To maximize the chances for a successful graft, we recommend you do not manipulate your mouth. Minimize your talking and do not pull your lips or cheeks to observe the surgical area. This can dislodge the tissue graft and cut off the blood supply. It is advisable to avoid the donor site, usually the palate, with your tongue or hard foods. This can loosen the scab and thus stimulate bleeding. The key is to keep your mouth at rest as much as possible.
Rest: Lying quietly with your head elevated is recommended for the remainder of the day. Please limit your physical activity for at least 72 hours. Always get up slowly from a reclined position. Treat yourself as if you have a cold or flu. We want your resistance to be as high as possible to encourage rapid healing.
Medication: If necessary, Dr. Manji or Dr. Faucher will have prescribed medication to be taken for relief of discomfort. The instructions for taking this medication will be on the bottle. Please follow them carefully. If you do not have any contraindications for the use of NSAID medications, it is strongly recommended that you take Advil/Motrin/Ibuprofen for the first 48 hours even if you are not experiencing any discomfort to minimize swelling. You can alternate between Advil and Tylenol every 3 hours. These med’s can be taken for the first week if required.
Sutures: The stitches may be a combination of resorbable and non-resorbable. Do not tug or pull on them; the periodontist will remove them when optimal healing is achieved.
Periodontal Pack/Putty: Often, a surgical dressing is applied over the sutures on the cheek side to protect the area for your comfort. Small particles of the dressing may chip off, but this is of no concern unless it causes discomfort. If the periodontal dressing should become loose apply slight pressure to place back or remove it completely if it does not stay in place. The pack may remain in place anywhere from a few hours post-surgery, up to 2 weeks afterwards. Is of no concern if the dressing comes away at any time.
Palatal Stent: If you had impressions taken before surgery to fabricate a palatal guard/stent, leave it in place for the first 24 hours. After the 1st day, it is most often used during eating and sleeping but can be worn all day. If worn all day, it should be removed for rinsing and cleaned at least twice daily. The donor site on the roof of the mouth is generally dressed with a special tissue adhesive which forms a rough “scab” for the first 4-5 days.
Bleeding: Some slight seepage of blood is expected for the first 24-48 hours. Apply pressure to the stent/retainer or with 1-2 pieces of wet gauze, with constant pressure for 15-20 minutes if this occurs. Extensive bleeding should not occur, but in an emergency apply pressure with a moistened tea bag for 1 hour to the bleeding area. If you have any concerns, please call our office.
Swelling: Some swelling often occurs and this is normal. You can minimize the swelling (and consequently the pain) by placing an ice pack on the outside of your face in the area of the surgical procedure. Hold the ice pack on for 20 mins, then off for 20 mins, for the first day. Do not use heat on your face for the first 24 hours and avoid hot drinks or hot foods. After 48 hours you can begin to alternate the use of heat and ice every 15 minutes to further decrease swelling if necessary. If excessive swelling or pain occurs, please call us.
Rinse: If you were given a prescription for Peridex, you may start using the antimicrobial mouth rinse the day after surgery. You should rinse with it two times per day, after breakfast and before bed. Additional saltwater rinses after each meal can be done in between the Peridex. 1TBS salt & ¾ glass of warm water. You should only gently move the liquid in your mouth, no vigorous swishing. If your pharmacy cannot provide Peridex, rinse with a hydrogen peroxide 3% diluted 1:3 with water. Ex: 1/3 cup hydrogen peroxide + 2/3 cup water. Rinse 2-3 times day for 1 minute & spit out.
Oral Hygiene: Meticulous oral hygiene should be continued in all other areas of your mouth, but do not brush or floss the surgical area or the adjacent teeth. Gentle rinsing after meals and before bed will be sufficient in the surgical area. Use Vaseline at the corners of your mouth to prevent drying and cracking.
Nutrition: It is very important to maintain an adequate diet after surgery. Drink at least eight glasses of fluids per day. You can chew on the opposite side of the mouth. Eat foods that supply nourishment with little (if any) chewing necessary for swallowing (broths, soups, mashed potatoes, eggs, puddings, smoothies, milkshakes, etc.) for the first few days, and slowly work up to more firm foods. Avoid anything too hot, spicy, sharp, hard, or crunchy. Avoid the use of straws. Food supplements (Ensure, Boost) are recommended if you have difficulty obtaining an adequate diet.
Smoking: You must avoid smoking/nicotine for a minimum of 10 days after your surgery Failure to adhere to this can result in delayed healing and increased risk of infection.
Alcohol: It is very important that you avoid alcohol as it can mix with the medications you are taking. Alcohol can also act as an irritant and delay healing or increase bleeding.
Infections: Post-operative infections are rare but can occur. If you notice a lot of pain or a hard mass of swelling that is gradually getting worse, bad, or foul taste and/or fever please call the office (day or night).
Second Week Following Surgery
Activities: Resume normal activities, unless otherwise instructed.
Swelling: if you still have swelling or bruising you can use a warm compress 15 mins on, and off.
Recipient Site: The graft will appear white in colour the second or third day and will remain that way for several days. It may have a flap or pouch-like appearance which is normal.
Oral Hygiene: Keep up gently brushing and flossing all areas of where surgery has not been performed. A Q-tip dipped in the mouth rinse can be used to gently clean the adjacent teeth. Do not touch the surgical site for the first two weeks, as you can dislodge the healing tissue.
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