Post Operative Instructions for Periodontal Surgery

Discomfort and Medications

Periodontal surgery, like other surgical procedures, may be associated with varying degrees of discomfort. This depends on the procedure involved and individual differences. If analgesics have been prescribed, it is usual to take the first dose while the surgical site is still anesthetized (“numb”). All medication should be taken strictly as prescribed. The interval between taking the medications and the total length of time that you are to remain on your medications has been carefully determined to give you the maximum benefit with the minimum use of drugs. Variation from the prescribed regime can affect healing and the success of your procedure.

Bleeding

You may notice slight bleeding from the surgical site. This type of minor bleeding for one or two days is not unusual and is not a major concern. If at any time you notice the formation of large blood clots or any obvious flow of blood which is more than a light ooze, notify your doctor at once.

Sutures

Sutures (“stitches”) are placed to hold the gingival tissues in the proper position for ideal healing. If sutures (“stitches”) were placed, your doctor will usually want you to return so that they can be fully removed once sufficient healing has occurred. Do not disturb the sutures with your tongue, toothbrush, or in any other manner since displacement will impair healing. If you notice that a suture has come out or loosens, notify your doctor during regular office hours.

Dressing

A periodontal dressing is often used to cover the surgical site for one to two weeks after surgery. The dressing is placed around your teeth to protect the surgical area and should not be disturbed. If small pieces become lost, and you have no discomfort, there is no cause for concern. If large pieces break off or the entire dressing becomes loose in the first 2-4 days, please contact the dentist.

Diet

For your comfort and to protect the surgical area, a soft diet is recommended. Avoid chewing in the area of surgery. Avoid hard, fibrous, or “sharp” foods (such as corn chips), as these may cause discomfort and can dislodge the periodontal dressing.

Drink plenty of liquids. It is important to maintain a diet with a normal calorie level that is high in protein, minerals, and vitamins to support post-operative healing. Eat as normal a diet as possible.

POST SURGERY IS NOT THE TIME TO START A DIET since this can have detrimental effects on healing and lessen the chances of success of the surgical therapy.

Oral Hygiene

Continue to brush and floss the teeth that were not involved in the surgery (or covered by the periodontal dressing). The surgical area should not be disturbed for the first week post-operatively. However, you may rinse gently with salt water or with a mouthwash if prescribed by your doctor. After your sutures have been removed, generally after one week, you should lightly clean the teeth using a soft toothbrush or as instructed by your doctor. The gentle application of a fluoride gel with your toothbrush will also help to control plaque.

Physical Activity

Avoid strenuous physical activity during your immediate recovery period, usually 2 to 3 days.

Swelling

Some slight swelling of the operated area is not unusual and may begin after the surgery. An ice pack may be used to minimize swelling. Ice should be placed in a plastic bag and then wrapped in a thick cloth towel and applied directly over the surgical area. You should keep the towel-wrapped ice pack in contact with the skin as much as possible for the first 24 hours after surgery. You should also keep your head elevated above the level of your heart during the first 24 hours after surgery. This may necessitate the use of several pillows to support your head and upper body while sleeping. If swelling occurs, it usually disappears after several days. Applying moist heat to the swollen area will help the swelling resolve; however, heat should not be applied until at least 1-2 days after surgery. Any unusual or large swelling should be reported to your periodontist at once.

Smoking

All smoking should be stopped until after your sutures have been removed to ensure the best healing and success of your surgical procedure. Healing results are significantly worse in smokers than in non-smokers.

Alcohol

All intake of alcohol should be stopped until after your sutures have been removed and minimized for the next several weeks after suture removal to enhance healing. The combination of alcohol and certain pain medication is not recommended.

Do Not

For the next several days, do NOT spit, smoke, rinse hard, drink through a straw, create a “sucking” action in your mouth, use a commercial mouthwash, drink carbonated soda, or use an oral irrigating device.

General

If you are experiencing problems that do not appear to be normal, please do not hesitate to contact us at (503) 224-3853 or Dr. Haghighat’s cell phone at (503) 358-2605.