Post-operative Instructions

These instructions apply to the surgical procedure just completed. They are designed to help you minimize post-surgical discomfort and inform you of any situation that may require special attention.

Pain Medications

It is not unusual to have discomfort for at least the first week following your surgical procedure. For most procedures prescription pain medications are not necessary. We can give you a hand-written prescription if you would like. You can keep it on hand and fill it if you feel you need it. It is advisable to not take pain medication on an empty stomach, as nausea may result. 

We recommend taking 2 Advil Dual Action every 6-8 hours. This is an over-the-counter medication that contains ibuprofen and acetaminophen in one pill. Most patients who take this medication experience no pain or just a little discomfort. It is an easier and more effective way to take pain medication. You can also take 500mg acetaminophen (Tylenol) with 600mg ibuprofen (Advil) every 4-6 hours. Remember to drink plenty of water when taking medications. This combination of acetaminophen and ibuprofen has been proven to be more effective at treating pain than leading prescription pain killers and has fewer side effects. This combination will address any nerve, muscle, and gum pain along with inflammation.  Take these medications as soon as you can post-surgery so they will be working once the numbing wears off. Keep up on them every 6-8 hours for 2 days following surgery. You can decide after that if you still need them or not.

Note: When taking any prescribed medication containing Acetaminophen (Tylenol), i.e.; Percocet, Hydrocodone, Vicoden or Tylenol with Codeine, you should not take additional Tylenol so as not to exceed the safety level of Acetaminophen. Please contact the office with any questions you may have. Do not drink alcohol while taking prescription pain medications. 

Swelling

Swelling may occur following your surgical procedure and will typically increase 2-3 days after the procedure. To minimize the swelling, place an ice pack over the outside cheek area for 10 minutes on and 10 minutes off. Continue using ice for 6 hours following the procedure.

Bleeding

Bite firmly on gauze for one hour. Switch the gauze every hour until bleeding stops. Seeping for a few days is normal.

A small amount of bleeding is normal. If excessive or continuous bleeding occurs:

  • Do not rinse your mouth.
  • Elevate your head when lying down.
  • Apply a moistened dark tea bag to the immediate area with moderate pressure for 1 hour; repeat if necessary.
  • Call the office if bleeding persists.

Smoking

Do not smoke for at least 2 weeks following your surgical procedure. It will significantly slow healing and can compromise results.

Numbing

Absolutely DO NOT chew solid food until the numbing wears off. You will chew your cheek and that is extremely painful.

Specific Instructions for Your Procedure

Extraction Without Bone

Extraction With Bone

Deep Scaling/Root Planing

Implant Placement

Connective Tissue Graft

Free Gingival Graft

Periodontal Surgery

Extraction without bone graft

During the first 24 hours after extraction:

  • Do not vigorously rinse your mouth
  • Do not suck on the extraction site or play with the suture with your tongue. This will result in a liver clot.

During the first 2 days after extraction:

  • Avoid any moderate-heavy exercise. Light work-outs, swimming, and walking are ok.

During the first week after extraction:

  • Eat softer foods until you feel comfortable. Avoid food with seeds.
  • DO NOT SMOKE CIGARETTES OR MARIJUANA OR VAPE or use tobacco products. This may result in infection, dry socket, increased pain, and a prolonged healing time. If you have to smoke, put gauze over the extraction site and take very short drags. Use edibles instead of smoking marijuana. If you smoke it’s very normal for part of the bone to break off. You may have sharp edges or pieces of bone that work their way out. They usually come out on their own. If sharp edges are still there in 6 weeks and bother you we can surgically smooth the area out.
  • Don’t floss where there are sutures.
  • If sutures are placed they will typically dissolve within the first week.
  • DO NOT USE A STRAW and DO NOT SPIT. This may cause a dry socket. If you get dry socket, it will be the worst pain you can imagine. Call us and we can put a special paste on the area.
  • Do NOT use a waterpik or electric toothbrush
  • Swab extraction site with Periogard/Chlorhexidine using a q-tip 3 times a day

Extraction with bone graft

During the first 24 hours after extraction:

  • Do not vigorously rinse your mouth
  • Do not suck on the extraction site or play with the suture with your tongue. This will result in a liver clot.

During the first 2 days after extraction:

  • Avoid any moderate-heavy exercise. Light work-outs, swimming, and walking are ok.

During the first 2 weeks after extraction:

  • Eat softer foods until you feel comfortable. Avoid food with seeds. Don’t eat anything crunchy or sticky such as peanut butter and nuts.
  • DO NOT SMOKE CIGARETTES OR MARIJUANA OR VAPE or use tobacco products. This may result in infection, dry socket, increased pain, and a prolonged healing time. This will significantly effect bone growth. If you have to smoke, put gauze over the extraction site and take very short drags. Use edibles instead of smoking marijuana.
  • Sutures will be placed and they do not dissolve. We will remove them in 2-3 weeks.
  • We will either use bone particulate with a barrier or bone putty.
  • If particulate is used: some pieces will come out and it will feel gritty like sand in your mouth. We always over pack the area so don’t worry if some comes out. You may see the white barrier in the extraction site, it takes a few weeks to dissolve and you may be able to see it during that timeframe.
  • Don’t floss where there are sutures.

During the first 6 weeks after extraction:

  • DO NOT USE A STRAW and DO NOT SPIT
  • Do NOT use a waterpik or electric toothbrush
  • Swab extraction site with Periogard/Chlorhexidine using a q-tip 3 times a day
  • It is helpful to mark your calendar at 6 weeks to remind yourself when you can go back to normal homecare

Deep Scaling/Root Planing

  • It is normal to have sensitivity to cold up to 4 weeks following treatment. Using a fluoride rinse or sensitivity toothpaste can help.
  • Brush and floss your teeth as normal. You will most likely have bleeding following treatment and this is very normal. Sometimes an area can gush blood when you floss. This is ok. Do NOT stop flossing. If you stop cleaning this area the inflammation will get worse and you will not get good results. Continue to clean and floss the area and it will stop bleeding over the course of a week.
  • Eat softer foods until you feel comfortable.

Implant Placement

  • Do NOT smoke tobacco, cigarettes, marijuana, or cigars EVER. Do NOT vape EVER. The heat from smoking will cause bone loss around your implant. There is a 40% FAILURE rate if you smoke. Vaping causes you to get a ton of cavities very fast. Edible marijuana is ok. A water pipe is ok once the implant has a tooth on it.

During the first 2 weeks after implant placement:

  • Do not lie on the side the implant was placed.
  • If the implant is placed on the upper jaw, do NOT sneeze or blow your nose
  • Avoid chewing anything hard on the side the implant is placed
  • Do not use an electric toothbrush. After 2 weeks brush implant regularly to keep clean
  • Sometimes we cover the implant completely or bone is placed. We will remove them 2-3 weeks after implant placement.
  • Swab the implant site 3 times a day with chlorhexidine

Contact us if you have: Excessive pain; numbness 12 hours after implant placement; pain or swelling several days after implant placement; or bleeding continues even after using tea bags

Future Implant Care

Just like natural teeth implants require yearly dental check-ups and regular cleanings. We recommend cleanings every 4 months with implants. Even if you have full dentures your implants need a professional cleaning every 3-4 months. Brush and floss your implants daily just like a natural tooth. Implants can get bone loss if plaque and tartar build up around them. This can lead to surgery and even removal in extreme cases. Not properly cleaning the implant after placement can cause the implant to fail to integrate. If your tooth was removed because of periodontal disease there is a 40% chance you will get bone loss around the implant so keeping it clean at home and getting professional cleanings is extremely important.

Connective Tissue Graft

DO NOT LOOK AT THE GRAFT. DO NOT PULL YOUR LIP OUT, DO NOT SHOW PEOPLE THE GRAFT. This can cause the graft to rip out. It will turn white and will eventually turn pink. It may look like a science experiment at first but this is normal. If a graft is going to fail it will do so within the first 48 hours and become very painful.

DO NOT SUCK ON THE GRAFT SITE OR PLAY WITH ANY SUTURES WITH YOUR TONGUE. This can cause the area to not get a proper blood clot. You may get a liver clot which is a large blood-filled bubble. Call us if this happens.

DO NOT TOUCH THE GRAFT. There are a lot of bacteria on your fingers and this can cause the graft to get infected and fail

During the first 48 hours:

  • The roof of your mouth will feel like a really bad pizza burn. Cold liquids will feel the best. Avoid hot drinks or food.*
  • A small amount of bleeding from the palate is normal. Apply pressure CONTINUOUSLY to the area with a piece of gauze or a dark, non-caffeinated tea bag for 20 minutes. Do not drink caffeine; this will cause you to start bleeding.* If the graft site is bleeding this is ok. Do not apply any pressure to the graft site. If it is bleeding then it is getting a blood supply and this is a good thing.
  • No strenuous activities or work-outs; it can cause you to start bleeding. Swimming is ok after 2 days.
  • You may get a bruise on your cheek/jaw in the area the graft is placed or under your eye where tissue was taken. Apply ice to this area for the first 6 hours after surgery at 10-minute intervals.

During the first week:

  • There is a liquid bandage placed on the roof of your mouth that will fall off after a few days. The sutures in your palate will also dissolve in a few days. If the bandage hangs down clip it with scissors, do not pull it off because it will start bleeding. If it starts bothering you we can remove it at your 1 week post-op visit.*
  • Take all medications as directed. Take antibiotics and pain medication with food and plenty of fluids to avoid nausea.

During the first 2 weeks:

  • Do NOT brush the graft area for 2 weeks. Do NOT floss the graft area until sutures are removed. After 2 weeks, ONLY use the provided soft toothbrush to gently brush the teeth. Stay away from the gums.
  • To clean the teeth place a q-tip at the base of the teeth and scrape up. Do NOT poke the graft.

During the first 6 weeks:

  • It is helpful to mark the 6 week date on your calendar so you know when to resume normal home care
  • Do NOT use a waterpik or electric toothbrush for 6 weeks. After 6 weeks you can resume normal brushing and flossing.
  • Saturate a q-tip with chlorhexidine & squeeze the q-tip to drip it onto the graft site 3 times a day. You can also use a pipette.
  • No scuba diving or snorkeling
  • Sutures dissolve very slowly over 4-6 weeks. If they are still present at 6 weeks we will remove them. Some of the sutures wrap around your teeth, these are very important. Keep your tongue away to avoid unraveling them. If they come out within 7 days (they will be about 1 inch long) call the office.
  • A liquid bandage will be placed around the graft site. It becomes hard and looks purple and then tan like tissue. It will eventually fall off. It may look like the graft has failed but it is just the bandage. The liquid bandage turns many colors and can turn the color of whatever you are eating or drinking. If you see something that looks purple, black, brown, green, or grey it is just the liquid bandage.
  • DO NOT USE A STRAW. Avoid negative pressure and suction like spitting.
  • DO NOT SMOKE CIGARETTES OR MARIJUANA. The graft will heal slowly and may never get a blood supply and it will fail. Avoid smoking for 6 weeks if possible. Use edibles instead of smoking marijuana.

These do not apply if you are using donor tissue and not tissue from your palate

Free Gingival Graft

DO NOT LOOK AT THE GRAFT. DO NOT PULL YOUR LIP OUT, DO NOT SHOW PEOPLE THE GRAFT. This can cause the graft to rip out. It will turn white and will eventually turn pink. It may look like a science experiment at first but this is normal. If a graft is going to fail it will do so within the first 48 hours and become very painful.

DO NOT SUCK ON THE GRAFT SITE OR PLAY WITH ANY SUTURES WITH YOUR TONGUE. This can cause the area to not get a proper blood clot. You may get a liver clot which is a large blood-filled bubble. Call us if this happens.

DO NOT TOUCH THE GRAFT. There are a lot of bacteria on your fingers and this can cause the graft to get infected and fail

During the first 48 hours:

  • The roof of your mouth will feel like a really bad pizza burn. Cold liquids will feel the best. Avoid hot drinks or food.
  • A small amount of bleeding from the palate is normal. Apply pressure continuously to the area with a piece of gauze or a dark, non-caffeinated tea bag for 20 minutes. Do not drink caffeine; this will cause you to start bleeding. If the graft site is bleeding this is ok. Do not apply any pressure to the graft site. If it is bleeding then it is getting a blood supply and this is a good thing.
  • No strenuous activities or work-outs; it can cause you to start bleeding. Swimming is ok after 2 days.
  • You may get a bruise on your cheek/jaw in the area the graft is placed or under your eye where tissue was taken. Apply ice to this area for the first 6 hours after surgery at 10-minute intervals.

During the first week:

  • There is a liquid bandage placed on the roof of your mouth that will fall off after a few days. The sutures in your palate will also dissolve in a few days. If the bandage hangs down clip it with scissors, don’t pull it off because it will start bleeding. If it starts bothering you we can remove it at your 1 week post-op visit.
  • Take all medications as directed. Take antibiotics and pain medication with food and plenty of fluids to avoid nausea.

During the first 2 weeks:

  • Brush the teeth above the graft gently using only the provided ultra soft toothbrush. Floss very gently at the graft site. Stay away from the gums.
  • Sutures dissolve very slowly over 4-6 weeks. We may remove them at your 2-week or 4-week post-operative appointment depending on healing. Some of the sutures wrap around your teeth. Keep your tongue away to avoid unraveling them.
  • A liquid bandage will be placed around the graft site. It becomes hard and looks purple and then tan like tissue. It will eventually fall off. It may look like the graft has failed but it is just the bandage. The liquid bandage turns many colors and can turn the color of whatever you are eating or drinking. If you see something that looks purple, black, brown, green, or grey it is just the liquid bandage.

During the first 6 weeks:

  • It is helpful to mark the 6 week date on your calendar so you know when to resume normal home care
  • Do NOT use a waterpik or electric toothbrush for 6 weeks. After 6 weeks you can resume normal brushing and flossing.
  • Saturate a q-tip with chlorhexidine & squeeze the q-tip to drip it onto the graft site 3 times a day. You can also use a pipette.
  • No scuba diving or snorkeling
  • DO NOT USE A STRAW. Avoid negative pressure and suction like spitting.
  • DO NOT SMOKE CIGARETTES OR MARIJUANA. The graft will heal slowly and may never get a blood supply and it will fail. Avoid smoking for 6 weeks if possible. Use edibles instead of smoking marijuana.

Periodontal Surgery

During the first 24 hours:

  • Do not chew solid food until anesthetic wears off. You will chew your cheek and this will be very painful.
  • A little bleeding and seepage is normal. If you have heavy bleeding bite on a damp dark tea bag for 1 hour with continuous pressure.
  • Take medications as directed. Drink plenty of fluids. Take antibiotics and narcotic pain medications with food to prevent nausea.
  • Apply ice packs on the outside of you face at 10-minute intervals for the first 6 hours to minimize swelling and bruising. Use a heat pack the day after surgery.
  • No strenuous activities or work-outs for 2 days after surgery. Light work-outs, swimming, and walking are ok.

During the first week:

  • Chew on the opposite side of the mouth. Eat soft foods until you feel comfortable. Avoid citrus and spicy foods/drinks. Avoid seeds.
  • Sutures dissolve slowly and will be removed if still present
  • Only use the provided ultra-soft toothbrush around the surgery site. Only brush the tops of the teeth and stay away from the gums.
  • Don’t floss the surgery sites until sutures are gone.
  • *If bone is placed some bone will come out and feel like sand in your mouth, this is normal

During the first 2 weeks:

  • Minimize smoking marijuana and cigarettes. The more you smoke, the slower you heal and the more pain you will have after. Use edibles instead of smoking marijuana.
  • Do not suck on the surgery site or play with the sutures with your tongue. This can result in a liver clot forming. A liver clot is a large blister on the gums that is filled with blood. Call us if this happens because we will need to drain it.
  • No straws or spitting or suction
  • *Avoid sticky and crunchy foods like steak and nuts
  • Swab the surgical site with Periogard/chlorhexidine three times a day using a q-tip
  • *Sutures that are non-dissolvable will be removed at this visit

During the first 6 weeks:*

  • Don’t use a waterpick for 6 weeks
  • Don’t use an electric toothbrush

*Only applies if bone is placed

Contact Us

Should you have any questions or concerns, please do not hesitate to contact us at [email protected]