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. Periodontal 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
It is normal to expect some minor bleeding, even though it will be sufficiently controlled during the procedure. Any provided gauze should be kept in your mouth for about 1-2 hours, but you can replace it as needed. If bleeding continues, you can manually apply pressure or gently bite down on the gauze over the site; a wet teabag can also be used if you run out of gauze. It is also important to avoid intense rinsing and spitting for at least the first 24 hours in order to aid blood clot stabilization.
Directly after your surgery and for 24-48 hours, swelling can be reduced by the application of a cold pack to your face on the part of your mouth closest to the surgical area. The best method for cold pack application is to use them intermittently every 15 minutes. All you need to do is fill a heavy duty baggie with crushed ice and apply as directed. Once you’ve reached the third day after the operation, you can begin using a heat pack for similar reduced swelling purposes; it is normal for some mild swelling to remain.
Some level of discomfort is to be expected from any oral surgical procedure. To stay ahead of the discomfort, you should take the first dose of pain medication before the local anesthesia wears off. From there, you can use the prescribed medication as directed by the doctor. By following the doctor’s directions, you can control pain and discomfort at the same time as preventing it in the days that follow.
The doctor will often prescribe antibiotics in order to prevent infection, so it is critical that you take the medications precisely as the doctor prescribed them. Additionally, the anti-inflammatory and pain medications are useful for reducing swelling and discomfort; staying on top of your medications is a simple way to make sure your recovery goes as smoothly as possible.
Doctors typically use long-acting local anesthetics during your surgery. As a result, it is normal to experience numbness in the gums, lips, and tongue for up to 6-8 hours. During that time, it is important to mindful of your teeth: biting your lips and tongue while they are numb should be avoided.
It is normal to experience minor bruising to the cheeks, lips, neck and face.
Stitches are used to close the gums back together. Doctors may use either dissolvable or non-dissolvable stitches, depending on your particular case. The dissolvable variety will begin to disintegrate in 1 to 2 weeks while the doctor will remove the non-dissolvable type at the first or second post-operative visit.
After your surgery, you will have to maintain a SOFT diet for at least 2 weeks. A diet of soft foods will serve to minimize trauma to the surgical sites, and this can have a positive effect on healing. Sometimes an even longer period of time is necessary, and the doctor will inform you if the period needs to be longer 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.
Peridex (chlorhexidine gluconate) is a special mouthwash that your doctor may prescribe; use the solution two or three times per day for one minute at a time. Since toothpaste can interfere with Peridex, you should use one hour before or after brushing your teeth. As an antibacterial agent, Peridex can keep the healing surgical areas clean, but don’t be alarmed if it stains your teeth or alters your taste perception: the stains are removable, and your tastes will return to normal after you stop using the solution. Continue to brush all areas of your teeth except for the surgical area with a medium or soft-bristled toothbrush; just take care when brushing near the surgical site so as to prevent further trauma.
In some cases, a surgical dressing may be utilized to cover the surgical site and prevent accidental trauma. Be mindful of the dressing and avoid hard foods or brushing the teeth in that area.
While taking pain medications, it is important to avoid driving a car or operating any kind of heavy machinery. Additionally, you should limit yourself to only light physical activity for at least two weeks after your surgery. This includes strenuous exercise and involved housework; walking and mild housework are both acceptable.
Alcohol and Tobacco
For 24 hours after surgery (48 hours if an IV anesthetic was used), do not drink any alcohol. Also, you shouldn’t smoke for at least two full weeks; smoking can have a powerfully negative effect on the healing process after surgery.