After Soft Tissue Grafting

One phase of your periodontal treatment has been partially or totally completed – the surgical procedure indicated in your case. Plastic surgery has been performed to correct the tissue defects that formed pockets around your teeth or to graft to those tissues.

Prescriptions

• Pain Medication – You have been given a prescription for pain pills (Darvocet/Propoxyphene or Vicodin/Hydrocodone). These are strong pain medications, but do on occasion make people feel tired or somewhat nauseous. Consequently, the following pain control regime has been found by our office to give our patients superior pain control, minimizing the side effects found with narcotics.
  
  Take 800 mg. of Ibuprofen (4 tablets of Advil, Motrin, or generic Ibuprofen) as soon as the numbness begins to wear off, and then another 800 mg (4 tablets of Advil, Motrin, or generic Ibuprofen) every 4–6 hours as needed for pain. If you have breakthrough pain before your next dose of Ibuprofen is due, or if the Ibuprofen alone is inadequate for pain control, you may take 1 of the stronger pain pills Darvocet/Propoxyphene or Vicodin/Hydrocodone every 4 hours, alternating with the Ibuprofen. This regime of medication should provide superior pain control, more than if you were taking the stronger narcotic medication alone. The Ibuprofen also has the added advantage of reducing inflammation and swelling much better than the narcotic pain medication, and may actually help the surgical site heal.
  
  If you have any questions regarding this pain control regime, please contact our office.
• Antibiotic (Doxycycline) – Take one tablet as soon as you get home, and then one tablet in the morning and one tablet in the evening until gone. Please be advised that antibiotics may reduce the effectiveness of some medications, such as birth control pills.
• Peridex Mouth Rinse – Rinse with ½ ounce twice daily after brushing. Please note that a light stain may develop on the teeth and tongue in patients that smoke or drink coffee. The stain can be easily polished off and should not worry you. The antibacterial effects of the mouthwash are significant and play a very important role in helping prevent postoperative infection.
• Muscle Relaxer (Flexeril/Cyclobenzaprine) – Take 1 tablet at bedtime to help control nighttime clenching or grinding. This is found to be a significant help in reducing postoperative pain.

Diet

For the next 4 – 6 hours you are to have cold liquids only (iced teas, carbonated beverages, fruit juice, lemonade, water). The cold liquids will allow proper clotting to take place and reduce some amount of discomfort. Do not use a straw; allow the cold liquids to pass over the surgical area. Drink plenty of liquids, at least 2 8-ounce glasses for every pain pill.

After the first 6 hours you may have something to eat, either warm or cold. Start with mushy foods: soup, yogurt, and scrambled eggs, for example. You should then gradually go to a soft diet for the rest of the week. A soft diet is anything you can cut with a fork (ground meat dishes, casseroles, cooked vegetables, chicken, fish, macaroni, etc). As a rule of thumb, if it hurts, don’t eat it. The only foods to avoid are popcorn, nuts, and foods with seeds or berries in them.

Swelling

It is natural to expect some swelling after surgery. To keep swelling to a minimum, apply an ice pack to the outside of your face for 15 minutes on and then 15 minutes off for the next 24 hours (except while sleeping). Do not be alarmed if you wake up more swollen than you were when you went to bed. Resume the ice pack in the morning. Sleep with your head elevated on 2 pillows. Keeping the head slightly elevated helps minimize swelling.

After 2 days you may begin to use moist warm packs on your face several times a day for up to 20 minutes at a time. This may not necessarily reduce any more swelling, but it will help if you are experiencing some soreness in your jaw.

Bleeding

It is natural to have some blood mixed with your saliva for the first two or three days afer surgery. It will not hurt you to swallow it, as it is mostly saliva. However, a bleeding problem would be considered if your mouth were to fill rapidly with blood in just a few minutes. Should this occur, do not rinse to stop the bleeding. Take a wet tea bag and place it over the bleeding area and press firmly for twenty minutes. If the bleeding will not stop, call the office.

Hygiene

In the first 24 hours you are not to rinse or spit as this may disrupt the blood clot and cause further bleeding. After 24 hours, begin rinsing with ½ oz of Peridex in the morning and evening. Do not brush the graft site, as this might cause it to slough or die. It is not unusual for the healing graft to turn white or gray, so don’t be alarmed.

A light pink rubber dressing has been placed over the roof of your mouth to protect the donor site. If after 3 or 4 days it becomes uncomfortable, you may gently remove it or call the office and we will remove it for you. If the retainer is loose, denture adhesive such as Fixodent or Polygrip can be purchased at the drug store to help keep it in place.

Fever

You may experience a slight feeling of weakness or chills during the first 24 hours. It is also possible to run a low-grade fever. If this persists for more than 24 hours, please call the office. Get plenty of rest this week and do not over exert yourself.

Please feel free to call at any time to have even the smallest question answered.

If you need to get in touch with the doctor, please call the office at 815-227-5858. After hours the phone is answered by an answering service that can page the doctor 24 hours a day.