What to Expect from Surgery

Years ago periodontal surgery was considered an ordeal. Things have changed! Today there should be no pain involved during surgery, and the postoperative discomfort is minimal. New and sophisticated medications ensure you a smooth procedure.

Postoperative discomfort has been dramatically reduced with the use of NSAIDS (non-steroid anti-inflammatant drugs). These drugs, such as Naprosyn and Motrin, stop the formation of the chemicals the body normally produces that cause heightened pain. NSAIDS are not narcotics, so you can function normally when taking them. Generally, NSAIDS are started the morning before surgery, and taken for six days. In addition to the NSAIDS, a narcotic is often recommended for the first day. It is used along with the NSAID, and will eliminate any "breakthrough" discomfort. Generally these medications are not needed more than the first day, if at all.

Some patients, especially implant and regeneration cases, are given antibiotics to take after surgery. It is important to take the prescriptions as directed, to optimize healing.

A prescription mouthwash is often prescribed after surgery, and may be used for 1-2 weeks. It is much more effective than any over-the-counter mouthwash, and kills bacteria throughout the mouth.

At 7-10 days sutures are removed. The area is cleansed, and postoperative care of the area reviewed. This appointment generally lasts 15-30 minutes, and should not cause discomfort.

With most cases it is important to keep all bacteria away from the surgical site for 8-10 weeks. We have found that careful control of plaque during the healing phase greatly enhances surgical results.

Pre Surgical Instructions

If you feel apprehensive about your surgical appointment, we offer nitrous oxide (laughing gas), presurgical sedatives (oral medication similar to Valium), or IV sedation to help you to relax. For further information, please speak with one of our staff members at least 24 hours before your appointment. If you will be taking a pre-surgical sedative or are scheduled with IV sedation, please arrange for someone to drive you to and from your appointment. <%--If you feel apprehensive about your surgical appointment, we offer nitrous oxide (laughing gas), presurgical sedatives (oral medication similar to Valium), or IV sedation to help you to relax. For further information, please speak with one of our staff members at least 24 hours before your appointment. If you will be taking a presurgical sedative or are scheduled with IV sedation, please arrange for someone to drive you to your appointment and home following your appointment--%>.

If you have received prescriptions from our office, please have them filled. You may bring them to your appointment if you would like assistance with your prescription instructions. Do not take any of the medications until after treatment unless directed otherwise.

Regular medications prescribed by your physician should be taken as usual unless you have been instructed otherwise.

Since aspirin/ibuprofen (Motrin, Advil) tends to prolong bleeding, do not take aspirin/ibuprofen containing medications for 7 days prior to your appointment unless required by your medical doctor (Please discuss with Drs. Reissner / Pomeranz / Neugeboren).

ALCOHOL AND CAFFEINE
Do not consume any alcoholic beverages for 24 hours before your appointment and do not consume any caffeine containing products the day of your appointment.

DRESS
Wear loose, comfortable clothing, avoid collared or white shirts. Women, please do not wear foundation facial make-up. Men, if you have a mustache, please trim it so that it does not extend below your upper lip.

MEALS
It is best to eat a normal, healthy breakfast at least one hour before your surgery appointment, unless you are scheduled with IV sedation.

During Your Surgery

RELAXATION
If you have taken a sedative medication, it will help you to relax, but you will remain awake. A local anesthetic (like that used for dental fillings) will be used. The area being treated will be numb so that you will be comfortable during the procedure.

COMFORT
Blankets, pillows, and music headsets are available for your comfort. You may bring in a favorite CD if you like.

SUTURES
Sutures (stitches) will be placed in the treated areas.

Post Surgical Instructions

These instructions are designed to advise you of procedures that will aid in promoting comfortable healing and inform you of situations that may possibly require special attention.

DISCOMFORT
It is not unusual to have a certain amount of discomfort for a few days following your surgery. In many instances, two Tylenol or Advil tablets taken every three hours will be sufficient to relieve discomfort. Do not take aspirin, as it prolongs bleeding. You will be given a prescription for a more potent medication to enhance a mild post-surgical recovery period. The first dose should be taken as soon as possible after the surgery, then use this medication every 6 hours as needed to control discomfort. The medication may be taken with food to prevent nausea.

SWELLING
Minor swelling may follow your surgical procedure. To minimize swelling, it is advisable to place an ice pack over the area, 20 minutes on and 20 minutes off for the first 24 hours. Start the ice pack application as soon as possible following surgery. Also hold cold water with ice chips in your mouth when the ice pack is not in place for the remainder of the day. Try not to rinse on the day of surgery, because this may disturb the blood clot. The swelling or discoloration may continue for 2 to 3 days after surgery and then subside. If after the second day swelling continues, heat may be applied to the involved area in the form of wet or dry compresses as often as is convenient.

BLEEDING
You can anticipate some seepage or slight bleeding for the first day. A small amount of bleeding is all that is necessary to discolor your saliva. This seepage is normal. If continuous bleeding occurs, it may be controlled by placing a moist fresh tea bag over the area with constant pressure for 20 minutes (repeat if necessary).

POSTURE
Keep your head in an elevated position for the first 2 days following surgery. Sleep with a few pillows behind you. Maintaining an up-right position will help reduce swelling.

DIET
Try to eat on the side of the mouth where surgery was not performed. Stay on a cold liquid diet the day of surgery (Ensure, milk shakes, instant breakfast, etc.). The day following surgery begin eating soft foods until gradually returning to your normal diet. Adequate nutrition is essential for healing. Avoid irritating foods that are spicy or acidic and carbonated beverages for at least 3 days. Foods such as popcorn, nuts, granola and small seeds should be avoided for the first month.

ORAL HYGIENE AND RINSING
The day following your surgery, carefully brush and floss your teeth in the areas where surgery has not been performed. Where you have stitches be sure not to brush or floss your teeth, but rinse your mouth with the prescription rinse that you may be given. This will keep the surgical site clean, odor-free, and reduce discomfort. We will inform you at your suture removal appointment when and how to resume brushing.

ALCOHOL AND SMOKING
Avoid alcohol for the first week following surgery. Do not drink alcohol if you are taking discomfort medication. Do not smoke for at least 4 hours following surgery. Smoking causes healing to progress more slowly.

Minimize smoking and alcoholic beverages for the entire healing time for optimal healing.

ACTIVITY
Do not engage in strenuous activity during the coming week. The use of discomfort medication will reduce your precision in judgement.

If any questions or concerns occur, please do not hesitate to contact the office at 303-695-0990. Normal office hours are Monday through Friday, from 8 a.m. until 5 p.m. After hours, our automated voice message system will answer your call and prompt you to press zero to be connected to a live operator. The live operator will then contact a doctor for you.