Post-Operative Instructions For Periodontal Surgery

Discomfort:

1. Depending upon the operation performed, you may expect no discomfort, little discomfort, or considerable discomfort when the local anesthesia wears off.
2. If considerable discomfort is anticipated, you will be given a prescription medication that will provide relief. Take the medication according to the directions on the label. The medication should not be taken on an empty stomach (carbonated beverages, at the least, are recommended.)
3. Immediately after the surgery, you will be given Ibuprofen or Tylenol (if you are allergic to Ibuprofen). If you have not been given a prescription medication, it is recommended that adults take Ibuprofen 600-800 mg. (brand names are: Advil, Motrin, Nuprin, and are supplied in 200 mg. tablets over the counter). Take 3-4 tablets every 4-6 hours for the first 24 to 48 hours after surgery.
4. If you are given a prescription for infection (such as penicillin or some other antibiotic), take the medication as directed until all of the tablets are gone. If you develop hives, rash or itching while on the antibiotic, stop the medication immediately and call our office or your periodontist at home.
5. It is not unusual to experience some sensitivity of the teeth following surgery. This normally corrects itself within several weeks, but can take a couple of months for some. Good home care (flossing and brushing to remove bacterial plaque) will help reduce sensitivity after the sutures (stitches) are removed. Rarely, some numbness or tingling in the area of surgery occurs, which normally subsides with time. Sensodyne toothpaste may help reduce sensitivity over time.

Swelling:

1. To help prevent swelling and discomfort in the surgical area, you may apply an ice pack to your face for the first 24 hours after surgery, (a small bag of frozen peas or corn wrapped in a pillow-case works well as an ice pack.) Keep ice pack on face for 15 minutes and remove for 15 minutes, then reapply for 15 minutes. Repeat this process for the first 24 hours after surgery. Do this only on the day of surgery; ice will not reduce swelling once it has occurred.
2. Keep your head elevated with at least 2-3 pillows for the first 24 hours to help prevent swelling.
3. It is normal to have some swelling following surgery; it should gradually subside during the week following surgery. A warm, wet washcloth may be applied to the face to help swelling and/or bruising to subside.
4. If you develop a fever with increased discomfort and swelling, call our office.

Bleeding:

1. It is normal to have some bleeding after surgery. You will be given a pack of gauze after the surgical procedure, and may leave the office with gauze placed over the surgical area. Bite firmly on the gauze for 30 minutes until the bleeding stops. Do not rinse or spit on the day of surgery; to do so can cause bleeding. Avoid taking aspirin following surgery. Avoid using a soda straw when drinking.
2. If you begin to bleed heavily, place gauze in mouth and bite down firmly for a full 30 minutes, then check to see if bleeding has stopped. If bleeding persists, a wet tea bag may be used in place of gauze, using hard, direct pressure over the bleeding area.
3. It is normal to have some blood stains in the saliva for the first 24 hours after surgery. It is not unusual to have bleeding from the roof of the mouth following some gingival (gum) grafts up to a week following surgery. If this occurs, apply hard, firm, direct pressure on the roof of the mouth with gauze for 30 minutes. If bleeding persists, call our office.

Home Care:

1. Do not rinse with water or mouth-wash the day of surgery.
2. Rinse the mouth at least six times a day with warm salt water, starting the day after surgery. (One teaspoon salt to a tall glass of warm water for the next two weeks.) If you have had a gingival graft, do not rinse and swish the water vigorously, as you may dislodge the graft. Roll the water around in your mouth gently and let it fall gently out of your mouth.
3. You may use a mouth-wash the day after surgery. It is recommended that you use a non-alcohol based mouthwash (Rembrandt) or dilute your mouth-wash with water.
4. You may brush gently in the surgical area with a soft toothbrush. This will help prevent the building-up of bacterial plaque on the surgical area and reduce discomfort. If you have had a gingival graft, do not brush in the graft area!

Eating:

1. The day of surgery, do not drink or eat anything hot (warm foods are acceptable). Avoid chewing until the local anesthesia wears off.
2. A soft, bland diet is recommended following surgery. Avoid peppery, spicy foods (Italian, Mexican). Avoid hard, crunchy foods (chips, toast, nuts). Avoid acid foods (tomatoes, citrus fruits, fresh pineapple). Examples of a soft, bland diet are: cream soups, soups, milk shakes, Carnation Instant Breakfast, protein drinks, mashed fruits and vegetables, scrambled or poached eggs, pancakes, oatmeal, cream of wheat, custards, puddings, yogurt, cottage cheese, macaroni and cheese, Slimfast diet drink, tuna or chicken salad, deviled ham, grits. This is a suggested diet for your comfort, (If you can handle firmer foods, they are permitted). If you have had a gingival graft, avoid all hard, crunchy food!

Summary Of Activities:

1. Take medication as directed.
2. Do not rinse or spit the day of surgery.
3. If bleeding occurs, apply hard, direct pressure with gauze for 30 minutes.
4. Keep head elevated with 2-3 pillows.
5. Apply ice packs every other 15 minutes for first 24 hours.
6. Soft, bland diet.

If Problems Or Questions Arise, Please Call Our Office Or We May Be Reached At Home.

Chesterfield Office: 748-9553
Dr. Slagle: 731-1006
Dr. Rezk: 859-447-6955