Patient Instructions Following Periodontal and Implant Procedures

he following information outlines important instructions for you following your procedure. Please read the instructions carefully. These instructions are designed to minimize post-surgical discomfort. Please call our office at 303-795-5700 if you have any questions.

What to Avoid

• Exercise – Wait at least 4 days after treatment to participate in any exercise that may elevate your heart rate. Avoid contact sports which can traumatize the surgical area during healing.
• Smoking – Smoking can delay your healing and is not recommended after any procedure AT ALL.
• Straws – The sucking motion that your mouth makes when you are using a straw can cause dry sockets to form or can cause your wound to reopen. NO SUCKING, NO SPITTING, NO STRAWS!!
• Waterpiks – Keep the use of your Waterpik away from the surgical area for at least two weeks.
• Looking – Avoid pulling at the lips to view surgery for at least two weeks. This can put stress on internal stitches and potentially cause failure. Please no fingers in the mouth, less bacteria in the mouth the better.

Discomfort

To minimize discomfort take medications as prescribed. Lodine (Etodolac) should be taken every eight hours. If you still have discomfort four hours after taking Lodine (Etodolac) then take 650mg of Tylenol (Acetaminophen). Alternate between Lodine (Etodolac) and Tylenol (Acetaminophen) 650mg every four hours thereafter. Do not exceed 3500mg of Tylenol (Acetaminophen) per day. If this still is not enough to curb discomfort, or if you have already been prescribed a narcotic by your periodontist, please discontinue the Lodine (Etodolac) and use the narcotic only. If you are on a narcotic then you can alternate with Ibuprofen only.

Antibiotics

Please take all antibiotics as directed until gone. These medications can cause GI upset, taking probiotics can be helpful. If any side effects occur like itching, severe stomach pain, rash, or diarrhea call the office at 303-795-5700. If you have trouble breathing call 911 immediately.

Oral Care

Do not brush or floss around the surgical area for the first week unless you are told to do so. Use only the post surgical brush provided to you. If you were prescribed mouth rinse, it is anti-microbial when used 2-3 times per day. No Swishing, please drool out onto the sink. Continue with normal home-care in the areas which have not been treated.

• Do not rinse on the day of surgery. Begin rinsing the day after treatment. 2 times a day.
• Do not rinse with other mouthwash unless approved by your periodontist.

Periodontal Dressing (“Packing”)

If your doctor placed packing, it will normally breakdown in a few days or even on the first day. Do not be concerned if it falls off, but if it becomes loose call us and we can remove. It looks like a pink putty material.

Sutures

If the sutures are dissolvable they will breakdown on their own. You will be informed how long this will take as some can last 6 weeks. Sutures can be annoying and they will be removed or trimmed at your first post-operative appointment. Do not pull on sutures.

Swelling

Swelling is normal. Apply ice packs to the outside of the cheek over the treated area for 10 minutes on and 10 minutes off for the first 2 days.

• Elevate your head (i.e. using more pillows to prop up head while sleeping).
• Minimize movement of the surgical area.
• Swelling will be the greatest after 2-3 days and may progress to bruising.

Bleeding

Red saliva or a small amount of bleeding is normal following most periodontal procedures for 1-3 days. Applying firm pressure for 10 minutes with gauze or a tea bag normally stops any longer bleeding.

Eating

Please eat softer foods for 2 weeks following periodontal surgery. Anything you can cut with the side of a plastic fork is usually okay. Avoid hot foods for the first 2 days.

Foods you can eat

• Soft meats like chicken or fish
• Pasta
• Shakes (do not drink with a straw)
• Yogurt
• Applesauce
• Eggs (cooled)
• Mashed potatoes
• Soup (room temp)
• Soft bread

Foods to avoid

• Anything crunchy (chips, crusty bread)
• Anything acidic
• Anything hard or sharp (crackers)
• Hot & spicy food
• Carrots & celery (other hard vegetables)
• Nuts & popcorn
• Hard crunchy bagels
• Anything with seeds like fruits, muffins, breads, jams with seeds (seeds can get stuck under gums)

Specific Periodontal Procedure Instructions

Sinus Augmentation Grafts

Refrain from blowing your nose for at least 2 weeks. Do not hold in sneezes. Please note that nosebleeds are normal after sinus grafting. Use Afrin nasal spray (1 puff per nostril) every 12 hours for four days then discontinue.

Gum Grafts (Connective Tissue Graft, Allograft, Free Gingival Graft)

DO NOT PULL your lip out to look at the surgical area, the sutures will tear. The area where the graft was taken (the palate) can be tender. Leave the retainer in place for 24 hours. The retainer is to protect the roof of your mouth during healing and for comfort, wear it at least for one week (as you desire). We also recommend that you wear it during eating, then remove it, clean it, and put it back in. If liquid bandage is used to cover the palate, it will peel off within about a week. If the graft changes color do not be alarmed as this is normal and part of the healing process. Please apply pressure with a tea bag for around 10 minutes with the stent out to help stop the bleeding.

Laser Periodontal Therapy

It is common to have gum tissue discoloration following treatment. Gum tissue will return to a normal pink color around 1-2 weeks after treatment. Cold sensitivity on teeth is normal and will lessen with time.

Ridge Augmentation / Bone Grafting

If you have a temporary prosthetic to replace missing teeth (flipper), refrain from wearing it as much as possible for the first six weeks of healing. We ask that you do not wear it at all for the first two weeks unless your periodontist has had a chance to look at it or adjust it. If pressure is put on the new bone graft too early it can cause the sutures to open and may affect the bone graft. Very normal for there to be some bone spurs or grafting material that can make its way through the tissue.

Hybrid Therapy / All on X

The healing of your implants is contingent upon them not moving, therefore, if you can cut it with the side of a plastic fork (extremely soft) it’s okay to eat. Chewing anything hard such as ice, hard candy, or other very hard foods can cause an implant to fail or your healing denture to break. Remember, if you can hear it crunching when you chew, it’s too hard! In rare instances, the acrylic temporary denture will break. If this happens, call our office immediately.

Vitamin Supplementation for Sinus/Ridge Augmentation, Bone Grafts and/or Implants

If you have been given a Vitamin D3, K2 supplement (for bone and wound healing) start 2 weeks or as soon as possible before surgery. Take 4 capsules daily with food. You can take this with your other medications/supplements. Use until gone.

Periodontal Associates – The Dental Implant Team

Colorado’s Premier Provider of Periodontics and Dental Implants

Littleton/Centennial Location

For questions or concerns: 303-795-5700

For a dental emergency outside business hours:

• Dr. Thousand – 303-601-4303
• Dr. Brett – 918-221-6825

Aurora Location

For questions or concerns: 303-795-5700

For a dental emergency outside business hours: 303-755-5700
Fax: 303-755-4047