Soft Tissue Graft

The following information applies when you have had soft tissue grafting.  In some cases, there are multiple surgical sites to care for.  Healing of the sites does not begin for 24 hours.  The natural response to “injury” is swelling.  The body always responds to an injury with a predictable inflammatory response as the first step towards healing. Our Post-Op instructions are designed to set up an environment of minimal swelling.  Your grafting procedure was performed using a minimally invasive pouch procedure.  Because it is a “closed” site, it is more subject to post-operative swelling.  It is very important that the post-operative instructions are followed.

Care of the Mouth

Brushing and Flossing

You may begin brushing and flossing the areas not operated on the day following surgery.  AVOID THE SURGICAL SITES until given specific brushing instructions at your post-operative visit.  You may notice a white film over the surgical sites.  This is completely normal.  DO NOT use an electric toothbrush such as Sonicare or Oral-B Braun for 8 weeks following your surgery. DO NOT use a Water Pik for at least 8 weeks following surgery.

Anti-Oxidant Gel

At your surgical visit, you will receive AO ProVantage Gel.  It is a dental antioxidant that is very soothing and promotes healing.  Apply two pumps to the surgical site every three hours during the waking hours the first week after surgery, then three times a day until your first post-operative appointment. Avoid eating or drinking for 30 minutes after application of the gel.

Eating

Adequate nutrition is essential for normal healing.  For the first 24 hours, your diet should be restricted to cold liquids.  Yogurt, smoothies, milkshakes, and dietary supplements such as Instant Breakfast or Ensure are good choices.  AVOID PEROXIDE, ALCOHOL, CARBONATED BEVERAGES, AND DRINKING THROUGH A STRAW.  After 24 hours, you may have soft foods such as cooked vegetables, fish, pasta, and meatloaf, which are easily chewed.  You should use utensils and avoid chewing at the surgical site for two weeks.  DO NOT SKIP MEALS.  If you take nourishment regularly, you will feel better, gain strength, have less discomfort, and heal faster

Activities

Plan to rest at home the remainder of the day of surgery and the following day.  When sleeping, elevate your head to decrease swelling.  After 24 hours, you may return to your normal daily routine, but avoid strenuous activities such as heavy lifting or exercise programs which elevate your heart rate for one week following surgery.

Pain

Take pain medication within one hour after treatment with milk, fruit juice, or a full glass of water.  Never take pain medication on an empty stomach.  For mild pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 4-6 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 6 hours as needed for pain.  For moderate pain, 1-2 Tylenol and 3 Ibuprofen (Advil or Motrin) may be taken together every 6 hours. For severe pain, the prescribed medication should be taken as directed (if taking prescribed medication, discontinue taking Tylenol, or any other Acetaminophin product). Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.  If you experience an adverse reaction to any of the pain medication, discontinue use and contact our office.

Antibiotics

Take prescribed antibiotics as directed until all have been taken.  You will begin this medication the day prior to surgery.

Swelling

Swelling is the body’s normal reaction to surgery and eventual repair.  Your swelling may increase until 3 day post-operatively.  This is totally normal.  If you experience an increase in swelling beyond the third day or an increase in discomfort, call our office.  Apply ice packs to the outside of your face, over the treated area, for ten minutes, and then take it off for ten minutes.  Continue to alternate 10 on, 10 off as much as possible during the first 24 hours after surgery, during waking hours. 

Bleeding

Because your graft was placed in a pouch, there will be minimal visible bleeding that will show in your mouth.  Sometimes any bleeding in your mouth that mixes with saliva can look like more than it is.  If excessive bleeding occurs, please call our office.    

Smoking

DO NOT SMOKE for three weeks after surgery.  Smoking is detrimental to healing tissues and will affect the results of surgery.  If you can stop smoking for three weeks postoperatively, you may as well quit all together. 

Sutures

We use two different kinds of sutures for this grafting procedure.  Some sutures will dissolve within 5-7 days, but the majority are non-resorbable and will need to be removed.  This type of suture is very clean and actually repels bacteria.  They will be removed at the two month post-op visit.  There will be very little sensation associated with suture removal and requires no anesthesia.