Post-Op Instructions

• DO NOT BRUSH GRAFTED SITE FOR 6 WEEKS
• Carry water and gauze at all times for 5 days; apply damp gauze to roof of mouth for 10 minutes if bleeding is more than a trickle
• Ice, 10 minutes on, 10 minutes off, for 48 hours
• Stiches will fall out usually in 7-14 days
• Take medication as prescribed; 600mg ibuprofen together with 500mg Tylenol every 6 hours. Caffeine helps the ibuprofen work better
• Do not use straw for the first 2 weeks

• THE GOAL IS TO PRESERVE THE BLOOD CLOT IN THE SOCKET
• DO NOT RINSE MOUTH TODAY – Avoid drinking from a straw for 2 weeks. Tomorrow you may begin rinsing gently several times a day, especially after meals, using one-quarter teaspoon of salt to a glass of warm water. Continue rinsing for several days.
• BLEEDING – Following extractions some bleeding is to be expected. If persistent bleeding occurs, place a damp gauze pad over the site and bite down firmly for 10 minutes. Repeat if necessary. A saturated black tea bag can also be used.
• SWELLING – Ice bag, chopped ice, bag of frozen peas, 10 minutes on, 10 minutes off, should be applied to area for 48 hours.
• PAIN – For mild to average pain use 600mg ibuprofen together, if necessary, with 500mg Tylenol every 6 hours.
• FOOD – Light diet is advisable during the first 24 hours.
• BONY EDGES – Small sharp bone fragments may work up through the gums during healing. These are not roots, if annoying, return to office for their simple removal.
• If any unusual symptoms occur, call the office at once.
• Proper care following oral surgical procedures will hasten recovery and prevent complications.

• 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 saltwater 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 the medications as prescribed.

• Please refrain from blowing your nose for up to four weeks following your surgery. Do not hold your nose when sneezing. Avoid flying in pressured aircraft, scuba diving, bearing down when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure for at least four weeks after surgery.
• Please take all the medications as prescribed, including decongestants as necessary.
• It is important to keep your mouth clean after surgery to reduce the risk of infection and promote rapid healing. Start saltwater rinses (one-half teaspoon of salt dissolved in an 8-ounce glass of water) the evening of surgery or the day following your procedure after each meal or four to five times daily.
• Brush your teeth gently with a soft manual toothbrush on the evening of your surgery or the first day following your procedure and continue brushing at least twice a day.
• Drink plenty of fluids. Eat soft foods for the first several days after surgery. Advance to a regular diet as you become more comfortable. Please avoid chewing or creating pressure on the bone graft site. Please avoid drinking alcoholic beverages or smoking during the first one to two weeks following your surgery.
• All removable appliances, including partial dentures, flippers and full dentures, must be checked for proper fit before they can be worn.
• Swelling and bruising may occur. Applying a cold compress to the face near the surgical site will help minimize swelling. If you use an ice pack, please do not apply ice directly to your skin but always place a cloth between the ice and your skin. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off as needed.
• If you experience severe or persistent sinus or nasal congestion, please let us know.

• Some pain, bleeding, swelling, and sleeping 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. If you experience excessive bleeding or discomfort after 48-72 hours, please call our office immediately.
• You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by our office as needed.
• Swelling around the face, eyes, and surgical site is not uncommon and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the implant site will help minimize swelling. If you use an ice pack, please do not apply ice directly to your skin but always place a cloth between the ice and your skin. 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.
• A warm saltwater rinse, approximately ½ teaspoon in an eight ounce glass of water, three times a day can be helpful.
• Avoid brushing your teeth near the surgery site but brush and floss the rest of your mouth as instructed by our office.
• For 24 hours following your surgery, do not suck on a straw, brush, rinse, spit, or smoke.
• For the first 24 hours you may experience some cold and heat sensitivity. Avoid hot and spicy foods as well as carbonated and alcoholic beverages.
• Restrict your activities on the day of your surgery. Avoid excessive work or play and resume normal activity the following day as tolerated.
• After the first day, gently rinse with a warm saltwater rinse, approximately one-half teaspoon of salt in an eight ounce glass of water, three times a day.
• During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
• Follow any other instructions provided by the office on your visit. Please take all medications as prescribed including your prescribed antibiotics to help prevent infection.
• If you have a denture that overlaps the implant site, please minimize the use of the denture following surgery to allow the site to heal. After the first week, you should be able to gradually increase the amount of time you can wear your denture.
• It is extremely important to keep your follow-up appointment(s) so that we can monitor the healing process.
• If pain and swelling are increasing after a few days, please call our office right away.

• Anti-microbial rinses and antibiotic medications may be prescribed for you. Take any prescribed medications according to directions and continue taking them until all meds are gone.
• Reduce physical activity for several hours following surgery.
• Periodontal laser procedures usually result in little or no discomfort following surgery.
• For the first 24-hour period immediately following surgery, take two (2) Advil or Motrin (Ibuprofen) every 4-6 hours even if you do not have any pain.
• For the first 24-hour period immediately following surgery, stay on a liquid diet only. For the following 3-7 days after surgery, a soft diet is recommended. Try to eat soft but nutritious foods such as eggs, yogurt, cottage cheese, malts, ice cream, etc. Stay away from spicy and “chippy” foods. It is also important to maintain good fluid intake during this period.
• Carefully avoid chewing food in the areas of the mouth where the laser has been used for at least one week following surgery. One of the most important results of laser surgery is the blood clots that form following surgery. It is extremely important not to dislodge the tiny clots that form in and around the gums.
• Do not be alarmed with any color changes or appearance of tissues following laser therapy. Tissues can be gray, yellow, red, blue, purple, “stringy” and reflect normal response to laser treatments.
• It is OK to spit, rinse, and wash your mouth today. Rinse as directed with Peridex or Periogard morning and night. In between, it is OK to rinse gently every three (3) hours with warm salt water (1/2 teaspoon of salt dissolved in an 8oz. glass of warm water). Do not brush or floss your teeth until instructed to do so (see Treatment and Home Care sequence sheet).
• Try to keep your mouth as clean as possible to help the healing process. Brush, floss, and follow other home care measures in all the areas of your mouth except for the surgery area.
• Do not apply excessive tongue or cheek pressure to the surgery area.

Do not be alarmed if one of the following occurs:

• Light bleeding
• Slight swelling
• Some soreness, tenderness, or tooth sensitivity
• Medicinal taste, from Peridex or Periogard

Please call the office at 308-237-0100 if you are experiencing any of the following signs and symptoms:

• Prolonged or severe pain
• Prolonged or excessive bleeding
• Considerably elevated or persistent temperature

Do not be alarmed that beginning within two weeks after therapy and extending as long as one year or more, the teeth may become sore, tender, or sensitive as the bone and ligaments around the teeth regenerate and become firmer. This is a sign of healing but may also indicate the presence of a bite imbalance that may need to be adjusted.

DAILY VITAMINS!

• Anything put through a food blender
• Cream of wheat, oatmeal, Malt o Meal
• Mashed banana, mashed avocado, applesauce
• Mashed potatoes or baked potatoes- okay with butter and sour cream
• Broth or creamed soups
• Mashed steamed vegetables
• Mashed yams, baked sweet potatoes, or butternut squash
• Cottage cheese, cream cheese, or soft cheeses
• Eggs any style, with or without melted cheese
• Omelets can have cheese or avocado
• Jello, pudding, ice cream, and yogurt
• Milkshakes, smoothies- okay to blend with fruit except no berries with seeds
• Ensure, Slimfast, nutritional drinks

DO NOT EAT:

• Chewing gum, candy, cookies
• Chips, crackers
• Nuts, popcorn
• Anything hard or crunchy
• Anything with hard pieces or seeds
• Raw crunchy fruits or vegetables
• Steak or meat that shreds and can lodge between teeth

After 10 days, healing is not complete. The first month following treatment, you should continue to make smart food choices. Softer foods are better. Gradually add back in your regular diet choices.