign of nausea.

 

Weakness, Chills, Fever, Sensitivity

You may experience a slight feeling of weakness, chills, or fever during the first 48 hours. If your temperature exceeds 101° or persists for more than a few days, please call our office. You may experience a slight sore throat or an earache for up to a week. This is not unusual and will subside as healing occurs. Most patients experience sensitive teeth, especially to cold, which usually slowly diminishes in a month or so after surgery. 

 

Toothbrushing and Oral Care

It is important to maintain a high level of oral hygiene after periodontal surgery. Normal brushing and flossing procedures should be followed throughout the mouth except in the area where the surgery was performed.  This reduces the accumulation of bacteria (plaque), reduces the chances of infection, and minimizes unpleasant mouth odor. No toothbrushing, flossing or pulling on tissues around the surgical site until otherwise directed. Do not disturb the surgical site. You may resume normal brushing/flossing in other areas the day following surgery.

 

Oral Hygiene at the Surgical Site

Do not brush or floss surgical areas for 2 weeks following surgery. Use the medicated rinse that was sent home with you to keep the area/areas clean.

 

Contact Us

Should you have any questions or concerns during regular office hours, please do not hesitate to contact us at 512-454-6861. In case of an emergency after hours (outside of normal business hours), please call (361) 549-7140.

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