Post-Surgical Instructions

While recovering from nay type of periodontal surgery, a positive mental attitude is the most important thing to have to ensure a quick, uneventful recovery.  Reassure yourself that everything will go well and that you are moving toward a healthier state every day and you will be pleased with your progress.

Different people will experience different degrees of discomfort following surgical procedures.  By reading and carefully following these post-surgery instructions, your recovery should be quick and comfortable.

  1. ACTIVITY:  Relax for the remainder of the surgical day.  Avoid strenuous activities such as heavy lifting or strenuous exercise for the next several days.
  2. MEDICATIONS:  Please take all prescribed medications as directed.  Antibiotics, if prescribed, will aid in healing and prevention of post-operative infection.  Analgesics may be prescribed to control pain and swelling.  There may be an uncomfortable hour as the anesthetic wears off and medications take effect.  This is normal and any discomfort will continue to diminish as your oral medications take effect. If possible, please take the first dose of analgesics while the surgical area is still numb.  Generally, medications should not be taken on an empty stomach.  IMPORTANT:  If narcotics are prescribed, do not consume alcohol, drive or operate dangerous equipment.
  3. SWELLING:  Minor swelling is normal and usually peaks 48-72 hours after surgery.  This can be minimized by placing an ice pack (a plastic bag filled with ice and covered with a dry cloth) on the outside of the face over the surgical site for intermittent periods (10 minutes on, 10 minutes off) for the first 24-48 hours.  After 48 hours, heat is encourages (heating pad, hot water bottle, etc) to increase circulation and promote healing.
  4. BLEEDING:  Slight seepage or oozing for the first several hours after surgery is normal. If bleeding continues, place moist gauze or a moist tea bag over the area with gentle but firm pressure intermittently for 15-20 minutes.  If excessive bleeding continues, please call Dr. Tohme at the office (419)-882-1807 or after hours at (419) 882-8107.
  5. NAUSEA:  This results from taking too much pain medication and/or not eating properly with the pain medication.  Simple, easy to chew foods such as warm (not hot) soup, scrambled eggs, cottage cheese and yogurt are good food choices after surgery.
  6. CONSTIPATION:  This results from taking too much pain medication and not eating or drinking enough liquids.  Try to drink about 8 ounces of liquid every waking hour after surgery.
  7. SMOKING/ALCOHOL:  Please refrain from smoking and alcohol consumption during the post-surgical period as they interfere with healing.  DO NOT SMOKE for at least two (2) weeks following surgery.  Better yet, use this “time off” as a platform to quit for good!  DO NOT DRINK ALCOHOLIC BEVERAGES for at least 72 hours following surgery.
  8. SUTURES (STITCHES):  Your sutures will begin to dissolve in approximately 4 days and are usually gone in 10 days.  DO NOT PULL LOOSE ENDS!  If we have placed non-dissolving sutures, we will inform you and schedule an appointment for suture removal in 7-14 days.

WHEN YOU GET HOME:

  1. Take pain medication as directed.  This will help control the discomfort that can begin as the anesthetic wears off.  Follow the prescription directions carefully.
  2. Prepare an ice bag.  Ice packs placed against your face are useful in reducing any swelling that may occur.  Use 10 minutes on and 10 minutes off the surgical site as often as you can during the first 24 hours after surgery.
  3. Gauze pads may be placed in your mouth.  Please remove them before taking medication. You will be given extra gauze to be used to apply pressure and absorb seepage the first day.
  4. Small pieces of surgical gauze may be placed between your teeth.  They will fall out or dissolve.  DO NOT remove them yourself.

THE EVENING AFTER SURGERY:

  1. Eating:  Good nutrition is the most important factor for your immediate well being and healing.  A soft diet is recommended for the first few days.  Avoid extremely hot, cold or spicy foods and any hard, gritty or sharp foods which may irritate the surgical area.  We highly recommend milk shakes or instant breakfast drinks the first evening.  After surgery, be certain to eat softer foods such as yogurt, pudding, eggs, cheese, fish, hot dogs, etc.  Be sure to eat!  Eating promotes well being during healing and prevents nausea and constipation.  Avoid eating any foods that could break into particles (for example:  peanuts, chips, nachos, popcorn, granola, etc.).  To maintain adequate fluid intake and to avoid dehydration, we advise that you force at least two quarts of liquid over the first two days.  A good rule of thumb is to drink 8 ounces of water or other clear fluids during every waking hour.  DO NOT DRINK THROUGH A STRAW, as this can disrupt a blood clot, especially if you have had an extraction.
  2. Rinsing:  Avoid vigorous rinsing for the first 24 hours following surgery.  Cold water held in the mouth during the first 12-24 hours may help reduce swelling and bleeding.  After 24 hours, rinse with warm saltwater 3-4 times per day for the week after surgery (1 tsp. salt in a glass of warm water).  If a prescription mouth rinse is prescribed, use as directed alternating with the saltwater.  This is very important to keep your mouth fresh and odor free and to reduce the possibility of infection.  Use the rinse for the first two (2) weeks or longer if desired.

THE NEXT DAY:

  1. Continue to use ice packs for 24-48 hours after surgery.
  2. Continue using saltwater or the prescribed rinses often throughout the healing period.
  3. Exercise your jaw muscles.  Please exercise your jaw muscles by opening and stretching often to prevent your jaw muscles from tightening up.

THE 2ND DAY:

  1. Use warm compresses at your jaw line after 48 hours to reduce any swelling that has occurred.  A towel soaked with moderately hot water is fine.  Continue to do this often for 3 or 4 days until any swelling that has occurred is gone. Do not place hot packs under your eyes.
  2. Begin carefully to brush your teeth.  You must keep your mouth and teeth clean.  Please brush your teeth and tongue at least three times each day and more often when possible.  Use the special red “surgical brush” if instructed to do so.
  3. Brush your teeth carefully in a “back and forth” motion. Try not to brush the gums in the surgical area(s) until we see you for your post-operative appointment.  Continue brushing, flossing and normal hygiene techniques in all areas other than the surgical site.  Avoid flossing the surgical site until instructed.

THEN AND THEREAFTER CONTINUE……

  • Brushing your teeth often, avoiding surgical areas
  • Rinsing with salt water or prescribed rinse.
  • Applying warm compresses until all swelling is gone.
  • Eating softer foods for one week – return to regular diet as soon as possible.