Patient Instructions Following Periodontal and Dental Implant Surgery

To help you get the best possible results, comfort, and peace of mind, please read these instructions before your treatment.

Refer to them immediately after treatment and also during your first week of healing.

IMMEDIATELY FOLLOWING YOUR SURGERY AND UNTIL THE NEXT MORNING

Unless advised otherwise, go home and rest—even if you feel fine. The more you move around the slower you might heal.

Lie down with your head slightly elevated or sit in a reclining position. Especially during the first few hours following surgery, please keep talking to a minimum, as your lips and cheeks act as natural “bandages” during initial healing.

You just had a surgical procedure and your body needs time to heal. Do not over-exert yourself through exercise or working too hard prematurely. Minimize talking for a few days.

Elevate your head when you sleep. If you are eating foods that cause discomfort or bleeding, simply eat something else. If you are doing an activity that causes discomfort or bleeding, stop that activity.

PAIN

When the anesthetic wears off (1-4 hours), you may experience mild-moderate discomfort/pain. Most patients describe this feeling as “annoying” and not extremely painful. Follow these instructions to help minimize discomfort. It is quite normal if you experience more discomfort approximately 4-8 days after surgery. Don’t worry! Discomfort typically diminishes thereafter.

BLEEDING

For the next few days you will probably notice some sporadic oozing and slight bleeding. This is quite normal and should diminish within 72-96 hours (3-4 days). To help reduce the chances of adverse bleeding, avoid anything that causes pressure in the mouth like the use of straws, smoking, or “holding-in” a sneeze. Also, avoid the use of blood thinning medications like aspirin unless otherwise directed by your medical physician.

For patients who had tissue transplanted from the roof of the mouth (palate): The roof of the mouth tends to ooze more than other areas. This is very normal. Follow special instructions if given to you. If bleeding persists to the extent that it bothers you, moisten a tea bag (not herbal tea) and apply a firm yet gentle pressure against the bleeding site of the palate for fifteen minutes. Repeat, if needed, a second time.

IF EXCESS BLEEDING CONTINUES PLEASE CALL THE OFFICE

SWELLING AND BRUISING PREVENTION

Slight swelling around the surgical site is expected and may be present following surgery. Usually, swelling increases slowly for several days before gradually dissipating. The swelling may persist for several days and usually peaks approximately 4-5 days after surgery. Follow these important steps in order to prevent or minimize swelling and bruising:

  1. Rest immediately after surgery
  2. Take anti-inflammatory medications as prescribed
  3. Use ice therapy for the first several hours following surgery

ICE THERAPY

If you have been instructed to do so, use ice therapy during at least the first 3-5 hours after surgery. Place an ice bag on your face over the surgical area (10-15 minutes “on” then 10-15 minutes “off”). Be gentle and do not apply pressure to your face.

Avoid pushing up or pulling down on your skin with the ice pack. Ice therapy can usually continue during the first 24 hour period following your surgery. After that, discontinue ice therapy, unless directed otherwise. Helpful hint: Use moldable soft ice packs, zip-lock bags with chipped ice or small plastic bags of frozen peas or corn. If you use frozen food, please discard after use. Do not put the cold plastic directly on your skin: wrap the cold pack in a slightly dampened towel.

MOIST HEAT

Do not use moist heat during the first 48 hours following surgery. After that time, if some swelling or bruising is present, consider applying moist heat on your face over the surgical area (hot water bottle, compress, etc.). It will increase circulation and decrease swelling/bruising. Wrap the heat pack in a slightly dampened towel or use a microwave-type moist heating pad. Be careful not to burn your skin.

MEDICATIONS

Before taking any prescribed medication, carefully read your drug prescription labels and medication fact sheets supplied by the pharmacist. If you develop any allergic or other adverse reactions to the medication, stop taking the drug. Depending upon the severity of the reaction, call our office or the pharmacy or go to a local hospital emergency room. Narcotic pain medications and sedative drugs impair motor skills and sensory awareness and cause sedation. Do not drive motor vehicles or operate potentially dangerous equipment while under the influence of these drugs. Check to insure that there will not be significant adverse reactions between medications prescribed for your surgery and other drugs that you are taking.

ALCOHOLIC BEVERAGES

It is recommended that you refrain from alcohol intake for 3-5 days following surgery. Alcohol can delay wound healing and/or cause increased bleeding. Do not drink alcohol while under the influence of narcotic pain relievers.

SMOKING

For the first 72 hours following surgery, do not smoke. It is even better to not smoke at all for 7 days following surgery.

Any type or amount of smoking significantly retards surgical healing and makes you more susceptible to adverse complications including but not limited to infections, graft/implant failure, poor surgical outcomes, and prolonged sensitivity/pain.

NOURISHMENT

High quality nutrients are very important for healing tissue. Go to http://www.mypyramid.gov/ for excellent nutritional information.

Helpful hints:

Try to avoid eating and chewing near the surgical site. Try to use the opposite side of the mouth if possible.

Drink lots of water (minimally 2 quarts per day). Increased fluid consumption will counter drug-causing constipation.

Avoid foods with small seeds or nuts.

If chewing is uncomfortable, pre-cut your food into smaller pieces or use a food processor.

Put vegetables in low sodium vegetable/chicken broth with some lean meat, pasta, or bread and heat to cook. To make chewing easier, lightly steam firm vegetables. Serve slightly above room temperature and be careful not to burn your mouth. Remember that excessive heat can increase bleeding and pain inside the mouth.

Plain baked potatoes or pasta are excellent sources of carbohydrate energy. Rice tends to stick between your teeth.

If you want to supplement your diet for a few days following surgery, consider nutritionally complete commercial available liquid supplements. Do not substitute power bars/high energy bars for nutritious natural food.

Avoid the use of straws.

EXERCISE

If you had a soft tissue graft, do not exercise at all until Dr. Temlock has approved these activities.

Cardiovascular exercise—excess exertion: Do not attempt these activities for the first 96 hours following surgery. You can typically resume these activities on the fourth day following surgery but do so gradually and carefully.

Yoga: Keep your head above heart level especially during the first 5 days following surgery.

Swimming: Avoid swimming in public pools or open body water until you are advised to do so. If you must exercise in water, ensure that you keep your mouth above water level.

STOP EXCERCISING IMMEDIATELY IF YOU BEGIN TO BLEED, EXPERIENCE DIZZINESS, OR FEEL FAINT!

BRUSHING AND FLOSSING

In all areas of your mouth that were not treated at this time, please continue with your daily self-care procedures as previously discussed. It is generally a good idea to resume hygiene on these areas the day after the procedure.

SUTURES (STITCHES)

Please don’t pull, push, or play with the sutures. Do not try and cut the stitches or take them out by yourself. If they bother you after the fourth complete day of healing, please call our office for instructions. Self-dissolving sutures will tend to loosen and droop after a few days.

VISUALIZING THE SURGICAL SITE

Do not try and visualize the surgical site. Do not show the surgical site to others. If you are curious how the surgical site looks, Dr. Raz will show you at your next visit. Pulling on the cheeks, lips, gum tissues, and/or the tongue can traumatize the surgical site or stretch the stitches leading to surgical failure and increased pain/discomfort.

Our Doctors are happy to answer any oral hygiene questions that you might have. Please feel free to call us at 818-225-9510 for more information or to schedule your periodontal disease screening today.

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