We want to minimize as much as possible any discomfort you may have after the procedures performed in our office and share information that will help you manage the first days post-surgery.
It is normal to experience minor swelling and bleeding during the first week after surgery. Each procedure (gum disease treatment, gum grafting, bone grafting, sinus augmentation, dental implants…) is different and so we will give you more specific written instructions depending on the case. There might be a peak of swelling around the third to fifth day after surgery. You can use an ice pack on-and-off, every 10 minutes, around the side of the face where the procedure was performed to diminish swelling during the first 24 hours. If persistent bleeding occurs, apply pressure onto the area for 20 minutes with a moist gauze or moist black tea bag. Repeat if necessary. Do not suck on candy, drink from a straw or spit, as these actions will induce bleeding. Please call the office if you have questions.
A specific prescription will be given to you if required or an over-the-counter substitute will be recommended in advance to help subside the swelling and improve the healing process. Please take your medications as directed. A combination of ibuprofen & acetaminophen has proven to work well for most patients the first 2-3 days of healing. Dosages ranging from 400-600 mg of ibuprofen only (Advil; Motrin; Aleve) every 6-8 hours for the first 2-4 days work well. If needed, you can combine it with 325 or 500 mg tablets of acetaminophen (Tylenol) every 6-8 hours as well for the first 2-3 days. The safe use of these medications should not exceed the daily dosage of 3000 mg a day of acetaminophen or 1200 mg of ibuprofen. Contact the office if you have questions. Please inform the office about any allergies you may have, specially, if a prescription for antibiotics is necessary. Antibiotics interfere with certain medications and substances, such as, birth control pills and alcohol, reducing their efficacy and/or causing adverse reactions. Metronidazole (Flagyl, Metrogyl) taken together with alcohol can cause very unpleasant side effects, such as, nausea, vomiting, headaches, skin flushing and fast/irregular heart beats. Alcohol can affect the efficacy of a medication by modifying its bio-availability.
Please refrain from drinking alcohol when the antibiotic metronidazole has been prescribed to you.
Take probiotic supplements if you start taking systemic antibiotics to protect your normal indigenous microflora.
Prebiotic substances (L-glutamine) may further help maintain a healthy ecological microflora balance, prevent the overgrowth of pathogenic microorganisms, stimulate the immune system, aid in protein synthesis & tissue repair and favor the intestinal permeability & absorption of important nutrients & minerals such as calcium & magnesium. The amino acid L-glutamine (500mg/twice a day on an empty stomach) could considerably aid with the recovery healing process the first 4-8 weeks after surgery. Trauma, stress, infection or heavy exercise could deplete our body’s glutamine stores. It is also found in lentils, beans, garbanzos, peas, quinoa, millet, oats, almonds, spinach, sparsely, cabbage, kale, beets, figs, plums & prunes, turkey, chicken, fish and eggs. A healthy diet will speed up your recovery.
Other supplements, such as vitamin c (1000mg/ twice a day as ester), L-proline/L-lysine (500mg/twice a day) and zinc (50mg/once a day), might also benefit & boost the healing process by favoring connective tissue repair & bone healing as well as strengthen your immune response.
Do not rinse for the first 24 hours. If a mouthwash is recommended use it only for the first week morning and night time for 30 seconds after brushing your teeth. A teaspoon of salt in a small half glass of water is a safe antimicrobial rinse and can be used for more than just a week. Make sure the rinses you do are gentle, bathing the area. Too much rinsing could disturb the initial delicate healing and blood supply to grafted sites or extraction sockets so keep it to twice a day.
Smoking and alcohol drinking can significantly delay healing, increase pain and interfere with the medications you might be taking. Please refrain from smoking for the first 4-6 weeks after surgery.
Try to rest the day of the procedure. Avoid strenuous exercise or heavy weight lifting during the first week of healing. Light cardio exercise is fine 2-3 days after the procedure.
Avoid hard crunchy foods. Food that is cooked and soft, such as, fish, oatmeal, avocado, beans, eggs, pasta, soup, goat yogurt, bananas, are good choices. Try not to chew on the side where the surgery was done during the first week. Avoid hot foods & liquids for 48 hours after surgery. Proper nutrition is vital to healing well and faster and reduce pain.
Do not brush the surgical site for the first week unless instructed to do so. If you had a gum graft, wait two weeks before brushing that particular site. You can gently swab the treated area using a Q-tip moistened with the prescribed rinse to clean around the teeth. You may resume normal brushing/flossing on the rest of the mouth the following day. If you use an oral irrigator device (waterpik), stop using it, specially, around grafted sites, for 4 weeks after the procedure. The water pressure can compromise the initial delicate blood supply to the graft. You may resume using oral irrigators after the grafted site and gums have healed. Sutures will dissolve within the first 5-10 days. A follow-up visit will be scheduled to evaluate healing at 1 & 4 weeks. Regular maintenance will be recommended accordingly.
Fernando Verdugo, DMD, PhD PERIODONTAL & DENTAL IMPLANT SURGEON DIPLOMATE IN PERIODONTOLOGY & DENTAL IMPLANT SURGERY
AMERICAN BOARD OF PERIODONTOLOGY