POST OP - PERIO/IMPLANTS

PERIODONTAL AND IMPLANT SURGERY

POST-OPERATIVE INSTRUCTIONS
REST: Limiting your physical activity is recommended for a day or two after surgery. When you lie down,
keep your head slightly elevated in the first 24 hours (an extra pillow or a thick book under the head of
your mattress). An old towel over your pillow the first night is recommended. Ideally, you should refrain
from vigorous work-outs for 2-3 days following surgery.

PAIN RELIEF: 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 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 24hou_r period. Pain levels vary a lot; do not worry if your pain peaks after 3-4 days, this is common.

If Sinus Involvement: Please use a decongestant as directed by your dentist. Minimize negative
sinus pressure (minimal nose blowing, drinking through a straw) for 7 days. A nosebleed can occur after
sinus lifting. Please avoid nasal saline rinses.

ANTIBIOTICS: Are prescribed for some surgeries. 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
@ 604-689-7551. If you experience difficulty 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 in order to maintain a healthy gastrointestinal flora while taking
antibiotics. Ideally, a probiotic should be taken in between antibiotic does, and not at the same time as
the antibiotic. Recommendations: Florjen3 (please feel free to consult with your pharmacist or health
food nutritionist for suitable alternatives).

ORAL HYGIENE: You must 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. 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.

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

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

PERIODONTAL PACK: 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 no influence healing and it is not harmful if ingested. Usually lasts 5-7
days. 

SWELLING/BRUISING: is very 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. Ice packs can help again.

BLEEDING: 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 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.
Sinus grafting surgery patients may experience a post-surgical nose bleed within 2 days following
surgery. Pinching the nostrils, tilting the head back will bring this under control.

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

ALCOHOL: 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.

NUTRITION: 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.

PROBLEMS: 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, the answering machine will list
emergency phone numbers.

ORAL/IV SEDATION:
If you have been under oral/iv sedation 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.

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