Post-Operative Instructions - PAOO/Soft-Tissue Graft Surgery

Work, Exercise & Sedation: Return Home immediately and Relax. If you took an oral sedative, it takes some time to completely wear off, possibly as much as 24 hours. It is normal to sleep a good deal during this period. Do not try to drive or operate any machinery for 12 hours, as your reaction time is slowed. It is advised to not use alcohol while on sedatives. We suggest complete rest for the first 6-12 hours, as this will reduce discomfort, decrease swelling and speed healing. Work can be resumed the following day, but you may choose to wait several days. Do not undertake any strenuous exercise for several days.

Diet: Soft and cool for the first 24 hours after surgery. We encourage you to restrict your diet to soft, nourishing foods, and plenty of liquids, as this will aid in healing. It is advisable to chew only on the side opposite surgery. Bland foods lacking high seasoning are less irritating and are encouraged during the healing phase as well. Some suggested foods: Dairy products, eggs, instant breakfast, ice cream, gelatin, pudding, yogurt, milkshakes, blended or pureed foods, and/or dietary supplements (Ensure, Boost, etc.).

For 24 hours after surgery, hot foods and drinks should be avoided because heat can cause swelling around the surgical site. An ice pack, or crushed ice in a plastic bag, covered with a thin towel, held on the lip or cheek over the surgical site for 20 minutes on, and 1 hour off will help reduce swelling (during the initial 12-24 hours). If swelling appears to be increasing beyond the initial 72 hours please call our office.

Home Care: Plaque control procedures must not be neglected, even during the post-operative phase of treatment. Beginning the day after surgery, all teeth NOT surgically treated must be brushed and flossed as you normally do. Teeth treated are not to be brushed until you return for post-surgical care. Toothpaste may be irritating to the healing tissues. Start the prescription mouth rinse the following morning after surgery.

Pain Medication: Pain medication may or may not be prescribed depending on the severity of your surgical procedure. If it is not prescribed or if you do not need it, Ibuprofen (Advil) (3-4 tablets every 6-8 hours_ or Acetaminophen (Tylenol) may be used (2 tablets every 8 hours) will generally keep you comfortable. Do not take pain medication if it is not needed.

Periodontal Dressing: If you had a graft, the graft is held in by sutures that will be removed approximately 7-10 days following surgery. A periodontal dressing (pack) has been placed over the graft. The dressing will harden to a firm, plastic-like consistency. It will also protect the grafted area, and allow it to be undisturbed during healing. If it comes out after 3-4 days, do not worry, generally it will stay until your post op appointment. If it becomes loose, do not try to remove it as it may be attached to sutures. Try to push it back into the original position.

If you were given a plastic covering (stent) for your palate, wear it as much as possible. It will be removed at your post-operative appointment. It is for your comfort and to protect the wound.

Bleeding: Slight bleeding, oozing, or redness in the saliva is not uncommon. Your saliva may be tinged with blood for the remainder of the day. Excessive bleeding may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If excessive bleeding does not subside, call for further instructions.

General Information: Smoking should be avoided, however, if this is not possible, refrain from smoking during initial healing phase, as it slows the healing process. Smoking also irritates the surgical areas. Do not use straws for drinking after any dental surgical procedure.

Swelling: The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body's normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling can be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on continuously while you are awake. After 36 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling.

Discomfort: Your jaw and lip will remain numb for approximately six hours. You should begin taking the medication prescribed for discomfort while you are still numb to prevent the onset of pain. If you should begin to experience more that mild discomfort, you may take the medication every two-three hours as necessary. If this is not sufficient, please contact our office.

Caution: If you suddenly sit up or stand from a lying position you may become dizzy. Therefore, immediately following surgery, if you are laying down, make sure you sit for one minute or so before standing.

Fever: A slight elevation in temperature is common on the evening of the surgery. However it should not exceed 101 degrees. If this occurs, please contact our office.

Infection: Infections may occur a day or even several; days following surgery. A sudden increase in swelling, throbbing pain, high fever and /or a foul tasting drainage may indicate infection. If you suspect an infection, please contact our office as soon as possible.

Bruising: Bleeding into the tissue around the jaws results in purplish bruises a few days following surgery. Do not be alarmed. Some patients have more bruising than others. These areas will become yellow as they move toward the neck and shoulders a week later.

Rinsing: No rinsing of any kind should be done until the day following surgery. You can gently brush your teeth the night of surgery-avoid the surgical site. The day after surgery you should begin gentle rinsing at least 5-6 times a day, especially after eating. Use approximately 1/2 teaspoon salt in 8 ounce glass of warm water. The use of commercial mouthwashes during the healing period should be avoided.

Denture Wear: If you wear a denture, your denture or partial should NOT be worn until it has been properly adjusted. The time you will be instructed to refrain from wearing your denture will be determined by the surgeon, and will vary from patient to patient. The success of your implants will depend on your compliance with this. Whenever dentures or partials are worn, they must be worn for appearance only, not eating or chewing. Chewing will cause implant loss.

Emergency number to call: 202.256.5798

Office number to call: 202.912.9200 or 703.299.4614

Call our conveniently located Washington, DC, or Old Town Alexandria, VA, dental office today to schedule a comprehensive consultation or second opinion visit. Dr. Singer will assess your current level of oral health, discuss your goals for your smile, and recommend a unique and practical treatment plan specifically for you. Outside of Washington, DC, and Alexandria, VA, we serve Arlington, Fairfax, Springfield, Burke, and surrounding areas.