POST-SURGICAL INSTRUCTIONS FOR SOFT TISSUE GRAFTING

Proper care of your mouth following periodontal surgery is very important for the healing process. Each person responds differently and the post-operative discomfort, swelling, and bleeding may vary from procedure to procedure. Please follow these instructions carefully to speed healing and make you more comfortable.

DISCOMFORT AND MEDICATIONS

  • Please take medications as directed. Variation from the prescribed regimen can affect the healing and success of the surgical procedure.
  • The majority of the discomfort is typically within the first 24-72 hours following surgery.
  • Pain medication has been prescribed and is best started before the numbness wears off. If taking a narcotic, it is recommended to take it with food, avoid alcohol, and do not drive.
  • Antibiotics are to be taken until gone unless otherwise directed. It is recommended to take probiotics to decrease gastrointestinal problems. 
  • Call if you experience a rash, itchiness, severe dizziness, difficulty breathing, fever, or diarrhea.  If you are experiencing a medical emergency, please go to the ER/ED or call 911.

SWELLING

  • Slight swelling and/or bruising of the surgical area is not unusual and may occur after surgery.
  • Gently apply an ice pack wrapped in a thin cloth towel to the outside of your face to minimize the swelling for the first 8-12 hours after surgery (20 minutes on and then off).
  • Keep your head elevated above the level of your heart during the first 24 hours. This may necessitate the use of several pillows while sleeping.
  • If the swelling does occur, it should start to disappear in 3-4 days. If needed after the second day, apply moist heat to the area.

BLEEDING

  • Bleeding/oozing may occur for the first 24-48 hours after surgery. If excessive bleeding occurs, apply a moist gauze or tea bag with firm, direct pressure to the surgical site (the tannic acid in the tea will aid in clotting).
  • AVOID any positive or negative pressure which may dislodge your clot (such as forceful spitting, rinsing, drinking through a straw, or blowing your nose forcefully).

SUTURES

  • Sutures (stitches) may have been placed to hold the gums in the proper position for the ideal healing. Some sutures will dissolve on their own. Others will usually be removed 2 weeks after surgery depending on your procedure. Some may be left longer, depending on the procedure up to 8 weeks on soft tissue grafts (long-lasting absorbable suture).
  • DO NOT disturb the sutures with your tongue, toothbrush, or in any other manner since displacement may impair healing.

APPEARANCE OF THE GRAFT

  • During the normal course of healing, the tissue graft may change appearance and color. The color may appear white/gray/red during the healing period. Do NOT be alarmed by the appearance of the graft.
  • To minimize the chance of failure, remember that the graft sites should not be disturbed. Minimize movement of the lips and mouth by not pulling your lip out to look at the graft.
  • You may have some purple tissue glue around the surgical site. Do not be alarmed if pieces of the tissue glue fall off during the healing.
  • Do NOT worry excessively about the appearance of the grafted site. It will look worse before it looks better.

DIET

  • For your comfort and to protect the surgical area, do not chew until the numbness has subsided. Avoid chewing in the area of the surgery until after sutures are removed. A soft diet is recommended until otherwise directed.
  • Remember to drink plenty of liquids and maintain a diet with a normal caloric level. Soft foods high in protein, minerals, and vitamins (such as soup, eggs, yogurt, cottage cheese, fish, bananas, applesauce, protein shakes, etc.) help support post-surgical healing.
  • When in doubt, blend your food and eat with a spoon. No straws!
  • AVOID hard, fibrous, or sharp foods as they may delay the healing (especially seeds, chips, nuts, and popcorn).
  • AVOID anything too hot for 48 hours after surgery; cool to lukewarm food and liquids are recommended.

ALCOHOL

  • All intake of alcohol should be AVOIDED while on prescribed antibiotics or pain medications.

ORAL HYGIENE-Do not use a Waterpik or an electric toothbrush (Sonicare or Oral B) for up to 8 weeks post-surgery for soft tissue grafts, and 4-6 weeks for other procedures.

  • Continue to brush and floss the teeth which were NOT involved in the surgery.
  • The surgical site should not be disturbed for the first 2 weeks of healing except as directed by your doctor. This means to avoid two teeth in front (towards the front of your mouth)  and two teeth behind (towards the back of your mouth) away from the surgical site.  This includes the tongue side and the cheek side.  
  • The surgical site should NOT be disturbed for the first 2 weeks of healing except as directed by your doctor.
    • The Peridex mouth rinse (chlorhexidine), or Stella-Life Products, if prescribed, may be started the day AFTER surgery so as not to disturb the blood clot the first day. Do not use other mouthwashes.
    • You will be instructed when to resume brushing and will be given a special toothbrush to use at one of your post-operative appointments.

REST

  • Avoid strenuous physical activity, heavy lifting, and bending over during your immediate recovery period, usually 2-3 days. This will help to reduce pain, swelling, and help prevent additional bleeding.
  • Rest with your head elevated the remainder of the day and sleep with an extra pillow for several nights.

SMOKING

  • All smoking should be STOPPED until your sutures have been removed to ensure your surgical procedure’s best healing and success.
  • Smoking delays the healing process increases discomfort and may encourage bleeding and infection.
  • Surgical success rates are decreased in smokers.

DENTURES

  • Your dentist will decide when dentures or partial dentures may be worn after the surgery. They must be worn with caution, as the pressure can negatively affect the surgical site.

If you have any questions or concerns please that are not answered by these instructions, please do not hesitate to contact Dr. Drake at our office phone number during normal office hours if you have any additional questions.  If you feel you are having a dental emergency, listen to the prompts on our office voicemail to get a call back after office hours. This includes any excessive bleeding, swelling, persistent or severe pain, fever, or reaction to the medication. IF YOU HAVE A MEDICAL EMERGENCY CALL 911.