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Instructions for your care following periodontal surgery.

If your surgery is in the morning, eat a light breakfast high in carbohydrates. If your surgery is in the afternoon, eat a light lunch.   Breakfast Example: Shredded Wheat, Corn Flakes with skim milk. Lunch Example: Yogurt, soup, salad with crackers or toast.

REST:
It is recommended you lie quietly with your head elevated for the remainder of the day.   Please limit your physical activity to a minimum, as it will possibly promote swelling and/or bleeding.
 
SWELLING:
Applying an ice bag to your face for 20 minute intervals for the first 4 to 5 hours after surgery will generally contribute to your comfort and minimize facial swelling.  DO NOT use warm compresses the day of the surgery.  If swelling continues, you may use warm compresses beginning in the second day after surgery.

MEDICATIONS:
Use your pain medication as prescribed to relieve discomfort.  It is important for you to start your anti-inflammatory medication (example: Motrin) the night before surgery.   This will keep you comfortable as well as promote healing.  If antibiotics are necessary, take as prescribed until they are gone.  If nausea, itching skin, or a rash develop after taking medication, discontinue use and phone the office immediately.
 
BLEEDING:
Some slight bleeding is normal today.  Do not rinse your mouth today as this may stimulate bleeding.  Avoid smoking and the use of alcohol as they will interfere with normal blood clotting and irritate your mouth.

DIET:
When all numbness is gone from your face, you may have something cold to drink or soft to eat.  Dairy products will help counter act nausea.  Eating a soft, bland meal the evening of your surgery is the best medicine for improving how you feel!

MOUTH CARE:
No spitting
Do not rinse your mouth
Do not brush or floss your teeth today
Do not use a straw the day of surgery.

* Our apologies if you feel as if an infantry battalion has marched through your mouth.  Take some pain medication before retiring tonight and use two pillows to keep your head elevated while sleeping.  We hope that you have a restful night.

DIET:
It is important that you maintain an adequate diet, rich in protein. If chewing is difficult, try to eat a smaller amount of food, but more frequently than normal mealtimes.   Avoid vigorous chewing of hard or tough foods as well as heavily spices or acidic foods.  Food of extreme hot or cold temperatures may be uncomfortable.  At this time, experiment and see if you can manage such things as eggs, cheese, ground beef, chicken, fish, cooked cereals, and soup.  Foods that add bulk (roughage) to your diet, as well as lots of liquids, will help to prevent constipation which is often a side effect of the prolonged use of strong pain medication.
 
SWELLING:
The day following surgery you will probably be aware of the onset of some swelling in your face, especially if you didn't apply ice packs the day of surgery.  Tomorrow it may even increase but should diminish greatly the third and fourth days following surgery.   This pattern of swelling is associated with normal healing.  The application of a moistened hot compress (washcloth) to the outside of your face on and off for several hours often decreases swelling significantly and will contribute to your comfort.  DO NOT use ice packs after the day of surgery.
  
MOUTH CARE:
Take a positive approach to the care of your mouth at this time!  The mouth is one of the most rapidly healing areas of the body.  Utilizing the following instructions, it will be virtually impossible for you to harm your mouth.  Moisten the bristles of your soft toothbrush by holding it under hot tap water for 30 seconds and use the brush on all exposed gumline areas at least twice daily.  While you may experience some tenderness and bleeding as your brush, this will diminish as the week passes on.   Gently rinse your mouth with a solution of 1/2 teaspoon of salt dissolved in a full glass of warm water. 
  
If Gel Kam (Fluoride Gel treatment) is prescribed, use in the evening after thorough cleaning.  Apply to sensitive areas with your toothbrush.  Allow to remain one minute.  Spit out excess.  Do not rinse.  If Gel Kam rinse was ordered, please follow the bottle directions.
  
If Periogard rinse is given, use in the morning and evening after plaque removal.  

If you are experiencing extreme discomfort while you brush, do the following:    One hour before retiring at night, take some pain medication.  In 30 to 45 minutes, when it has taken effect, you should find that you can brush more comfortable.   Rinsing your gumline areas to eliminate bacterial plaque accumulations will greatly increase the rate of your healing and return of your comfort!    Allow 5-8 days before flossing.

1. If stitches around the gum should become loose, do not attempt to remove them yourself.
2. As the week progresses, stitches may become tight and create some dull aching which can usually be controlled by mild pain medication.
3. You may have a plastic-like material around your teeth which may tend to break loose or fall off as the week progresses.  If this results in increased discomfort or excessive bleeding, please call the office.
4. Constipation can result from the prolonged use of strong pain medication.  This can be treated by increasing your liquid intake, and the use of either Milk of Magnesia or Mineral Oil as directed.

There is much variation in peoples' reaction to this type of surgery and to the medication which you have taken.  It is important for you to realize that the symptoms described and discomfort you might be experiencing right now, are all part of a positive experience: HEALING!!  With your proper care at this time, it will only be a short time before your mouth returns to normal.
 
It is also important that at this time you realize you are not alone.  Should you need us, CALL US!!  We are committed to giving you the best of care and keeping you as comfortable as possible.  If you have any questions that are not covered in the above information, please feel free to phone us at any time.