As in every surgical procedure, surgery aftercare plays in very important role for proper healing and for the success of objectives of surgery. Similarly in Periodontal surgery, you need to take good aftercare. However after periodontal surgery, there are few things which one must be aware. Like every dental surgery there can be pain, swelling, bleeding. However you periodontist is aware of all these problems and must have given you instruction and meds to take care. These instructions will assist you in caring for your mouth after periodontal surgery. These are instructions to control PAIN, SWELLING, BLEEDING, and PREVENT INFECTION.
Pain after Periodontal Surgery
The doctor may have prescribed a pain medication for you. Please take the medication(s) as directed. Usually three (3) to four (4) 200-mg tablets of Ibprofen (Advil or Motrin) every 4 to 6 hours are sufficient. If this is not effective then try the other medications that have been prescribed for you. Slight dull pain is normal but should be tolerable. Pain medications can make some people drowsy. Do not operate heavy or dangerous machinery, drink alcohol, nor drive an automobile or motorcycle while taking these medications.
Swelling after Periodontal Surgery
Swelling is normal after surgery. Normally, swelling will be greatest on the third post-operative day. The doctor may have given you a prescription for medication that may decrease swelling. An ice pack placed outside of the mouth over the surgical area may significantly help reduce swelling. Place the ice pack over the area for twenty minutes on and then wait twenty minutes to apply again for twenty minutes in a cyclic fashion for about six hours. If swelling foes not decrease in three days then call the office or the emergency pager number (below).
Intermittent Ice Application to Reduce Swelling after Periodontal Surgery
Bleeding after Periodontal Surgery
The doctor may have placed a protective bandage/dressing over the surgical area to help protect the area from abrasion and/or food impaction for the first couple of days. The dressing may fall off over the next week, which is normal. If the dressing appears to be hanging and not falling off completely, then call the office. Some slight bleeding from the site is normal for the first few hours after surgery. Your saliva may appear pink for the next few days, this is normal. If the dressing is moved then bleeding may persist. If more than slight bleeding persists on the first day or any bleeding on the second day, call the office.
Ways to prevent and stop bleeding
1. Avoid chewing food on the operated area, smoking, spitting, vigorous rinsing, drinking through a straw, or brushing the area
2. Apply finger pressure on the bleeding area for up to twenty minutes
3. Hold ice-cubes in the mouth for five minutes at a time, up to twenty minutes
4. Place a moistened tea bag over the bleeding site to stop bleeding (with pressure applied)
5. Use extra pillows with a towel or old pillowcase over to keep head elevated while sleeping
Preventing Infection: Take prescribed antibiotics as directed. If you smoke, do not smoke for the week after surgery (and if possible quit smoking forever). It would be best if you stop smoking thereafter since many cases of adult periodontitis in which the patient smokes are very difficult to treat.
Keeping your mouth clean after periodontal surgery: Rinse your mouth GENTLY with a mild salt-water rinse (½ teaspoon of salt mixed into 8oz clear tap water). Rinse with this solution twice a day for thirty seconds the first two days. If a Chlorihexidine gluconate 0.12% (Peridex or Periogard) mouth rinse was prescribed to you then rinse with 15 mL or half a cupful twice a day for thirty seconds on the first day until the doctor tells you to discontinue at which time you will resume normal oral hygiene. Do not brush or floss the surgical site until directed by the doctor.
Eating and Diet: For the first day, make your food cool or luke warm to avoid burning the tissues and to prevent pain. Avoid chewing on the operated side. If both sides were operated on, then keep foods soft, liquid, or blended until the sutures and dressing are removed. I recommend that you take a multivitamin supplement unless you already take one. Taking extra vitamin C daily for several weeks post surgically is recommended. Supplementing your diet with instant breakfast drinks may also enhance your nutrition. Drinking plenty of water (8-10 glasses per day) is recommended unless your physician directs you otherwise.
Some Important Points about Periodontal Surgery:
1. You may experience bruising of the skin at the site of the surgery.
2. The corners of your mouth may become dry and cracked. Keep them moistened with petroleum jelly (Vaseline) or ointment.
3. You may have a mild sore throat and elevated temperature. If your temperature is higher than 101°F, then call the dental office.
4. There may be a dull ache in the neck, throat, ears, jaw, or head. This is temporary. If it persists, call the dental office.
5. It is normal not to be able to open our mouth wide for the first few days after surgery.
6. It is unusual for the pain to get worse after the third day post-operatively. If it does then, call the dental office.
7. It is normal for the teeth to become loose for 2-3 weeks and then tighten again.
8. Your teeth may become sensitive to cold and sweets for between two weeks and two months following surgery. This is normal and should minimize over time.
9. The result of surgery must be evaluated at regular intervals as the doctor indicates.
10. Most of the time, you will require supportive treatment and re-evaluation of the results three months after surgery. Most of the results of surgery can be evaluated at that time, even though the treated area may be completely comfortable in a week or less. Do not go by what you feel in managing your gum problems. (Periodontal disease can recur at any time and may not hurt until it is too late!!!)
11. Without good professional supportive care after your surgery, on a continuing basis, your surgery will most likely FAIL. Maintenance is a MUST.