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.

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. These instructions are designed to help you minimize post-surgical discomfort and inform you of any situation that may require special attention.

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 10-14 days. In order to evaluate your progress and healing, we will see you in two weeks following your surgery.

Food and Exercise

Immediately after surgery, we will provide you with a protein drink, but please have cold, soft foods on hand for the day of your surgery.

  • For the first 48 hours, avoid ANYTHING hot, fizzy, or anything with alcohol.
  • Avoid chewing on surgical sites for 10 days or until comfortable. No crunchy foods or small seeds (ie: chips, popcorn, nuts, berries, etc.).
  • No rinsing, excess spitting or sucking from a straw or for 5 days after surgery. (This may dislodge regenerative materials.)
  • No heavy activity/exercise for 48 hours. Keep blood pressure down!

On surgery day and the day after, keep all food and drink temperatures cold or lukewarm – not hot. Avoid carbonated beverages for 2 – 3 days because this can increase chances for bleeding. Do not use straws for three days. Eat soft foods and avoid hard or crunchy foods until your post-op visit. You will be on a soft diet for several days until you feel that you can chew firmer foods. (Examples: Breakfast: scrambled eggs, applesauce, yogurt, cottage cheese, pancakes, oatmeal. Lunch / Dinner: baked or broiled fish or chicken, soft cooked veggies, mashed potatoes, mashed sweet potatoes, pasta, ice cream, puddings, Jell-O, protein drinks. 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.

Pain Medications

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. 

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. It is advisable to not take pain medication on an empty stomach, as nausea may result. If necessary, you may take your pain medication more frequently than every 4-6 hours to stay ahead of the soreness. Do not take narcotic medications while driving or performing duties which require one’s full reasoning faculties. Do not take aspirin products unless instructed. (Aspirin increases bleeding. Use Tylenol or Advil instead.).

Many types of pain medications contain hydrocodone, codeine, or a similar narcotic, and can make you light-headed and nauseous.  Take proper precautions while taking these medications (i.e. driving, do not drink alcoholic beverages, etc.)

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, Vicodin 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.

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 (such as ginger ale, Sprite, 7-Up, Kool-Aid, etc.) and/or take an over-the-counter Dramamine tablet at the first sign of nausea.

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 during the first 24 hours following surgery. The day after surgery, alternate the use of warm, wet compresses with ice packs on the areas of the face that are swollen for 15 minutes, repeating every 2 hours. Continue to alternate warm/cold applications for 2-3 days following the procedure as often as needed. Sleep with your head propped up the first 2 nights. If swelling is still present, do not use ice packs. Instead use warm, moist compresses.

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. If you notice continued or excessive bleeding:

  • Do not rinse your mouth.
  • Elevate your head when lying down.
  • Do not panic. Locate the exact bleeding site.  Place a moist tea bag or moist rolled up gauze with biting pressure, or using your finger to apply moderate pressure for 20 Carefully remove the gauze or tea bag.  The bleeding should stop.  If there is still heavy bleeding try fresh gauze or tea bag for an additional 20 minutes.  If bleeding does not stop, please call our office.
  • Put a towel on your pillowcase in the evening to avoid staining linens.

If excessive bleeding, pain, swelling or infection occurs following periodontal surgery, please contact us immediately at our office (512) 454-6861. In case of an emergency after hours (outside of normal business hours), a Dr. Chapa or Dr. Ferguson can be reached by cell phone at (512) 643-9356.

Dressing

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. Most of the dressing will be out by the first post-operative visit.

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. Foods such as Jello, pudding, yogurt, cottage cheese, oatmeal, soup, eggs, pasta, baked fish, soft-cooked vegetables, mashed potatoes, mashed sweet potatoes, casseroles, and fruits are more easily eaten. Remember, adequate nutrition is essential for feeling better as well as for healing.

Toothbrushing and Oral Care

It is important to maintain a high level of oral hygiene after periodontal surgery the day following surgery.  Normal brushing and flossing procedures should be followed throughout the mouth except in the area were the surgery was performed.  This reduces the accumulation of bacteria (plaque), reduces the chances of infection, and minimizes unpleasant mouth odor.

Do not disturb the surgical site. You may resume normal brushing/flossing in other areas the following day.

  1. No toothbrushing or pulling on tissues around the surgical site until otherwise directed.
  2. If a periodontal dressing (pink) is used, do not remove it intentionally. It may fall off throughout the following week, but try to leave it undisturbed.
  3. Never remove sutures or barrier membranes. (This may dislodge regenerative materials.)

ORAL HYGIENE AT THE SURGICAL SITE: 

  • Beginning the day after surgery, gently rinse 2-3 times daily (after breakfast and before bed) with a capful of Peridex for a full 30 seconds.
  • Do not brush the surgical site. You may resume normal brushing/flossing in other areas the following day.
  • If you do not have a periodontal dressing, gently brush the upper portions of the teeth where the surgery was performed.  Do not floss these areas.  If you received a gingival (gum) graft or have a periodontal dressing do not brush, floss, or otherwise disturb the area during the first week.  You may use wet cotton swab (Q-tip) to gently clean the periodontal dressing. 

Rinsing

Do not rinse for the first 24 hours. After that, you may use a mild, diluted mouthwash. Repeat as necessary to help keep the dressing clean.

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.

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.

Answers to Other Frequently Asked Questions:

  1. It is common to have an increase in temperature above normal for the first few days following surgery. If the temperature exceeds 101° or persists for more than a few days, then please call the office.  You most likely have a co-existing cold or medical problem, unrelated to the surgery, and should see your physician.
  2. You may experience slight feeling of weakness or chills during the first 48 hours, which is not abnormal.
  3. You may experience a slight sore throat or an earache up to a week. This is not unusual and will subside as healing occurs.
  4. Sensitivity: Most patients experience sensitive teeth especially to cold, which usually slowly diminishes in a month or so after surgery.  Patients with excellent oral hygiene habits generally notice a more rapid decrease in sensitivity than patients with poor plaque control.

Contact Us

Should you have any questions or concerns during regular office hours, please do not hesitate to contact us at 512-454-6861. For after-hours emergencies, please refer to the phone number listed in your post-operative paperwork.