PERIODONTAL DISEASE

 


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What to Expect with Periodontal Surgery

Dr. Caplanis has perfected his techniques to the point where periodontal surgery is generally a painless procedure. Local anesthetic is administered to completely “numb” the area to be treated. Flap surgery for a single quadrant in the mouth is quick and usually only takes about 45min to complete. Patients can watch TV or listen to music from personal headphones during the procedure. All procedures can also be performed under a Twilight sleep for maximum comfort if desired.

What to expect during the post operative phase

Bleeding

Bleeding is well controlled prior to your discharge. However, some amount of bleeding is perfectly normal. If gauze was placed in your mouth keep it in for approximately 1-2 hours. You may replace this gauze as needed with new gauze given to you. Apply pressure with gauze manually or by biting with gauze over the surgical site if bleeding continues. If you run out of gauze you may use a wet tea bag or purchase gauze from any pharmacy. Refrain from vigorous rinsing and spitting for the first 24 hours to prevent blood clot destabilization.

Swelling

Immediately following surgery, apply cold packs to the face adjacent to the affected surgical areas for the first 24-48 hours to reduce swelling. Cold packs are to be applied intermittently 20 minutes on, 20 minutes off. Simply place crushed ice within a heavy-duty sandwich bag and apply as directed. Starting on the third post-operative day, heat packs may be used in the same manner as above to reduce swelling. Mild swelling is normal.

Discomfort

Minor amounts of discomfort can be expected from all oral surgical procedures. Take the first dose of pain medication prior to the local anesthesia wearing off. Continue taking the prescribed pain medications as directed. Do not allow the pain to catch up with you. Take the medications on schedule to help control as well as prevent the pain.

Medications

It is imperative that you take all medications as prescribed. Antibiotics are prescribed to prevent infection and must be taken as directed to be effective. Anti-inflammatory and pain medications are prescribed to prevent and reduce swelling as well as pain.

Numbness

Long acting local anesthetics are commonly used. Therefore, you may expect numbness of the gum tissues, lips and tongue for as long as 6-8 hours. Great care must be exercised to prevent biting or maceration of the lips and tongue.

Bruising

Minor amounts of bruising around the cheeks, lips, neck and face can sometimes occur.

Sutures

Stitches are used to close the gums back together. Both dissolvable and non-dissolvable stitches are commonly used. Dissolvable stitches will begin to untie in 1 to 2 weeks. Non-dissolvable stitches will be removed at the first or second post-operative visit

Diet

Following surgery, a SOFT diet must be maintained for at least 2 weeks in order to minimize trauma to the surgical sites which can effect healing. In some situations, a longer period of time is required. The doctor will discuss this with you if you require a longer soft diet period or if a liquid diet is required. Try to chew on sides not affected by surgery when possible.

It is very important that you eat well balanced, nutritional meals. This is not a proper time to diet or restrict caloric intake. Following surgery a soft diet is strongly recommended. This includes, Soups, Broth, Creams, Cereals, Oatmeal, Cream of Wheat, Applesauce, Rice, Overcooked Pasta, Mashed Potatoes , Scrambled Eggs, Baby Food, Blenderized Foods, Fruit and Vegetable Juices, Milk Shakes, Puddings, Yogurt, Ice cream/Sherbets. 2000-4000 calories per day is recommended following surgery. To supplement caloric intake try the nutritional drinks (i.e. Ensure, Sustical), available at most supermarkets. Avoid spicy or highly seasoned foods. They can irritate tissues. Increase consumption of liquids.

Hygiene

A special mouth rinse, Peridex (chlorhexidine gluconate) may be given or prescribed to you. Rinse with this solution two to three times per day for one minute at a time. Toothpaste interferes with Peridex. Therefore, rinse with the Peridex one-hour before or after toothpaste use, or discontinue toothpaste use with toothbrushing. Peridex is an antibacterial agent and will help keep the healing surgical areas clean. DO NOT BE ALARMED if Peridex causes tooth staining or changes taste perception. The STAIN IS REMOVABLE and taste sensation will return when Peridex is discontinued. In addition to the Peridex rinsing, (or if Peridex was not prescribed) continue brushing as usual in all other areas (excluding the surgical sites), using a medium or soft bristle toothbrush, and exercise great care to prevent trauma from your toothbrush to the surgical sites.

Surgical Dressings

Following certain surgical procedures, a periodontal dressing may be used to cover and protect the surgical site. If a dressing was placed in your mouth, try not to disturb it with hard foods or by brushing.

Activity

Avoid driving a motor vehicle or operating machinery when taking pain medications. Limit moderate and high physical activity for two weeks following surgery. This includes jogging or running, aerobics, and heavy housework. Walking and light housework is permitted as tolerated.

Alcohol and Tobacco

Refrain from alcohol consumption for 24 hours following surgery and 48 hours if IV anesthetics were used. Smoking severely compromises tissue healing. Refrain from smoking for at least 2 weeks following surgery. Be aware that smoking dramatically slows down the healing process following surgical procedures.