Post-Operative Instructions

At Peace Periodontics, we ask that you, please follow the post-operative instructions in caring for your mouth after periodontal treatment.  They are necessary for your comfort and to maximize the result of surgery.

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Pain and Discomfort

Most commonly, the post-operative instructions would include taking ibuprofen (Advil or Motrin) is recommended as it is an effective pain medication that has anti-inflammatory properties and will reduce swelling.  Take 400-800mg every 4-6 hours for the next two days. After two days, take only as required.  We may prescribe alternate or additional medications, depending on your individual needs.  DO NOT TAKE ASPIRIN for the pain, as it thins the blood and will promote bleeding.  The amount of pain you may experience is variable and may range from none at all to more than average; most people are somewhere in between.  Pain may last for 2-5 days.

Diet

Also included in the post-operative instructions would include drinking plenty of fluids and choose a balanced, nutritious diet of cooler softer foods for the first three days
(i.e. Eggs, yogurt, lukewarm soups, and smoothies).  Try to avoid the surgical area(s) when eating.  If you have difficulty obtaining an adequately balanced diet, Boost or Ensure nutrition drinks are recommended.

Foods to Avoid:

  • Hot, Hard, Spicy, Citrus
  • Crunchy foods (nuts, crackers, toast)
  • Foods with small seeds (berries, kiwi, popcorn, whole grain bread)
  • Limit alcohol & caffeine consumption – these thin the blood and promote bleeding

Bleeding & Numbness (Tingling)

  • DO NOT suck through a straw, spit or smoke. The vacuum effect increases the risk of bleeding.
  • DO NOT sleep with gauze in your mouth (choking hazard).
  • DO put a dark towel on your pillow when you go to bed.
  • DO avoid the surgical area(s) with your tongue and toothbrush.

Oozing is normal from the surgical site(s) and should subside by the third day.  The local anesthetic you received for your surgery has epinephrine, a vaso-constrictor, in it.  As the epinephrine wears off in the next 1-3 hours, you may notice an increase of bleeding.  This is normal.

Please be careful to avoid hot fluids, chewing on your tongue, cheek or lip while you are numb.  More specific post-operative instructions on how to deal with excessive bleeding vary, depending on what type of surgery you have had.  If bleeding persists, despite following the instructions below, please call the office or after hour numbers listed on the last page.

Gum Grafts

Donor site:  (roof of the mouth)
If you are experiencing bleeding from the roof of your mouth, sit quietly and apply firm pressure with your thumb and a moistened gauze or tea bag for 20 minutes at a time.  The tannins in black tea, such as Red Rose and Earl Grey, promotes blood clotting.  Repeat until the bleeding lessens or stops.

Graft site:  (area receiving the graft)
If the area bleeds, please sit down, relax and let it stop on its own.

  • DO NOT apply pressure to the graft site.
  • DO NOT pull out your lip or cheek to look at the graft.

Not following these instructions could compromise the result of the graft.

Direct Sinus Bone Grafting

  • DO apply a lot of ice (20 minutes on, 20 minutes off).
  • DO take the medications as directed.
  • DO NOT stifle a sneeze.
  • DO NOT blow your nose for two weeks.
  • DO NOT sleep on the surgical site for two weeks.
  • DO NOT fly for four weeks.
  • DO NOT snorkel or dive for three months.

Other Surgeries

Post-Operative Instructions will advise that if the surgical site is bleeding excessively, sit quietly and apply pressure with your thumb and a moistened gauze or tea bag for 20 minutes at a time.  The tannins in black tea, such as Red Rose and Earl Grey, promotes blood clotting.  Repeat until the bleeding lessens or stops.

Your face may swell around the treated area, peaking at day 3-5.  This can be lessened by applying ice packs or a bag of frozen vegetables to the affected area for 20 minutes on, 20 minutes off.

Activity

Avoiding strenuous, or vigorous, physical activity for the next ”X”  days.  This will help to keep your heart rate and blood pressure lower, reducing the risk of bleeding.

Oral Hygiene

Please DO NOT brush the surgical area(s) for  ”X”  weeks.  Brush and floss all non-surgical areas as normal.  Starting this time tomorrow, gently rinse with either 1) Listerine 2-3 times a day or 2) Your prescription mouth rinse as directed.

(Variable “X” – The length of time will be dependent on the individual procedure that you are receiving and will be filled out at your surgical appointment.)

Sutures/Follow Up

The sutures placed in your mouth need to be left in place until they dissolve or are removed at your post-op appointment in 2-3 weeks.  Occasionally, sutures fall out before your follow-up appointment.  This is normal after the first 4-5 days and is not cause for alarm.  If your sutures prove to be problematic, please call the office.  It is important to keep your post-op appointment so that sutures can be removed and healing monitored.

Bruising

You may experience bruising, which typically appears lower than the surgical site, by the third day.  It is difficult to know who is more susceptible to bruising.   Any bruising should resolve after several days.

Smoking

Smoking delays healing and increase the risk of post-surgical complications.  If you smoke, it is in your best interest to stop smoking for as long as possible following surgery.

Antibiotics

If an antibiotic was prescribed, please take the medication as directed and to completion.  Discontinuing the antibiotic before completion may increase your susceptibility to infection.  Common side effects include nausea, vomiting, and diarrhea.  If this occurs, contact your periodontist and/or pharmacist.  Please note that certain medications may inhibit the effectiveness of oral contraceptives.

Feeling Unwell/Feverish

You may feel tired, unwell or run a mild fever for 1-2 days.  You may feel nauseous, vomit or have diarrhea.  This may be due to post-operative medications, the surgery itself or sedatives you may have taken for this procedure.  If symptoms persist beyond 1-2 days or are severe, please contact us.

Stiff or Sore Jaw

It may be difficult to open your mouth wide for several days due to swelling or tight muscles after a lengthy procedure.  DO NOT “test” how wide you can open.  A healthy liquid diet for 1-2 days can alleviate the irritation of chewing.  Rest your jaw and apply warm moist compresses to the cheek muscles and in front of the ear, where the muscles are sore or tight.  If symptoms are severe or persist, please call.

Sedation

Please ensure that the responsible person that accompanied you to and from this appointment remains with you until the drowsiness and disorientation have subsided.  You may not drive a vehicle, operate hazardous machinery, make important decisions or consume alcohol for a minimum of 18 hours or longer if drowsiness or disorientation persists.

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Dr Ward Piepgrass is an amazing Dentist and human being. I have had him as a dentist for 31 yrs. his work is excellent, he Has tremendous talent and is a kind gentle Person. He explains what the procedure will be, his staff are kind and courteous. I would highly recommend him!

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I am terribly scared of dentist from past experience! Thankfully the staff and Dr. Piepgrass made me so comfortable and fixed such a big problem I was having! You gave me so much out of this visit I cannot thank them all enough!! I highly recommend this dentist!!

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