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Post-Operative Instructions

Scaling and root Planing

You have just had your teeth scaled and root planned (deep cleaned), and the bacteria and hardened deposits of calculus on the teeth, both above and below the gingival tissues, have been removed. This is a very important stage in periodontal treatment, as it greatly reduces the number of bacteria responsible for the destruction of the tooth supporting structures. These are some of the things you may expect in the coming days, all of which are normal responses:

Your gums may be tender and bleed slightly for several days, as they heal. If you find they are too sensitive to brush for the first several days, you may use a moist cloth towel to clean the tooth along the gum line along with a mouth wash. As soon as possible, resume oral hygiene, which have been prescribed for you.

If a pain reliever has been prescribed take it only as directed. REMEMBER some of these drugs such as Oxycodone will cause drowsiness and alter judgment. For these reasons do not drive, use machines or tools, which could injure you, or drink alcoholic beverages within six hours of taking medication. For most people regular Ibuprofen (Advil) is all that is needed to control any discomfort, and it is not uncommon that people don’t require any pain relief.

For the next few days, the teeth may be sensitive to chewing hard foods. If you find that this is the case, try to eat softer foods and chew on the opposite side of your mouth. The teeth may feel somewhat looser, but soon will return to their normal tightness.

You will find that your gums will return to a healthier pink color and may shrink back slightly from the teeth. This is a result of reduced inflammation. The teeth may be sensitive to hot and cold foods, beverages and sweets. This may occur soon after scaling or may take several weeks to happen. If this is a problem, please bring it to our attention as soon as possible, as it is easily treated in most cases if treated early.

If any problems arise, please contact the office. Rest assured that our staff is well qualified and can answer most of your questions. In Case of an after-hour emergency please call Dr. Slagle at (804)731-1006.

Periodontal surgery, Implant, Tooth Extraction

Bleeding: It is normal to have some bleeding after surgery. You will be given a pack of gauze after the procedure, and may leave the office with a gauze pad over the surgical area. Bite firmly on the gauze for 30 minutes until the bleeding stops. Do not spit or rinse on the day of surgery; to do so can cause bleeding. Avoid taking Aspirin following surgery. Avoid drinking through a straw for at least 48 hours following surgery.

If you begin to bleed heavily, place gauze in your mouth and bite down firmly for 30 minutes. If this does not stop the bleeding, place a moist tea bag (black tea) over the bleeding site and hold firm pressure for 30 minutes.

It is normal to have some blood stains (pink saliva) in the saliva for the first 24 hours after surgery. It is not unusual to have some minor bleeding from the roof of the mouth following some gingival (gum) grafts up to a week following surgery.

If bleeding persists, please call our office.

Discomfort/Medication: Depending on the procedure performed, you may experience no discomfort, little discomfort or considerable discomfort when the local anesthesia wears off. If considerable discomfort is anticipated, you will be given a prescription for medication that will provide relief. Take this medication according to the directions on the label. Most medications should not be taken on an empty stomach (carbonated beverages, at the least, are recommended). Some pain medicines may make you groggy and can slow your reflexes. Suddenly sitting up or standing may make you feel dizzy. Driving, making important decisions, or operating machinery should be avoided while taking your pain prescription. Avoid alcohol when taking medications.

Immediately before or after the procedure you will be given Ibuprofen or Tylenol (if allergic to Ibuprofen). If no prescription medication has been prescribed to you, it is recommended that adults take Ibuprofen (brand names: Advil, Motrin, Nuprin and are supplied in 200mg tablets and available over-the-counter) 600-800mg every 6 to 8 hours, respectively, for the first 24 to 48 hours following surgery. You can also take 1000mg Tylenol in between Ibuprofen doses. This combination of ibuprofen and Tylenol works better than using a narcotic.

If you are given a prescription for an antibiotic (Amoxicillin or Clindamycin or other), take the medication as prescribed. It is important to finish all the tablets. If you develop hives, rash or itching while on the antibiotic, stop the medication immediately and call our office or Dr. Slagle. If necessary, seek immediate medical assistance.

Occasionally after surgery, teeth may become very sensitive, especially to cold, this is normal and should subside in couple weeks, if not please report it and we will prescribe special medication for that sensitivity.

Swelling: To help prevent swelling and discomfort to the surgical area, you may apply an ice pack to your face for the first 24 hours after surgery (a bag of frozen vegetables works well if no ice pack is available). Keep ice pack on face for 15 minutes and remove for 15 minutes, and repeat. Repeat this process only for the first 24 hours after surgery. Ice will not help reduce swelling once it has occurred.

Keep your head elevated with at least 2-3 pillows for the first 24 hours to help prevent swelling.

It is normal to have some swelling following surgery; it should gradually subside during the week following your procedure. A warm, wet washcloth may be applied to the face to help reduce swelling and/or bruising to subside.

If you develop a fever with increased discomfort and swelling, please call our office or Drs. Slagle.

Dressing: If a periodontal pack (band-aid) is placed, it should stay in place until your return. Small pieces may break and become dislodged. This loss is not a problem unless the surgical area is extremely sore. If so, call.

Eating: The day following surgery, do not drink or eat anything hot (warm or cool foods are acceptable). Avoid chewing on the same side where surgery was performed and be sure to wait until local anesthesia has worn off.

A soft, bland diet is recommended following surgery. Avoid peppery, spicy foods (ie Italian and Mexican). Avoid hard, crunchy foods (ie chips, nuts, toast). Avoid acidic foods (ie tomatoes, citrus fruits). Examples of a soft, bland diet are: creams soups, soups, milkshakes, Carnation Instant Breakfast, protein drinks, mashed fruits and vegetables, scrambled or poached eggs, oatmeal, cream of wheat, custards/pudding/jello, yogurt, cottage cheese, macaroni and cheese, Slimfast diet drink, tuna or chicken salad, deviled ham, and grits. This is a suggested diet for your comfort (if you can handle firmer food, they are permitted). If you had a gingival (gum) graft it is important to avoid all hard, crunchy foods.

Home Care: Do not rinse with water or mouth wash the day of surgery. You may rinse your mouth up to 6 times a day with warm salt water (tea spoon of salt to 8oz of water) for the first 2 weeks following surgery. If you have had a gingival (gum) graft, do not rinse and swish the water vigorously, as you may dislodge the graft. Roll the water around in your mouth gently and let it fall gently out of your mouth.

If you have been prescribed a mouth rinse (Peridex, PerioGuard) for use after surgery, please follow the directions as labeled.

If directed, you may gently brush the surgical area with a soft toothbrush. This will help prevent the building-up of bacterial plaque on the surgical area and reduce discomfort. If you have had a gingival (gum) graft, do not brush the surgical area!

Sutures: If dissolvable sutures (stitches) were not used, they will be removed at your postoperative appointment.

Sinus Surgery

The key to a successful sinus grafting procedure is your comfort and the care taken of the area during the next few days. This means that you must keep the area stable and take the prescribed medications as directed to prevent infection. Here are some tips that should help you out:

DO NOT blow your nose

Try not to sneeze as this will increase the pressure in your sinus and risk the displacement of the graft. If you must sneeze, attempt to open your mouth wide during a sneeze. This will greatly reduce the pressure within the sinus.

Coughing may place additional pressure on the sinus membrane and introduce bacteria into the graft. Therefore coughing, if it occurs, should be done with the mouth open to relieve pressure within the sinus.

Apply ice pack or in a cloth to your face 10 minutes on, 20 minutes off for 24 hours to reduce pain and swelling.

Eat very soft foods as tolerated. They should be of a high protein nature.

For the first 24 postoperative hours drink plenty of fluids: juice, soda, water, milk.

Expect a good amount of swelling and some discoloration. These findings are common and do not indicate infection or other problems. Sleep with your head well-elevated; even so, you will find swelling will be most marked on arising the next morning.

Don’t exert yourself for the next couple of days. The surgical site needs to be stable for optimum results. Avoid bending over and other postural movements. Sleep with your head elevated.

Follow the instruction(s) given by Dr. Slagle, and take your prescribed medication as directed on your prescriptions:

ANTIBIOTICS
DECONGESTANT
PAIN MEDICATION
STERIODS, which may or may not be prescribed

Do not hesitate to telephone us if any question or problem regarding your condition arises. In an emergency (bleeding, extreme swelling or pain and infection), you should immediately contact us. In Case of an after-hour emergency please call Dr. Slagle at (804)731-1006.