Periodontal Surgery Post Operation Instructions

You have just undergone Periodontal Surgery.  After your periodontal surgery, your lips, teeth, cheeks and tongue may be numb for several hours.  It is normal to experience some discomfort for several days after a surgery. 
By following these instructions you will assist the area in its recovery and prevent complications.

1. You may be asked to apply pressure to the surgical area with your hand for 30 minutes following the procedure.  This will assist clotting and proper tissue adaptation. Apply steady but moderate pressure.
   
   
2. Under the surgical area, clots are now forming. These are important for proper healing. Do not rinse or spit today.  Rinsing can dislodge the clot and result in bleeding.
   
   
3. It is important to ice the area immediately to prevent swelling.  A certain amount of swelling is normal and varies from patient to patient. Swelling will peak at 48 hrs after the procedure.  Use crushed ice or gel packs (even a bag of frozen vegetables will work in a fix).  Apply at 15 minute intervals, alternating ON and OFF for the rest of the day. The more you ice the area today, the less swelling there will be tomorrow.
   
   
4. Elevate the head for the first 24 hrs. When sleeping, use an extra pillow. Try not to bend over as this increases blood pressure in the head and can cause bleeding. Limit physical activity that day – this includes any aerobic activity and weight lifting.
   
   
5. There may be some bruising and discoloration in the surgical area. This is not of concern and will fade.  Occasionally, bloodstains in the saliva will appear for the first 24 hours.  Should prolonged bleeding develop take moist gauze and apply pressure to the area for 20 minutes. If this does not reduce the bleeding, call the periodontist immediately.
   
   
6. Several sutures (stitches) may have been placed in the treatment area to keep the incision closed.  It is important that the area be left alone for 48 hrs to allow closure of the wound.  Do not attempt to look at the area because this can cause stretching and tearing of the sutures.  An appointment will be made in approximately one week to remove the sutures if they are not resorbable (dissolvable).  Occasionally one or more of the sutures may fall out toward the end of the week.  This is normal.
   
   
7. Some regenerative materials such as bone or membrane may have been placed in the treated area.  Do not pick at or dislodge these materials.  Doing so may result in failed treatment and may require additional surgery and associated material costs.  If bone has been placed, you may note a few sandy particles in the saliva – this is fine since it is only the very top of the graft and will not affect the final result. If a membrane has been placed, it may peek out from the tissue and appear gray, white or yellow. This is normal and does not mean there is an infection.
   
   
8. The following day, brush other areas of the mouth normally. Do not brush in the surgical area until the Periodontist has done the  follow up exam.  Instead, use Peridex mouth rinse twice a day to keep the area clean.
   
   
9. Nutrition is an important part of post-operative healing.  Patients should try to eat normally with a few exceptions.  Avoid any chewing or having any hot liquids until the numbness has completely worn off.  Don't eat anything for two hours following surgery.  A softer than usual diet is necessary for the first week.  Pasta, eggs, sandwiches, lukewarm soup, stew, salads and other similar foods are acceptable.  Avoid hard or sharp foods such as chips, bagels, pretzels, crusty bread, pizza, crackers, granola bars etc.
   
10. You may be provided with a prescription for medication to help with any discomfort.  We suggest that you fill the prescription and begin taking it immediately.  The following day, you should expect to have swelling and some minimal discomfort.
    
    
11. Smokers are urged to cease smoking until the follow up visit.  Nicotine has been shown to delay wound healing.  Should you be unable to stop, try to cut down by at least half.  Consumption of alcohol should be avoided while you are taking any pain medication since it can interact with the narcotics.  Take any narcotic pain medicine after a full meal at bedtime as it can cause drowsiness and nausea as side effects.
    
12. An appointment will be made for you in approximately 7-14 days for a follow up visit.

If any problems or questions arise, please contact the specialist.  Your cooperation is important in obtaining the best possible result.  Should you have any questions, please call the doctor at the regular office number 508-424-2525. 

Dr. Paul C. Kuo, MD, DMD, Oral and Maxillofacial Surgery, Dr. Ann-Marie O’Connor, DMD, MMSc Periodontist,
Dr. Thomas R. Ollerhead, DMD, CAGS Endodontist, Dr. Willie L. Stephens, DDS, Oral and Maxillofacial Surgery

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