Kennedy K Periodontics J. Edward Kennedy, DMD MS Williston Park Office Center 910 Williston Park Pointe, Suite 1050 Lake Mary, FL 32746 Instructions Following Soft-Tissue Grafting Surgical dressing - A surgical dressing may be placed over the surgical site following some procedures. Do not eat or drink anything warm for the next two hours as this may soften the dressing. The dressing will be removed when you return for your next appointment. It is not uncommon for dressings to become dislodged. This is no cause for alarm. If only part of the dressing comes off, do not try to remove the remaining part. Stent/shield - A surgical stent may be provided after gingival grafting. This shield will protect the roof of the mouth during healing. The stent should be worn at all times for the first 24 hours with the exception of removing it to clean or after eating. Before removing the stent, pleas wash your hands thoroughly and clean the stent with diluted Listerine (50% Listerine/50% water). Cleaning your teeth - Do not clean the area of surgery for two weeks. The rest of the teeth may be brushed as usual, but for the first three days, do not brush with toothpaste; only brush with diluted Listerine (50% Listerine/50% water). When brushing, do not pull the lip or cheek out as this may cause serious damage to the surgical site. After 3-days, you can begin brushing with toothpaste (BUT NOT IN THE SURGICAL SITE(S)), then gently rinse with diluted Listerine (50% Listerine/50% water) for at least 60 seconds. Do not rinse your mouth with water or eat or drink anything for 30 minutes after rinsing with diluted Listerine, as this will make its antimicrobial agents ineffective. You may use warm salt-water rinses as often as you’d like after the first 24 hours. Just rinse very gently. Swelling - Some swelling is common following periodontal procedures. After 24 hours, use warm, moist heat to help the area feel better for minimal of 3 days post surgery. Discomfort - You can expect some discomfort for a week or so. The following medications will help make you more comfortable: Ibuprofen (Advil). (600 mg-equal to 3 tabs). Do not take ibuprofen 24 hours prior to surgery. This is a very effective pain reliever when taken on a regular dosing schedule. I recommend that it be taken at 4-hour intervals for the first 3-4 days (e.g. 8:00am, 12:00pm, 4:00pm and 8:00pm). After the first few days, you may lengthen the dosing interval to every 6-8 hours or as needed. It is best taken with food. The most common side effect is a heartburn type of indigestion, which may usually be avoided by taking the medicine with food or with an antacid. It is very important to take 600mg faithfully every 4 hours for minimal 3 days post surgery. Instructions Following Soft-tissue Grafts Page Two Oxycodone with acetaminophen (Percocet). This medication should be taken only if the ibuprofen does not control the discomfort and NEVER to be taken instead of the Ibuprofen. You should: 1) take the oxycodone only if needed, 2) start with the lowest dose that will control the discomfort (one tablet), and 3) minimize activity. It is extremely important that you take this medication with food! Phenergan. This medication is taken to combat the nausea often associated with taking the oxycodone (Percocet). Please take it 15-20 minutes before taking the Percocet. When these two medications are taken in conjunction with one another, they will make you very groggy/drowsy and your reflexes and/or balance may be affected. Please just sit or lie down after taking this combination. Eating- Eat a soft or liquid diet for the first week or so. Foods to avoid include: 1) hard foods (such as chips), 2) hot or spicy food (such as salsa dip) and 3) popcorn. There are many foods that you can eat, including milkshakes, soups, pasta dishes (if not spicy), and dietary supplements such as Boost or Carnation Instant Breakfast. You should drink plenty of fluids. PLEASE do not use straws for the first week, they cause unwanted muscle pull and suction on the surgical area. Activities- You have just undergone dental surgery. You will need to restrict your activities for several days after surgery. Avoid unnecessary exertion (aerobic exercise, bending and lifting, yard work, sports, swimming), smoking, alcoholic beverages, mouth rinses (other than the Periodex), playing wind instruments and vigorous rinsing. DO NOT pull the lip or cheek out to clean the teeth or inspect the surgical site. Any of these activities could greatly reduce the success of your surgery. Sutures - The sutures that I use will dissolve on their own after about 2-weeks, but may become irritating. I will remove the remaining at your 2 weeks post-op visit. If any sutures feel loose, please do not attempt to remove them. This could cause serious damage to the surgical site. Bleeding - Bleeding is common following periodontal procedures, especially grafting. It can be minimized by elevating your head with an additional pillow when sleeping and minimizing activity. Due to potential bleeding, and the common occurrence of night drooling after surgery, you may want to cover your pillow with a towel or use an older pillowcase for the first night or two. Do not be alarmed to see a little bit of blood in your saliva for the first few days following the procedure. This is normal. Smoking - Smoking is without exception, prohibited following surgery. Smoking during the healing process will/may cause damage to the surgical sites and may in some circumstances cause the procedure to fail. Questions- If you have any questions or experience any problems, please call us at one of the following numbers: 407-833-8522 (Office) 321-277-5800 (Dr. Kennedy’s Cell) 407-324-6826 (Kerry Scott – surgical assistant) Thank you for allowing us to serve you! Dr. Kennedy and staff