Patient Self-Care Following Periodontal Flap Surgery for
ACTIVITY: After leaving our dental office today, we suggest you consider relaxing or at least limiting your activity as much as possible for the remainder of the day. Avoid strenuous activity and all aerobic exercise for the next 3 days as this might cause the graft to separate from the underlying tissue due to an elevation in your blood pressure.
DISCOMFORT: Some discomfort may be present when the anesthesia wears off. You may have been given a prescription for an anti-inflammatory (NSAID) analgesic. Please take this every 4-5 hours or four times per day for the first 3 days. This drug will greatly decrease the possibility of post-surgical swelling and pain and has been shown to accelerate healing. After the first 3 days, 1-2 Tylenol, or 1-2 Advil taken every 4-6 hours as needed, should keep you comfortable as long as you take these medications. Should intense discomfort occur at any time after the surgery, please telephone the doctor and he will phone in a prescription for you.
SWELLING: It is normal for some swelling to occur after surgery, particularly in the lower jaw. To minimize swelling after surgery, apply an ice bag wrapped in a light tea towel or handkerchief to the outside of your face over the operated area. This should be left on your face for about 5 minutes, then removed for 5 minutes, or alternated from side-to-side, between operated areas, for 2-3 hours after surgery. The use of both ice and the NSAID analgesic as described above will reduce the amount and duration of facial swelling.
BLEEDING: It is common to have bleeding for a few hours following soft tissue graft surgery. Try to avoid repeatedly spitting or rinsing your mouth after surgery as this will encourage bleeding. If bleeding persists, rinse your mouth or remove blood by wiping with a Kleenex tissue to identify the location of the bleeding site and then apply a regular black tea bag to the area with firm but gentle pressure for 15-20 minutes. Let yourself rest for 15 minutes then repeat the application of the tea bag for a second time if you still have slight bleeding. If excessive bleeding continues, please call us. Remember, most of the blood you may see in your mouth is actually a little bit of blood mixed with a lot of saliva – blood is a very strong “dye” and a little bit of blood will color your saliva dramatically.
ORAL HYGIENE: Brushing and oral hygiene procedures should be done as usual in all untreated areas starting the night of surgery. In exposed, operated areas limit your oral hygiene to gentle brushing using a soft bristled toothbrush. In areas covered by periodontal dressing, brush only the chewing surfaces of teeth. Avoid dental flossing in operated areas during the first week following surgery and in areas covered with periodontal dressing. No undiluted mouthwash, salt water or peroxide rinses should be used during the first week following surgery. Also avoid the use of water irrigation devices such as Water-piks or electric toothbrushes in the operated areas for 2-3 weeks following surgery. The exposed operated areas should be gently rinsed with Peridex, Periogard or the generic Chlorhexidine as a last oral hygiene procedure at bedtime and again in the morning, after eating and drinking.
EATING AND DRINKING: Do not try to eat until all anesthesia (numbness) has worn off. High protein foods and liquids are desirable for 3-5 days following surgery. Semi-solid foods may be eaten as long as this may be done comfortably. . Eggs, custard, yogurt, pasta, steamed vegetables, casseroles, cooked cereals are some things that you might consider eating during the first few days following your surgery. Avoid spicy, salty, acidic, very hot or very cold foods or liquids. Also, avoid hard foods: toast crust, nuts, chips or crunchy or fibrous foods such as raw carrots that may become caught between your teeth or traumatize exposed operated tissues. Please refrain from drinking alcoholic beverages the day of surgery and one week after surgery.
CARE OF THE DRESSING: Covering the area where the gum was removed from the roof of your mouth may be a silicone putty-like material. Its purpose is to “protect” this area so as to minimize bleeding or discomfort. If small pieces of the dressing break off, do not be concerned. If large portions of the dressing are displaced or lost during the first few days and discomfort is experienced, we may need to replace the dressing – please contact our office. If the dressing should fall off after 4 days, and you are comfortable, replacement of the dressing is unnecessary.
USE OF REMOVALBLE DENTAL APPLIANCES: If you normally wear a removable appliance which replaces missing teeth, and it rests on the operated area, it is best to minimize use of this appliance as any pressure on the surgical site could be detrimental to healing and cause discomfort, unless otherwise instructed.
CARE OF THE DRESSING: If small pieces of the dressing break off, do not be concerned. If large portions of the dressing are displaced or lost, and discomfort is experienced, please contact our office. If the dressing should fall off after 4 days, and you are comfortable, replacement of the dressing is unnecessary.