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Post Operative Instructions

Following all procedures Dr. Britten and one of our assistants will go over post­operative instructions and answer any questions you may have. Here is some more information in case you have additional questions.

Following periodontal surgery, the discomfort level often varies from patient to patient and even from one area to another in the same mouth.  You may have been given a longer lasting local anesthetic and it is not uncommon for you to remain “numb” for several hours after surgery.  In order to minimize the discomfort, it is best to start taking your prescription medication prior to the local anesthetic wearing off.  Continue to take your medication according to the instructions placed on the label for as long as necessary.  Sometimes, you may supplement your prescriptions, if necessary, by taking two non­prescription analgesic tablets, such as Tylenol or Aleve, in between doses of the prescription medication.  Please check with Dr. Britten for specific instructions regarding which type of analgesic you may use as a supplement.

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Blood stained saliva is not at all unusual during the first few hours after surgery and it does not take very much blood to cause the saliva to be “pink” in appearance.  In order to prevent potential bleeding problems, it is advisable to avoid rinsing, vigorous swishing, or the use of a straw for the first week.  Should significant bleeding occur, gently rinse your mouth with strong, cold tea or water to determine the exact location.  If bleeding persists in one area, dip a regular tea bag in cold water, squeeze out the excess water, place the tea bag in the area of the bleeding and apply gentle pressure for 20 minutes.  Repeat this if the bleeding has not stopped completely.  When bleeding occurs, it is always best to keep the head elevated.  If it continues, contact the office.

Should nausea occur, it is most likely the result of swallowing small amounts of blood or as a side effect from your medication.  To minimize the possibility, avoid taking medications on an empty stomach.  Take all medications, if possible, with a small amount of food.  If it persists and results in vomiting, stop taking all medications and contact the office.

This is a normal sign of healing, unless it exists in the presence of temperature and pain.  If severe swelling is present, or you have a temperature of 101 or greater, please contact our office.  To minimize swelling, place an ice pack on your face over the area as soon as possible after the surgery.  Hold this in place for 20 minutes and then remove the ice pack for 20 minutes.  Repeat this as often as possible, for the first 24­48 hours after surgery.  If you are using the ice pack provided by our office, the gel pack that was provided can be placed in the microwave for 10­15 seconds and it can be used as a moist heat pack until the swelling subsides.

Bruising is not unusual and can occur in varying degrees.  To minimize bruising utilize ice packs as described above. A homeopathic medication called ARNICA, can be purchased at health food stores.  This topical gel and/or tablets that dissolve beneath the tongue can minimize or shorten the extent and duration of any bruising.

If you were given a prescription for an antibiotic, be sure to take all of it as prescribed.  Ladies, please be aware that antibiotic medications can reduce the effectiveness of birth control pills.

Oral hygiene procedures should be performed in your mouth, but avoid the areas of surgery until directed otherwise. If you were given a prescription for Peridex (Chlorhexidine Gluconate) rinse, beginning the day after surgery rinse gently twice a day after cleansing the rest of your mouth.

A “bandage” or dressing material may have been placed in order to protect the surgical area.  This is a pink, putty­like material that is placed around the teeth in the area of the surgery.  It should be in place until your first postoperative visit.  At times, small pieces of the dressing may break off, but this is of no concern unless the area becomes uncomfortable.  If a larger portion of the dressing or the entire dressing comes off, please contact the office.

If you have had a tissue graft, try to keep the area as immobile as possible for the first 72 hours.  To help keep the dressing in place, DO NOT pull on your lip.  When needing to cough, yawn or sneeze, cup your hand over the area of surgery to help prevent the dressing from becoming dislodged.  If the tissue graft was “borrowed” from the roof of the mouth and there is significant bleeding coming from that area, refer to the “Bleeding” section for directions in the use of a tea bag.

If a bone graft was done, you will likely have additional prescriptions to aid in the healing and there may not be any dressing (bandage material) placed in the area where the bone graft was placed.  You will be given a prescription for an antibiotic and for a special mouthwash to help cleanse the area; as you will not be able to brush the specific area for a number of weeks.  The antibiotic will give the bone graft the best possible chance of success.   Please be sure to take ALL of the medication as directed.  Ladies, please be aware that antibiotic medications can reduce the effectiveness of birth control pills.

As long as you can refrain from smoking and as much as you can reduce the frequency, the more quickly you will heal.  Smoking greatly reduces the healing process and may cause additional discomfort and bleeding.

Eat and drink as much as you can!  If possible, do not chew in the area(s) where surgery was performed for a period of 2 hours or longer.  Avoid hot foods and liquids for 2 hours.  Adequate nutrition is essential for healing.  Diets rich in quality protein, Vitamin C and Vitamin B complex are especially desirable.  Eat softer foods such as eggs, potatoes, ground chicken, fish, soups, pastas, and cooked vegetables.  Avoid foods with small seeds such as tomatoes, strawberries, blueberries, and seeded breads for at least the first week following surgery.  Return to your regular diet as soon as you feel comfortable.  Avoid alcoholic beverages for a minimum of 24 hours after surgery and possibly longer depending on the type of medication you are taking.  Should you have questions regarding this, please call the office.  Drink plenty of water and other clear liquids.

If you were advised to stop taking aspirin, Coumadin, Plavix or other type of blood thinners, resume taking your medication the day following your surgery unless instructed otherwise.