Instructions Following Gum Grafting

 CARE OF THE MOUTH 

Brushing and Flossing. Begin brushing and flossing the areas not operated on the day following surgery. AVOID THE SURGICAL SITES until given specific brushing instructions at your postoperative visit. You may notice a white film over the surgical sites. This is completely normal. 

Mouthwash. Use the prescribed mouthwash twice daily beginning the morning after surgery until instructed to discontinue. 

Electron Toothbrushes. DO NOT use an electric toothbrush such as Sonicare or Oral-B Braun for 6 weeks following surgery. 

Water Pik. DO NOT use a Water Pik for at least 6 weeks following surgery. 

EATING 

First 24 Hours. Adequate nutrition is essential for normal healing. Following surgery, your diet should be restricted to COLD LIQUIDS. Dietary supplements such as Instant Breakfast or Ensure are good choices. AVOID PEROXIDE, ALCOHOL, CARBONATED BEVERAGES, AND DRINKING THROUGH A STRAW. 

After 24 Hours. Gradually progress to soft foods such as cooked vegetables, baked fish, tuna, pasta and meatloaf, which are easily chewed and swallowed. DO NOT SKIP MEALS. If you take nourishment regularly, you will feel better, gain strength, have less discomfort, and heal faster. 

ACTIVITIES 

Rest. Plan to rest at home the remainder of the day of surgery and the following day. You may read, watch TV or work at your desk at home. When sleeping, elevate your head to decrease swelling. 

After 24 Hours. You may return to normal daily routine, but avoid strenuous activities such as heavy lifting, or exercise programs which elevate your heart rate for one week following surgery. 

MEDICATIONS 

Pain Medications. Take pain medications within one hour after treatment with mild, fruit juice, or a full glass of water. Never take pain medications on an empty stomach. This medication may be repeated every three to four hours as needed for discomfort. DO NOT USE ASPIRIN or products containing aspirin for one week following surgery. Aspirin, Advil, and Aleve can contribute to bleeding problems. Only the non-aspirin pain reliever, Tylenol is acceptable. 

Antibiotics. Take prescribed antibiotics as directed until all have been taken. You will begin this medication the day prior to surgery. 

SWELLING 

Ice Packs. Some swelling occurs after periodontal surgery. To minimize this, you will be advised to use ice packs. Place the ice pack on the outside of your face, over the treated area, for 10 minutes, and then take it off for 10 minutes. Continue to apply ice packs as much as possible the first 24 hours after surgery. 

BLEEDING 

Slight bleeding or oozing is normal during the first one- or two-days following surgery. If excessive bleeding occurs, please call our office. 

SMOKING 

DO NOT SMOKE for three weeks after surgery. Smoking is detrimental to healing tissues and will affect the results of surgery. If you can stop smoking for three weeks postoperatively, you may as well quit all together. 

SUTURES 

Resorbable. The resorbable sutures used usually will be resorbed by the time you return for your post-operative visit. 

Non-Resorbable. If non-resorbable sutures were placed, they will be removed at your post-operative visit. 

It is our sincere desire that you are as comfortable as possible following surgery. If you should have any questions or problems, please call our office anytime. 

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• For the first 24 hours you may experience some cold and heat sensitivity.
• Do not consume hot foods or beverages until the anesthesia and numbness have worn off.
• Avoid vigorous physical exercise as well as extremely hot or spicy foods for the first 24 hours.
• Do not consume alcoholic beverages or smoke for at least 48 hours following treatment.
• Some bleeding following a deep cleaning is normal, but if you experience excessive bleeding, please call our office.
• You can take ibuprofen or acetaminophen as needed according to the instructions on the label or those provided by your doctor.
• A warm salt water rinse, approximately one teaspoon in an eight-ounce glass of water, three times a day can be helpful.
• Brush and floss gently following a deep cleaning, resuming normal brushing and flossing when the soreness is gone.
• Follow any other instructions provided by our office during your visit.
• Please take all medications as prescribed.

 1. Some BLEEDING after surgery is normal. If the bleeding is excessive, place gauze or a moistened (not soaked) tea bag over the surgical area and “pinch” the gum line. Apply CONSTANT FIRM PRESSURE for 15 to 30 minutes. After this time has elapsed, if the bleeding continues, repeat the procedure. If bleeding does not cease, call the office or if it is after office hours, please call the emergency number. 

2. To minimize swelling apply ICE to the outside of the face adjacent to the surgical site for the first 24 hours after surgery. Use firm pressure for intervals of 10 minutes on and 10 minutes off. The ice is removed periodically to prevent frostbite from occurring. 

3. If SWELLING occurs, it will usually start the day after surgery. This is a normal and common occurrence, and it may be accompanied by bruising. Do not be alarmed if swelling occurs. After the first day, keep repeating the icing protocol. If the swelling seems excessive, do not hesitate to call 516-799-2222. 

4. After the first night, you should rinse your mouth regularly with salt water (1 cup of warm water to 1 teaspoon salt) or peroxide and water (50:50). This will help healing and promote better breath. It will also make your mouth feel better. If you have high blood pressure, use the peroxide mixture. 

5. Soft foods are generally advisable following surgery and for the first few days. Fluids, soups, yogurt, soft cheeses and foods mixed in a blender are all good choices. It is important that you are nourished adequately to promote healing. Return to a normal diet as quickly as possible. 

6. If your lips become dry or chapped or if cracks develop at the corners of your mouth, use Vaseline often to soften your lips, especially at bedtime. 

7. Start to brush the surgical site after about 5 days. You can soften the bristles of the brush by running them under hot tap water. Be gentle at first and gradually increase the pressure on the bristles, as you feel more comfortable. You can try to floss after about 5 days also. 

8. Be certain to take the prescribed antibiotic at the recommended dosage and to return to the office for all scheduled post-operative visits. These will usually be weekly for the first few weeks and monthly until the second stage surgery. 

9. Smoking has been shown to delay healing in the mouth and should be completely eliminated for at least the first week or two following the surgery. Smoking after surgery is one possible cause for early implant failure. 

In the case of an emergency you may contact Dr. Kaur at 914-980-2682 or Dr. Gewant at 516-376-5442, please leave a message including your name and phone number, and we will call you back. 

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• Some pain, bleeding, swelling, and seeping is normal following oral surgery. Please do not try to view the site by pulling on your lip and do not probe the area with your tongue or fingers.
• Avoid forcefully rinsing or spitting or drinking through a straw. Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding. Some bleeding is normal for the first 24 hours. If bleeding continues please call our office.
• Please take all medications, including mouth rinses, as prescribed.
• After 24 hours, warm salt water rinses (one-half teaspoon of salt in a cup of warm water) can be used 4-5 times a day after meals.
• After 24 hours, brush your teeth with a soft manual toothbrush. Be gentle with brushing the surgical areas.
• Sutures may be placed after the surgery, and most sutures dissolve on their own.
• Swelling and bruising may occur. Applying a cold compress to the face near the surgical site will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off as needed. After 36 hours the cold compress will have no further impact on swelling. After this period, the application of moist heat to the sides of the face can help reduce swelling. Alternate the warm pack on and off in 15-minute intervals as needed.
• Drink plenty of fluids. Stay away from spicy or acidic foods. Also avoid sharp and crunchy foods like tacos, chips, and nuts. Tobacco and alcohol should not be used. Alcohol should not be used in combination with pain medications nor antibiotics.
• Keep physical activities to a minimum immediately following surgery.

 Avoid doing the following: 

1. Chewing on the side of the mouth that has undergone treatment.
2. Brushing the treated area.
3. Applying tongue or cheek pressure to the surgically treated area.
4. Eating spicy foods or acidic citrus drinks.
5. Drinking excessively hot liquids the first day after surgery.
6. Drinking alcoholic beverages, especially if taking antibiotics.
7. Spitting to clear the mouth, drinking with a straw or smoking—do not do anything thatcreates a pressure in the mouth as this will cause bleeding to occur.

After Sinus Surgery: 

• It is not uncommon to have some slight bleeding from the nose/nostril on the same side that was treated.
• Avoid blowing the nose too aggressively for the first 2 weeks after surgery.
• Sneeze with your mouth open during the first 2 weeks after surgery.
• If you suffer from common nasal congestion, you can use an over-the-counter nasalspray/decongestant as long as it is not contraindicated due to other health reasons (e.g.high blood pressure, etc.) 

It is not uncommon to observe some of the following after having had surgery: 

• Slight bleeding
• Moderate swelling
• Moderate discomfort
• Black, tan or purple threads may be visible.
• Tooth tenderness, sensitivity to cold/hot or slight tooth mobility/looseness
• If used, the pack (or a piece of it) may fall off or come loose

What you should do following surgery: 

1. Take prescribed medications as directed. (If a rinse is prescribed, begin using it on the dayafter the surgery was performed.)
2. If bleeding occurs, determine the exact site of origin and then place pressure on that areawith damp gauze or a tea bag for 15-20 minutes. Oozing of blood will be greatly exaggerated when mixed with saliva.
3. Minimize swelling by placing an ice pack on the outside of the face for 10-15 minutes thenremoving it for 10-15 minutes. This should be repeated for several hours beginning immediately after the surgery.
4. Continue home care procedures for the rest of the mouth (e.g. brushing, flossing, etc).
5. Call the office if any of the following occurs:

• • Excessive bleeding
  • Pain is not controlled by the prescribed medications
  • Fever occurs

CALL THE OFFICE IF YOU HAVE ANY QUESTIONS OR CONCERNS! In the unlikely event of an emergency after normal hours of practice, call the emergency Dr Kaur’s cell at 914-980-2682.

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1. Apply ICE to the outside of the face where the tooth was extracted. Use firm pressure for intervals of 10 minutes on and 10 minutes off. Do this for the first 24 hours only. 

2. If swelling occurs the next day, keep repeating the icing protocol. This should be continued until all swelling and bruising resolves. 

3. DO NOT RINSE OR DRINK THROUGH A STRAW for the first day following surgery. Do not eat anything on side of the extraction for at least the first several days and ideally for the first week. All of these things will cause bleeding, discomfort, and they will delay healing. 

4. You may eat following extractions after the novocaine has worn off. Please be sure to chew on the other side and avoid foods that are too cold, hot or spicy. 

5. After the first day frequent warm water rinses with either a teaspoon of salt or 2 ounces of peroxide will help aid healing. If you have high blood pressure, use the peroxide. 

6. Start to brush the surgical site after 7 days. You can soften the bristles of the brush by running them under hot tap water. Be gentle at first and gradually increase the pressure on the bristles, as you feel more comfortable. You may also floss after 5 days. 

7. If you experience BLEEDING, bite on a piece of rolled gauze to apply pressure to the surgical site. If there are no opposing teeth, apply pressure with your fingers by pinching the gum line at the surgical site. Constant firm pressure should be applied to the area which is bleeding for 15 to 30 minutes. If bleeding continues, repeat the process using a moistened (not soaked) teabag. If bleeding does not cease, call the office. 

****In the case of an emergency you may contact Dr. Kaur at (914) 980-2682 or Dr. Gewant (516) 376-5442 

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