Post-operative Instructions for Periodontal Flap Surgery/Crown Lengthening
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.
Rest
It is recommended that you lie with your head elevated with a couple of pillows. For the remainder of the day, please limit your physical activities to a minimum, as it will help prevent swelling or bleeding.
Mouthcare
No spitting, swishing, smoking, drinking through a straw or rinsing for the first 24 hours. Do not brush or floss the surgical area today. If a surgical dressing is placed, you will not need to brush or floss the surgical area until your follow up visit one week later. You can start using PERIOSCIENCE after your sutures are removed. Follow the directions provided regarding PERIOSCIENCE. Please brush and floss the remainder of your mouth as you normally do. Brushing your tongue is also helpful.
Take a positive approach to your mouthcare at this time. The mouth is one of the most rapidly healing areas of the body. If you utilize these instructions, it will be virtually impossible for you to harm your mouth. If there is a surgical dressing placed there is no need to apply PERIOSCIENCE or brush the surgical site. If a dressing is NOT placed, it is best to start applying the PERIOSCIENCE 24 hours after surgery.
Ice
In order to minimize swelling following surgery, apply an ice pack to the outside of the face in the operated areas 20 minutes on and 10 minutes off for a period of two hours. DO NOT use warm compresses today.
Pain Medications
Use your pain medication as prescribed to relieve discomfort. It is important for you to start your anti-inflammatory medication (Example Motrin) when you arrive home after surgery. You should continue taking the Motrin for 3 days post treatment to help with the swelling. This will keep you comfortable as well as promote healing. Should you need additional pain relief, take 1 Tylenol with your dose of Motrin. DO NOT exceed 3,000 mg acetaminophen per day. Take with food. If antibiotics are necessary, take as prescribed until they are gone. If nausea, itching skin or a rash develops after taking medication, discontinue use and phone the office immediately.
Bleeding
A small amount of bleeding is normal. DO NOT rinse your mouth today as this may stimulate bleeding. Avoid smoking and the use of alcohol as they will interfere with normal blood clotting and irritate your mouth. Smoking will delay healing. NO smoking is best. We will give you sterile gauze to take home. Should have bleeding, apply firm but gentle pressure to the area. If after 30 minutes bleeding continues PLEASE call the office.
Eating
Anesthetic may last 6-8 hours. While you are still numb please do not have anything hot (temp). You may burn or bite your lip/tongue and not feel it. When the anesthetic has worn off, you may have something cold to drink or soft to eat. Eating a soft meal the evening of your surgery will certainly help the comfort of your mouth. It is important that you maintain an adequate diet which includes protein. Avoid vigorous chewing on surgical site, or any hard or tough foods, as well as spiced or acidic foods. Foods that add bulk (roughage) to your diet, as well as lots of liquids, will help prevent constipation which is often a side effect of the prolonged use of strong pain medications.
Exercise
No strenuous exercise for 2 days.
Swelling
The day following surgery, you might be aware of the onset of some swelling in your mouth, especially if you don’t apply ice packs the day of surgery. Tomorrow it may even increase, but should diminish greatly the third and fourth days following surgery. This pattern of swelling is associated with normal healing. The application of moistened hot compress (washcloths) to the outside of your face, on and off for several house, often decreases swelling significantly and will contribute to your comfort. DO NOT use ice packs the day after surgery.
Other Possible Side Effects
1. If stitches around the gum should become loose, do not attempt to remove them yourself.
2. As the week progresses, stitches may become tight and create some dull aching which can usually be controlled by the medications.
3. You may have a plastic-like material around your teeth, which may tend to break loose or fall off as the week progresses. If however, you have had a bone graft, the dressing may need to be reapplied and you should call and speak to one of us.
You will notice the spaces between your teeth have become larger. Food will catch, but it will be removable through your cleaning efforts. This is a positive change.
Post-Operative Instructions for Soft Tissue Grafts
Pain Medication
Upon returning home, please take the pain medication as directed. We recommend 3 Motrin a day but you may take up to 4 if you should need it. In our experience most patients do fine with the Motrin only. However, if you do take the Motrin as recommended and you still have discomfort, add 1 Tylenol to each of the doses of Motrin. Do not exceed 3,000 mg acetaminophen per day.
Bleeding
Should bleeding occur, apply a moist gauze to the bleeding site with firm pressure. Pressure should be applied for a period of 10 to 20 minutes. This can usually control bleeding. Should you find this to be inadequate, the following step should be taken: Make a strong cup of Black tea, dip the piece of gauze into the tea, wring it out so it is not hot and apply firm pressure. Tannic acid, present in the tea, can serve to readily accelerate the formation of a blood clot. Should this fail, please call our office for further instructions.
Rest
24 hours after the procedure, make an effort to keep your head elevated above your chest and avoid lying flat. This is also helpful as a means of minimizing any swelling.
Swelling
To prevent the possibility of swelling we suggest using ice for 20 minutes on the outside of the face, 10-15 minutes off, for a 2-hour period immediately after surgery. Bruising is normal and may occur.
Mouthcare Instructions Immediately Following Surgery
Anesthetic may last 6-8 hours. While you are still numb please do not have anything hot (temp). You may burn or bite your lip/tongue and not feel it. You can brush and floss the rest of your mouth, avoiding the surgical areas, starting 24 hours after surgery. DO NOT spit or drink out of a straw for 24 hours after surgery, as that could disturb the blood clot. Starting 24 hours after surgery, please use the PERIOSCIENCE GEL.
Diet
It is requested that you modify your diet to eliminate foods such as French bread, pickles, apples, carrots, chips, and anything that has the possibility of moving or displacing the graft. Please stay away from any hard or crunchy foods in the area of the graft. Please see the recommended food list. You may chew or eat a softer diet in any uninvolved area. It is not necessary that you starve yourself, but reasonable caution will minimize possible complications.
Healing
Please be aware that during the healing process your tissue will undergo many changes. If you notice the surgical site is changed colors varying from red to white to yellow to blue to purple, do not be alarmed, this is common and indicates normal healing. The sutures on the roof of your mouth will begin to dissolve in 3-5 days. If they start to unravel and hang down, don’t be alarmed it is normal. PLEASE NOTE: On occasion, the sutures can be irritating to the lip and cheek, and may cause canker sores to form. If you have any discomfort from the sutures, or notice a canker sore forming, please call us so that we may advise you further. We are here to help!
Stent
If you have received a stent (a plastic covering for the roof of your mouth), please use as instructed. The stent is used for protection of the donor site and can be used in conjunction with an ointment that helps numb the area. Please note a modest amount of ointment is all that is necessary to assist in minimizing discomfort on the roof of the mouth. Please clean the appliance with a toothbrush and warm water.
Smoking
Please be aware that smoking significantly affects the healing of the surgical procedure.
Exercise
No strenuous exercise for 2 days. No swimming for 1 week.
Contact Us
Should you have any questions or concerns during regular office hours, please do not hesitate to contact us at Practice Limited to Periodontics Phone Number 650-556-9999.