KW PERIODONTICS POST-OPERATIVE INSTRUCTIONS GENERAL INFORMATION ACTIVITY After leaving the office, relax for the remainder of the day. For the next several days: avoid strenuous activity that would increase your heart rate; sleep with your head slightly elevated by using some extra pillows. It is important to NOT spit, rinse hard, drink through a straw, or create a “sucking” action in your mouth – all of these actions can create too much movement and/or pressure on the surgical site. MOVEMENT Wounds will heal by tiny blood vessels growing through the wound. Even small movement or pressure on the surgical area can tear these vessels and impair healing. It is important to minimize touching or any movement of the surgical area so that the healing is not impaired (e.g. playing with the site or sutures with your tongue is not a good idea). This is especially important if any type of bone or tissue grafting was done. CLEANING It is important to maintain a normal level of oral hygiene in the non-operated areas by brushing and cleaning like normal. Do not brush, floss, or otherwise physically clean the surgical area for the first 10 days post-operatively unless explicitly directed otherwise, only use the chlorhexidine (Peridex) rinse. Do not use an irrigating device (eg. water pick) on the surgical site for the first 3 months unless explicitly directed. Sometimes you will be directed to clean the surgical area during the first 10 days. If so, the aim should be to remove debris and plaque and not to disturb the actual wound. Rinsing with a chlorhexidine (Peridex) rinse should begin after your surgery. This should always be done gently by rolling the rinse around your mouth, never vigorously. Carefully and gently rinse three times daily for 60 seconds and then do not rinse or eat for 30 minutes. The chlorhexidine (Peridex) may stain your teeth; this is easily removed by a professional cleaning afterwards at your request. Sometimes you will be directed to use something other than a chlorhexidine (Peridex) rinse (e.g. warm salt-water). Please use any other rinse in a similar manner. EATING It is recommended to maintain a healthy diet throughout the course of healing. Chewing should be done away from the surgical site (if possible) and with small pieces of food at a time. Often you will be directed to eat only soft foods for a portion of the healing time. In general, to determine if a food is soft you should be able to easily mush it between your fingers. Examples of soft foods are: fish, pasta, thoroughly cooked vegetables, mash potatoes, Jello, eggs, yogurt, etc. MEDICATIONS Please follow the instructions on the bottle of any medications prescribed. If any adverse reaction to those medications should arise, such as nausea, itching, bloating, diarrhea or other symptoms, please discontinue the medication and contact our office. Pro-biotic yogurt may help prevent stomach upset while taking antibiotics. SMOKING AND ALCOHOL Smoking and alcohol will impair the ability of oral wounds to heal. Wounds are more vulnerable to these poisons when they are newer, so it is important to avoid smoking for 2 weeks after a surgical procedure. It is generally recommended to minimize alcohol consumption for the first 2 weeks after surgery. It is mandatory to completely avoid alcohol consumption if you are taking an antibiotic called metronidazole. SOFT TISSUE GRAFTS, BONE GRAFTS, AND SINUS LIFTS If you had a soft tissue graft, you may notice the graft turn white over the next few weeks. This is a normal part of the healing process. If you had a bone graft, you may notice some granules in your mouth a few days after the procedure. This is expected and nothing to be concerned about. If you had a sinus lift avoid internal pressure on the sinus. Sneeze with your mouth open, wipe instead of blowing your nose, and do not spit rinses out of your mouth but instead let them drain out of your mouth. DISCOMFORT Some discomfort should be expected when the dental anesthesia wears off. Please make sure you are taking any pain medications as directed. Discomfort is normal after surgical procedures and can last 1-2 weeks, although most patients are pain-free after 2-7 days, depending on the procedure. If you require additional pain medication please ask. BLEEDING There may be a red colouration of your saliva after the surgery as your saliva washes over the wound. This is normal and is often confused as actual bleeding even though it is not. Bleeding can be caused by disturbing the surgical area, physical activity, or hot drinks. If you find that blood is persistently pooling in your mouth, place slightly moistened gauze over the bleeding area and hold with firm but gentle pressure while NOT MOVING for 20 minutes. Make sure you are sitting up and not lying down. You can use moistened gauze, tissue, paper towel, or a tea bag (not herbal tea). If there is no change in the amount of bleeding please call our office for further instructions. SWELLING Some swelling may be present the day after the surgery and may peak 2-5 days after surgery. Swelling of the area where the surgery was performed is normal and can be extensive. You can use an ice pack on and off every 20 minutes with gentle pressure to help reduce swelling for the first 36 hours following surgery. BRUISING Bruising of an area on the outside of the face is possible, and varies from patient to patient and procedure to procedure. During resolution of the bruising it may extend down the neck or up around the eye – this is expected and nothing to be concerned about. SUTURES AND DRESSINGS Sutures (“stitches”), cyanoacrylate patches (“band-aids”) or periodontal dressings (looks like pink plastic) are placed to hold the gum tissues in the proper position for ideal healing. Try not to disturb any of these since displacement may impair healing. The dressings and sutures will dislodge or dissolve anywhere from 1-14 days after the procedure – this is normal and not a cause for concern. If they have not, they will often be removed at your first post-op appointment (approx. 10 days later). PROBLEMS OR QUESTIONS? Our office number is 519-576-5891. If you have any difficulties and cannot reach the office please do not hesitate to call us at home. Dr. Nicolucci’s personal cell phone number is 226-989-2333. Dr. Fleming’s house phone number is 519-725-1358.