Post-Operative Instructions for Periodontal Surgery

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Things To Expect

Bleeding

A little bleeding or “oozing” for the first 12-24 hours is not unusual. Leave it alone as it is probably just minor.

Swelling

Some swelling and discoloration is normal following a surgical procedure in the mouth. It should reach its maximum in two-to-three days after surgery and should begin to diminish and improve following the third day after surgery.

Discomfort

The most discomfort that you may experience may occur for a few hours after the local anesthesia wears off and sensation returns to your mouth. It may gradually increase again for 2-3 days, and then begin to diminish over the next few days.

Things To Do Immediately Following Surgery

Bleeding

Keep your head elevated while resting/sleeping (use an extra pillow if necessary). Do not suck (or use a straw), spit excessively, rinse your mouth vigorously, or brush your teeth on the first day. Do not pull your lip or cheek to look at the surgical site.
NOTE: Some “oozing” and discoloration of the saliva is normal.

Swelling

Place ice or cold compresses on the region of surgery (ten minutes on, ten minutes off) for the first 8-12 hours.
NOTE: Ice bags or cold compresses should only be used on the day of surgery.

Smoking

Avoid smoking during the healing period (at least for 7 days, purchase the patch if necessary). It is recommended that you do not smoke for the first four weeks since smoking can interfere with the healing and make the results less predictable. If a bone graft was placed, it is recommended to quit for at least 6 weeks. Bone grafting results are not predictable in patients who continue to smoke.

Discomfort

Take medications as directed for PAIN. Do not take any medication if an allergy is present to that medication, or if allergic reactions appear. Call your periodontist immediately if this occurs. The ibuprofen tablet prescribed can relieve mild-to- moderate pain. For more severe pain, take other prescription pain medication (narcotic) as directed. Remember that these medications can take up to 30 minutes to one hour to take effect. If you are using any of these medications for the first time, exercise caution with the initial doses (start with 1⁄2 a pill). Remember that the narcotic medication can make you drowsy, and therefore, plan to be home or resting (do not drive).

Diet

A nutritious liquid or soft diet will be necessary for the first two weeks after the surgery. Do your best to NOT eat on the side surgery was performed. Healing will occur in weekly increments; therefore, it is best to gradually (in weekly increments) return the diet and/or other mouth/oral activities back to normal. On the first day following surgery, limit yourself to cold and soft foods, chewing on the opposite side of the surgical area. Starting tomorrow, you can eat warmer foods, but limit yourself to a soft diet for 2 weeks, chewing on the opposite side of the surgical area, until your first post-operative visit.

Physical Activity

For the first 24 to 48 hours, one should REST. Patients who have sedation should refrain from driving an automobile or from engaging in any task that requires alertness for the next 24-48 hours. Avoid exercise for the first few days. Avoid swimming and contact sports for the first 2 weeks.

Special Instructions for Sinus Augmentations: For the first 2 weeks, do not blow your nose. Gently wipe it clean as necessary. Do not hold your sneeze, as this will cause pressure within the surgical area. If excessive pressure develops in the maxillary sinus area (surgical area) or congestion develops, contact your periodontist.

The Days After Surgery

  1. BRUSHING – For the UNTREATED AREAS of your mouth, you may continue to brush and floss as you would normally. DO NOT BRUSH OR FLOSS TREATED AREAS of your mouth for the first 2 weeks. Do not use an electric toothbrush at the surgical site for the first 4 weeks. Remember, the cleaner you keep the teeth the better it will heal.
  2. Beginning 24 hours after the surgery, rinse with PRESCRIPTION MOUTHWASH twice daily for 2 weeks. This will keep the treated area clean while you are not brushing.
  3. If ANTIBIOTICS are prescribed, be SURE to take ALL that have been prescribed, AS DIRECTED.
  4. Use WARM, MOIST HEAT on face for swelling, STARTING THE SECOND DAY OF RECOVERY continue until the swelling subsides. A warm, wet washcloth or heating pad will suffice.
  5. SUTURES may dissolve or be removed at your follow-up appointment. DO NOT pull your lip or cheek to look at the surgical site. Avoid playing with the sutures with your tongue.

Contact Your Periodontist If

  1. Bleeding is excessive and cannot be controlled.
  2. Discomfort is poorly controlled.
  3. Excessive nausea.
  4. Swelling is excessive, spreading, or continuing to enlarge after 72 hours.
  5. Allergic reactions to medications occur. Signs and symptoms may include skin rash, hives, itching, fever, swelling, shortness of breath, wheezing, runny nose and itchy/watery eyes.

Should you have any questions or concerns during regular office hours, please do not hesitate to contact us at Columbia Office Phone Number 410-997-1189.