Post-surgical care following periodontal and dental implant surgery

Rest:

Limiting your physical activity is recommended for 1-2 days following surgery. When you lie down, keep your head slightly elevated in the first 24 hours (an extra pillow is recommended).An old towel over your pillow the first night is recommended.
Ideally, you should refrain from vigorous workouts for 2-4 days following surgery.

You will have been advised to use one of many different pain killers available either over the counter (OTC) or by prescription.
400-600mg Advil or other forms of ibuprofen effectively control pain when taken every 4-6 hours. If you have an intolerance to ASA or aspirin-like drugs, you should not use Advil. Acceptable alternative options include 325mg or 500mg Tylenol (OTC) or Tylenol/codeine (by prescription).
A combination of Advil or Tylenol (500mg) can improve your pain management. Do not exceed 2400mg of Advil (ibuprofen) or 4000mg Tylenol within a 24hour period.
Pain levels vary a lot; do not worry if your pain peaks after 3-4 days, this is common.

Please use a decongestant as directed by your periodontist.
Minimize negative sinus pressure (minimal nose blowing, drinking through a straw) for7 days.
Sinus grafting surgery patients may experience a post-surgical nosebleed within 2 days following surgery. Pinching the nostrils, tilting the head forward will help bring this under control.

If you are prescribed antibiotics following a surgery, it is important to take the full prescription as directed. If you develop itching, a skin rash or swelling, immediately discontinue the drug and contact our office at 604.939.8467. If you have trouble breathing, proceed to the hospital emergency department.
Please contact our office if you experience symptoms such as increased pain and or swelling after 5-6 days.
Probiotics can be taken to maintain a healthy gastrointestinal flora while taking antibiotics. Ideally, a probiotic should be taken in between antibiotic doses, and not at the same time as the antibiotic. Please consult with your pharmacist to discuss the best time to take the probiotic and what probiotic is best suited for you.

Please avoid brushing/flossing the surgical site until you are seen for your post-operative follow up since this can break stitches prematurely or cause movement of the gum tissues.
You will rely on an antibacterial oral rinse given to you at the time of surgery to keep the area clean. You should rinse/swish for 30 seconds/spit out 2 times per day (follow instructions on bottle) or swab the site with a Q-tip dipped in the rinse. Do not swallow the rinse.
You can also rinse with warm salt water during the day, 1 tsp of salt to 1 cup of warm water.

Do not rinse your mouth vigorously for the first day after surgery since this can cause bleeding.
Do not suck from a straw during the first 48 hours, as this can also cause bleeding

Dissolving stitches are generally used. Dissolving rates vary significantly from person to person, in some cases the stitches can start to fall out within 2 -5 days. This is normal.
If non-dissolving stitches have been placed, you would have been advised of this and an appointment to remove the stitches would have been scheduled.
If a stitch comes loose and is bothersome, simply clip if off with small scissors.
Medical glue may also be used which will gradually chip off as healing progresses.

This is a protective dressing sometimes used, most commonly in association with gum grafting.
Its role is to protect a surgical site from trauma and reduce discomfort.
If it falls off or you swallow it, do not worry; it does not influence healing and it is not harmful if ingested. A periodontal pack can last 5-7 days (or longer)

Swelling and/or bruising is quite common and normal (it can vary).
You can minimize the swelling by placing an ice pack on your face over the surgical site during the 1st day after surgery (on for 20 minutes, off for 20 minutes; repeat this throughout the day).
Swelling is often worse in the mornings because you have been lying down. It will reduce gradually after you get up.

Slight seepage/blood staining in your saliva is expected following the surgery, and no action is necessary.
Profuse bleeding is extremely rare. If it should occur, apply pressure with a moistened gauze or a black tea bag for 20 minutes.
If you are still unable to control the bleeding after 40 minutes, call our office. If you are unable to reach the periodontist, you should go to the nearest hospital emergency department.

Affects healing and generally has a negative impact on the surgical result. Avoid smoking as much as possible.

Can adversely interact with painkillers (codeine-based drugs) and some antibiotics.
Alcohol will also affect your body’s normal clotting mechanism and can contribute to bleeding problems within the first few days after surgery.

Maintain as close to normal as diet as possible, especially if you are a diabetic.
Avoid eating hard/crunchy foods; with small seeds or popcorn which could get stuck in the surgical site.
Liquid food supplements are recommended if you are having difficulty eating.

Occasionally minor complications may occur after surgery. Please do not hesitate to call our office if you are concerned about your situation. Outside of office hours, please contact Dr. Nazanin Narani 604.728.4937 or Dr. Ahmed Ballo 604-363-2897.

If you have taken an oral sedative for your appointment, you are legally impaired for 24 hours. You cannot operate any motor vehicles or make any legal decisions. You must have an escort to and from your appointment and must have someone at home to accompany you for 12 hours after your appointment.