Surgical Care Instructions | Before & After Your Procedure

Instructions for Before Gum Surgery

DO limit your fluid intake for 5 hours prior to your appointment if your appointment is scheduled to exceed 2 hours.
If you are receiving oral or IV conscious sedation, those instructions supersede these instructions. Follow
Instructions for a Sedation Patient regarding restrictions on food and liquid.
DO wear loose fitting clothing. To maintain an ultra-clean environment, protocol requires that you be draped over your clothing from the neck down. Please wear something comfortable with this in mind.
DO continue taking aspirin if you are on a once-a-day aspirin regimen.
DO NOT take any additional (beyond a once-a-day regime) aspirin or aspirin-like products for 5 days prior to the surgery.
DO alert your treating surgical team if you are taking Coumadin (warfarin) or Plavix.
Patients may continue taking Coumadin (warfarin) during dental surgery if their INR blood levels are 2.5 or below.
Patients taking Plavix should specifically discuss this circumstance with their Perico doctor.

DIET

Avoid hot, crunchy, or hard foods for 1 week
Begin with soft and cold foods—yogurt, pudding, applesauce, smoothies, ice cream, protein shakes, chicken, eggs, pasta
If certain food causes pain, try softer foods
Hydrate! Water is best. No straws for 1 week
Normal diet can be resumed as tolerated after follow up appointment at 1-2 weeks

PAIN

Staying on top of the pain is key!
For the first 48 hours, we recommend alternating over the counter acetaminophen (Tylenol) 1000mg and ibuprofen 600mg every 6 hours—by staggering the medications, you will be taking something every 3 hours
Narcotic pain medication may have been prescribed to manage moderate to severe pain
The narcotic may be taken in addition to your scheduled ibuprofen and acetaminophen, as prescribed—always eat with food to avoid nausea
If the narcotic is combined with acetaminophen, you will need to reduce the use of acetaminophen accordingly
Do not work, drive, or go to school if you are taking any narcotics
If prescribed flurbiprofen, take one tab every 12 hours for pain and swelling. Continue acetaminophen in between as needed.

SWELLING

Apply ice packs to the outside of face for the first 24-48 hours in 20-minute increments
Keep head elevated
Limit physical activity for 48 hours

CONTROLLING BLEEDING

Place folded, wet gauze directly over surgical site and bite down firmly
Replace gauze every 30 minutes for 2 hours until bleeding subsides or is light pink
Do not fall asleep with gauze inside the mouth
Avoid heat for the first 24 hours as this can stimulate bleeding
If bleeding continues, biting on a wet, cold, black tea bag for 30- minutes can help constrict blood vessels
If persistent or heavy bleeding lasts longer than 8 hours and cannot be controlled, call us!
Some sutures dissolve and others will not. Sutures will be checked in 1-2 weeks and removed if needed.

ORAL HYGIENE

Resume normal brushing and flossing immediately, but avoid surgical site for 1 week
Gently rinse mouth after meals to avoid getting food trapped in sockets—Do not spit after rinsing
If instructed by your doctor, complete gentle warm salt-water rinses 3-5 times per day for the first
Mix 1 tsp of salt with 1 cup of warm water until salt is dissolved— Gently rinse
Use prescribed Peridex twice daily for 1 week to keep surgical area clean
Standing over a sink, allow salt-water to fall out of your mouth—Do not spit!

PAIN AND SWELLING

Around day 2, increased pain due to swelling and absence of local anesthetic is normal
The use of ice, pain medication schedule, rest, and elevation of the head should help manage discomfort
Applying ice packs every 20 minutes to the outside of the cheek where surgery was done, can help minimize swelling
Swelling can last up to 7 days or longer
Around day 3-4, use moist heat compresses to decrease any swelling that is still present.

CURVED SYRINGE

If provided a curved syringe, it may be used 5 days after your procedure for removal of debris that is not cleared with gentle rinsing
Irrigate surgical sites with Peridex or warm salt water until food debris has been cleared
Avoid aggressive use of the syringe as this may dislodge the blood clot
You may use the syringe until instructed otherwise by the doctor

DRY SOCKETS

3-5 days after your procedure, dry sockets can occur, here’s what to watch for:

Increased pain that progressively worsens despite medication Radiating jaw or ear pain
Foul taste or smell near the extraction site
Excessive swelling for 7 days
Avoid using straws, spitting, or smoking as these actions may cause blood clots to become dislodged
Call our office if dry socket symptoms occur