Instructions to Patients After All Periodontal Surgeries
You may have moderate discomfort after the anesthesia wears off. The soreness can often increase for two to five days after surgery and can linger longer. Most discomfort can be controlled by 600-800 mg (3-4 tablets) of ibuprofen taken with water every 4-6 hours as needed. If this is not controlling pain, take the ibuprofen 2 hours after each dose of your prescribed pain medication. If you are due for a dose of pain medication, take it. Discomfort is easier to control if you stay on a schedule with your pain medication. Excessive use of pain control medication may result in constipation. Be sure to take all pain medications on a full stomach or with meals to minimize nausea.
Antibiotics may be prescribed depending upon the surgical procedure. It is important that these antibiotics be taken completely as directed to prevent the possibility of an aggressive infection. It is not necessary to get up in the middle night to take your antibiotic but spread your doses out as much as possible with the first dose taken first thing in the morning and the last dose taken right before bed.
In some cases swelling and facial bruising are to be expected. To help alleviate this, ice packs may be applied to the outside of the face over the area of surgery for 15-20 minutes every hour, beginning the day of surgery. Ice cubes in a plastic bag or a bag of frozen vegetables work nicely for an ice pack. The swelling can occur over a period of 5 days and is usually at its worst at 3-5 days after surgery. If swelling and discomfort persist, warm wet compresses may be used over the area on the third and subsequent days. These are to be applied for twenty minutes throughout the day.
Do not be concerned if traces of blood are noted in the saliva for several hours to a few days after your surgery. Do not rinse the mouth vigorously for the first two days as disruption of the clot may occur, but gentle rinsing is fine. Avoid the use of straws. If heavy bleeding occurs, apply direct pressure to the area using moist gauze or a moistened, standard tea bag for at least 45 minutes. It is critical that you remain seated and inactive while applying pressure to control bleeding. If continuous, excessive bleeding occurs, please contact the office (425-402-1246). It is best to avoid hot and spicy foods or fluids until the second day following surgery.
Meticulous oral hygiene should be continued in all other areas of the mouth, but the area of surgery should be avoided for 7-10 days to prevent dislodging the sutures. Gentle rinsing after meals with a solution of one teaspoon of salt to one 8 oz. glass of warm water will be sufficient. You should continue to brush the teeth elsewhere in the mouth. Rinsing helps flush out the debris which collects around the teeth. It is important to begin brushing at 10 days to control plaque buildup. Plaque can cause the teeth to be sensitive and irritate the gums causing the surgical site to heal poorly. Do not be afraid to brush gently at 10 days.
Do Not use a water pik, Sonicare or other electric toothbrush in the surgical area for 14 days.
Avoid the use of alcoholic beverages or aspirin products for 2 days after surgery. Alcohol and aspirin can delay healing by causing bleeding by acting as blood thinners. Alcohol can also dangerously interact with some pain medications.
We recommend you do not smoke during the healing period. Smoke acts as an irritant to the healing tissues resulting in delayed healing and possibly increased post-operative bleeding and soreness. It can also compromise blood flow resulting in a poor outcome from the surgical procedure.
Maintaining a good diet after surgery is important. You can chew on the opposite side of the mouth and should avoid extremely hard or spicy foods. We have listed below some foods that supply nourishment with little if any chewing necessary for swallowing.
• Broths and Soups
• Custards or puddings
• Ice Cream, Malted milk and shakes
• Food supplements such as Ensure, metrecal or Carnation Instant Breakfast
• Baby foods
• Chopped or ground meat
Tooth Sensitivity following surgery is very normal. It is usually related to the surgical procedure, but can also be related to inadequate plaque removal. It is very important to be very meticulous with your plaque control procedures.
If any concerns arise that are not addressed here Dr. LaBell can be reached by pager at the number listed on the post-op instructions given to you the day of your surgery.