After Periodontal Surgery

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.

POST OPERATIVE INSTRUCTIONS FOR EXTRACTIONS

So that your discomfort following the surgery will be minimized, the following instructions are given and it is necessary that you follow them.

  1. Keep the Protective gauze pack in position for two hours after the surgery or until the bleeding has stopped. (Fold the gauze to the size needed for the area put in place and gently bite down to apply pressure) This pack serves several useful purposes, and your long-range post-operative course will be more comfortable and shortened appreciably if the pack remains undisturbed as directed.
  2. Discomfort may be expected soon after the surgery and reaches its maximum during the first few hours. It is recommended that one of your prescription tablets be taken approximately two hours after surgery, with a drink of water. Thereafter, take only as needed every 4 to 6 hour intervals, or according to your individual instructions. It is helpful if you remain inactive, or better still, go to bed during the period of discomfort. One should not drive while taking medications for pain. In most cases, prescription medications are necessary for the first 24 – 36 hours. Beyond that, over the counter pain medications may be used.
  3. Bleeding is to be expected in variable amounts for several hours and oozing may continue throughout the night. This is normal and should not be cause for alarm. Saliva may be pink for 2-3 days. Control of this bleeding is best affected by keeping gauze sponges where they have been placed. If the bleeding seems to be excessive there are several things you can do. First, remove any superficial blood by thoroughly rinsing the mouth one time with cold water. Second of all place tightly folded clean gauze over the bleeding area, using enough gauze to apply firm pressure to the tissue when the jaw is closed. Maintain pressure with the gauze pack for a full 30 minutes. Remain quite and keep the head elevated. If this does not control the bleeding, wrap a moist black tea bag in gauze and place this over the socket and bite firmly. There may also become an increase in the amount of saliva as the anesthetic agents wear off. This is also very normal and should not be a cause for alarm. Hemorrhage (bright red bleeding that wells up rapidly from the socket) rarely occurs, but warrants a call to the office.
  4. Swelling may be expected in variable amounts for one to three days after surgery. More swelling may be noticed on the second to third day after the procedure rather than the first. To minimize swelling, place an ice pack on the outside of the cheek in the area of the surgery. Use the ice pack intermittently (20 minutes’ on/20 minutes off) for the first 24 hours after the surgery.
  5. . Nourishment during the day of the surgery should be liquids such as carbonated beverages, ice tea, milk, shakes, instant breakfast, jello, etc. Colder foods are best on the day of surgery. If sponges are in proper position in the cheek area, their presence should not interfere with drinking of fluids. After the packs are removed, soft solid foods may be eaten if desired. Do not use a straw for drinking for 2 days.
  6. 6. Good oral hygiene is important to normal healing. Starting the day after surgery, gentle rinsing with 0.12% Chlorhexidine rinse prescription mouth rinse. DO NOT SMOKE OR CHEW TOBACCO FOR 48 HOURS AFTER SURGERY! Discoloration of the skin is frequently seen in patients who “bruise” easily. It is due to bleeding from the operative site into the tissue.

Our interest in your progress does not cease with the completion of the operation. We surely hope your postoperative course is reasonably comfortable and uneventful. If there are any questions or needs, please call us at Boulder Office Phone Number 303-449-1301, Dr. Horrock’s Cell 303-588-0757, Dr Cole’s Cell 303-819-4209

Pain Medications

It is not unusual to have discomfort for at least the first week following your surgical procedure. You will be given a prescription for medication to help you tolerate the post-surgical recovery period. Please take your medications as directed. If necessary, you may take your pain medication more frequently than every 4-6 hours to stay ahead of the soreness. It is advisable to not take pain medication on an empty stomach, as nausea may result.

As an alternative to prescription medications, some patients have found taking a combination of over-the-counter Ibuprofen and Tylenol to be effective. You may take the combination in either of the following dosages: 3 Advil Liqui-Gels and 2 Regular Strength Tylenol or 3 Advil Liqui-Gels and 1 Extra Strength Tylenol, every 4-6 hours as needed.

Note: When taking any prescribed medication containing Acetaminophen (Tylenol), i.e.; Percocet, Hydrocodone, Vicoden or Tylenol with Codeine, you should not take additional Tylenol so as not to exceed the safety level of Acetaminophen. Please contact the office with any questions you may have.
Antibiotics

Please alert the office to any allergies or sensitivities that you might have to antibiotics. An antibiotic may be prescribed following your surgical procedure. Take as directed until gone. It is advisable not to take these medications on an empty stomach, as nausea may result. For women taking birth control pills, be advised that antibiotics may interfere with their effectiveness.

Swelling

Swelling may occur following your surgical procedure and will typically increase 2-3 days after the procedure. To minimize the swelling, place an ice pack over the outside cheek area for 20 minutes on and 20 minutes off. Continue using ice for 2-3 days following the procedure as often as possible.

Bleeding

A small amount of bleeding is normal. If excessive or continuous bleeding occurs:

  • Do not rinse your mouth.
  • Elevate your head when lying down.
  • Apply moistened gauze to the immediate area with moderate pressure for 20 minutes; repeat if necessary.
  • Enclose a moistened tea bag in a gauze square and apply pressure for 20 minutes.
  • Call the office if bleeding persists.

Dressing

The dressing (which acts as a bandage) is used to protect the surgical site and help reduce discomfort. If the dressing comes off or is uncomfortable, please call the office for direction.

Diet

Until comfortable, avoid chewing on the side where surgery was completed. Avoid hot foods and liquids for approximately 1 hour following the surgery so as not to soften the dressing. A soft diet is recommended. Foods such as cottage cheese, oatmeal, soup, eggs, yogurt, pasta, mashed potatoes, casseroles, and fruits are more easily eaten. Remember, adequate nutrition is essential for feeling better as well as for healing.

Smoking

Do not smoke for at least 2 weeks following your surgical procedure. It will significantly slow healing and can compromise results.

Alcohol

Do not drink alcohol while taking prescription pain medications.

Rinsing

Do not rinse for the first 24 hours. After that, you may use a mild, diluted mouthwash. Repeat as necessary to help keep the dressing clean.

Brushing

Do not brush the surgical site. You may resume normal brushing/flossing in other areas the following day.

Suture Removal

You may notice increased discomfort 3-4 days after the surgical procedure. As the tissues begin to heal, they may pull against the sutures and dressing. You may choose to take some form of pain medication one hour prior to your suture removal appointment to minimize tenderness. If you are a patient for whom Antibiotic Pre-Medication is required, take the prescribed antibiotics 1 hour prior to your suture removal appointment.

Contact Us

Should you have any questions or concerns during regular office hours, please do not hesitate to contact us at Boulder Office Phone Number 303-449-1301.