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POSTOPERATIVE INSTRUCTIONS FOLLOWING Periodontal (Gum) Surgery & Periodontal (Gum) Grafts

Bleeding will likely be present for several hours and oozing which results in bright red saliva is common for 24 hours after surgery. If there is excessive bleeding, remove any clots with a gauze square, and place moderate but constant pressure over the bleeding area with a damp tea bag. Hold in place for at least 30 minutes. If this is not successful, call us. Avoid forceful rinsing for 48 hours; for minor bleeding, gently rinse with cold tea.

Swelling is to be expected, often peaks on the 3rd day and is usually gone by the seventh day. Apply an ice bag to the side of your face where the surgery was performed to help reduce swelling. Hold ice in place for 20 minutes on and 20 minutes off for 48 hours. Some swelling and discoloration of the skin are common and need not cause alarm. However, if swelling continues to enlarge after three days or if the swelling is hot/red, contact our office immediately. Normal swelling may last for 7- 10 days. Sleeping with the head elevated (an extra pillow or two) can help reduce swelling or discomfort. Starting three days after surgery (two days of using ice + one extra day), moist heat (heating pad, etc.) over the surgerized area will help reduce residual swelling.

Food: Please do not eat, drink, or rinse your mouth for 3 hours after surgery. After 3 hours, begin with liquid foods for 1 days and then soft/ liquid foods for 2 weeks. Avoid foods likely to get caught in the surgery site or tear the stitches such as chips, nuts, rice, popcorn, etc. Avoid hot food, drinks, or active chewing while your mouth is still numb; avoid very hot food and drinks for two weeks. Blenderized (drinkable) foods, and protein/nutritional drinks are very helpful during this period. Drink at least 6-8 large glasses of liquids per day to avoid dehydration, fever, possible shock, and possible hospitalization.

Surgical Dressing, if present around your teeth, is to protect the surgical area and facilitate healing. It should stay in place until your next appointment. Small particles of dressing may chip off from time to time; this is normal. If the entire dressing comes loose, or if you feel discomfort, please call. Do not over exercise your mouth or lips or try to see the surgical site. This may accidentally tear the sutures or displace the dressing and graft tissue. Drink cold fluids during the first 24 hours; this will keep the dressing hard.

Stitches (Sutures) may dissolve on their own or may need to be removed in one week. This will be taken care of at your post-operative appointment. Stitches falling out present no problems unless persistent bleeding occurs, or the gum tissue becomes loose.

Alcohol and Smoking should be avoided for one week following periodontal surgery and gum grafts.

Avoid the following during the recuperation period:

  • Spitting or rinsing hard for several days
  • Using a straw
  • Carbonated (fizzy) drinks
  • Hot liquids
  • Electric toothbrush or vigorous tooth brushing
  • Vigorous activity and exercise for one week
  • Contact sports for one week or longer

Oral Hygiene will speed healing and reduce odor and infection; one day after surgery begin rinsing your mouth gently with the prescribed mouthwash. Allow the mouthwash to remain in the mouth for 60 seconds but DO NOT rinse vigorously. Rinse 2 times daily for 2 weeks. You may also begin regular brushing and flossing teeth not involved in the surgery. Avoid areas of surgery, sutures, or dressing. Please use fluoride toothpaste.

Medications: Take your antibiotic and painkiller by following the directions on the bottle. Expect 2-3 days of significant discomfort following surgery. Take your prescribed pain killer or over the counter ibprophen (Motrin, Advil, Nuprin), naproxyn (Naprosyn, Aleve), aspirin or Tylenol regularly for 3-5 days as recommended. Take your medication before the numbness wears off. Antibiotic and pain medication can cause upset stomach and nausea; therefore, it is best to take with food.

Fever (under 101°) is usually due to decreased fluid intake, vomiting, and dehydration. It usually responds well to increased fluid intake; at least 6-8 large glasses of liquid per day. Fever of 102° and above may be a sign of infection and you should notify us immediately.

Please call us if you experience any of the following:

  • Generalized rash or itch
  • Bloody or persistent diarrhea
  • Increasing pain or swelling after the 3rd day
  • Fever greater than 101 degrees
  • Foul taste or discharge in the mouth
  • If numbness continues for more than 12 hours

Post-Op Instructions Following Extractions

Follow these instructions carefully to ensure the successful healing of your tooth extraction.

When to call us
It is normal to experience some discomfort for several days after a tooth extraction, but call us right away if you have:

  • Heavy or increased bleeding
  • Pain or swelling that increases or continues beyond two or three days
  • A bad taste or odor in your mouth
  • A reaction to the medication

During the first 24 hours:

It is important that a blood clot forms on the extraction site to stop bleeding, reduce pain, and speed healing. To protect the clot and avoid the pain of dry socket:

  • Bite on a gauze pad firmly for 30-60 minutes. Blood and saliva mix in the mouth and make it look like there is more bleeding than there really is. Some oozing is normal; however, after 1 hour, repeat with a clean gauze pad if oozing is profuse.
  • The site could ooze for as long as 24 hours.
  • Don’t spit, and don’t suck on candies or through a straw.
  • Don’t rinse your mouth, and don’t brush or floss next to the site.
  • Don’t smoke or use tobacco. Avoid tobacco for at least 72 hours because it slows healing.
  • Don’t sneeze or cough, so have sinus or allergy medication on hand if necessary.
  • Limit yourself to calm activities and elevate your head with pillows when you lie down to reduce bleeding.
  • Don’t drink hot, carbonated, or alcoholic drinks, and avoid hot or spicy foods
  • To control discomfort, take pain medication before the anesthetic has worn off or as recommended.
  • To keep swelling to a minimum, use an ice bag over the area, 20 minutes on and 20 minutes off.
    When the numbness has worn off completely, drink lots of fluids and eat only soft nutritious foods, chewing on the opposite side.

After the first 24 hours:

  • Begin to eat normally as soon as it’s comfortable.
  • Resume brushing and flossing, but clean gently around the site for about a week.
  • If antibiotics were prescribed, continue to take them for the indicated length of time, even if all symptoms and signs of infection are gone.
  • Reduce soreness or swelling by applying moist heat. Swelling usually starts to go down after 48 hours.
  • Further reduce swelling by rinsing your mouth very gently with warm salt water. Use about one teaspoon of salt per glass of warm water.
  • Rinse two to three times a day for the week following the extraction.

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