Patient Instructions After Periodontal or Implant Surgery

Please read the following instructions carefully. They will prevent complications and improve the surgical results.

Activity:  Reduce your activity following surgery.  Do not run, weight-lift, or do strenuous aerobic activity for at least 3 days.  If you nap after returning home from the surgery, using a few pillows to keep your head elevated will help reduce swelling.

Care of your mouth:  Immediately after surgery keep ice chips (or other cold foods such as a milkshake or ice cream) in your mouth for 6-8 hours after the surgery.  Please do not use a straw as this may create a suction to dislodge the blood clot.  Allow these cold foods to defrost at the surgical site, thereby cooling the surgical site.  Do not brush or floss your teeth in the areas that have dressing or sutures until your next visit.  Rinsing with the Chlorhexidine mouthwash prescribed will help reduce bacteria at the surgical site.  Do all normal cleaning procedures on teeth that did not have surgery.  If you have a gum graft, do not touch the area or pull the lip out to view the surgical site.

Discomfort:  Following all types of surgery you can expect some discomfort. To minimize discomfort, take pain medication as prescribed.  If you have been prescribed an anti-inflammatory (Ibuprofen), take it as directed for the first 3 days after surgery.  This medicine will greatly reduce post-surgical swelling which will result in less discomfort.  Should there be further discomfort, please take the narcotic (Norco) if prescribed.  You may take both the NSAID and narcotic together.  If nausea develops, take the medication with milk or other foods.  Do not drink alcoholic beverages.

Swelling:  Swelling and bruising should be expected after surgery, but in most cases it will go away in 3-4 days.  During the first 24 hours, application of an ice pack applied to the outside of your face over the operated area may help reduce external bruising.  Apply the ice gently to your face for 5 minutes, then remove for 5 minutes and repeat as much as possible on the day of surgery.  After the first 24 hours, use warm, moist washcloths on the face if there is noticeable swelling.

Bleeding:  There will be a small amount of bleeding in your mouth following surgery.  Most of the blood you may see in your mouth is actually a little bit of blood mixed with a lot of saliva.  Ice cold fluids after surgery will minimize bleeding.  Avoid spitting, rinsing or sucking actions since this will disturb the surgical site.  If bleeding persists, dip a caffeinated tea bag in cold ice water and gently press it in the area of bleeding for at least 10 minutes.  Call Dr. Tsai if bleeding cannot be stopped.

Eating:  Maintaining an adequate diet after surgery is essential.  Cold or warm temperature foods are recommended for the first day.  Coffee or tea can be consumed if it is not hot.   After the first day, stay on a soft but balanced diet.  Eat foods you can smash with a fork and avoid hard, chewy, or spicy foods.  Citric acid (orange juice and grapefruit juice) may sting.  Foods with small seeds should be avoided.  Fluid intake is very important – try to drink 8 glasses per day, but do not use a straw.  Nourishing foods that require little chewing include: Soup/broth, pasta, rice, mashed potatoes, yogurt, pudding, Jell-O, bananas, eggs, milkshakes, or food supplements.  If you have had surgery on one side of your mouth, it will be possible to eat soft foods on the opposite side of the mouth – please cut soft foods into smaller pieces such as soft meats (chicken, fish) or steamed vegetables.

Stent for Palate (retainer):  If you are given a stent to cover your palate, leave it in place for 24 hours.  Remove and clean after eating and wear it as much as possible the first week.  After the first week, please wear the stent for eating.

Dressing:  A surgical dressing may be placed in some cases.  Pieces of the surgical dressing (pack) may come off.  This is not a problem and should be expected.

Antibiotics:  Take as prescribed until all gone. If an allergic reaction and/or nausea develop, call the office.

Smoking:  Please do not smoke following periodontal surgery.  Tobacco smoke is an irritant and delays healing of the tissue.  Refrain from smoking as long as possible.