Postoperative Instructions Following Gum Grafting

The instructions below are meant to guide you though the next few days after the surgical procedure. They cover the most common issues and experiences that arise.

Pain/discomfort

• Right now you are frozen. But when the numbness wears off, the area of the surgery will feel sore. Everyone is different – some people feel only minor discomfort, while other people feel serious pain for a few days. Most people are somewhere in between. If you are given pain medications – take them to make yourself comfortable. You can also take over-the-counter medications such as Advil or Tylenol. It is always best to take pain medications before the pain actually starts. We find that a common reason for discomfort is insufficient or incorrect intake of the prescribed pain medications.

Bleeding/bruising

• Bleeding is to be expected after a surgical procedure. Everyone is different – some people stop bleeding right away, while others continue bleeding for a longer period of time. You may notice some bleeding tonight and even tomorrow. Until the bleeding stops it is very important that you don’t rinse and don’t spit. You can drink water, but you can’t swoosh it in your mouth.

• The blood (and saliva) in the mouth should be swallowed. Again, do not spit or rinse.

• Bleeding may resume at a later time. If you notice some blood in your mouth at a later time, that may be because you accidentally disturbed the wound. This should not concern you. Small bleeding will stop on its own within an hour.

• Bruising is uncommon, but may occur. If bruising occurs, it may appear anywhere on the face – under the eye, near the nose, in the cheek, or on the neck. Bruising on the face is unsightly, but is perfectly normal and should give no grounds for concern. If a bruise appears, it will go away like any other bruise in 1 to 2 weeks.

• Due to the presence of large blood vessels on your palate, rarely you may experience a rapid significant arterial bleed from the mouth. For example, in a matter of minutes, your mouth may fill with blood or your clothes may be covered in blood. This is very rare, but you are made aware of this possibility so as to be prepared. This is what you do:

1. First, don’t panic

2. Take a single sheet of napkin/Kleenex and fold it to a small area 2 x 2 cm.

3. With the thumb of the hand feel the area of the palate where the surgery took place – you will be able to feel it, because the area will have stitches or will feel rough (and sore). The bleeding is coming from the back most area of the wound.

4. Apply prolonged firm pressure with your thumb (or with a small napkin under your thumb) for at least 30 minutes. You will need to apply pressure as long as it takes to stop the bleeding. Typically, 30-60 minutes of direct pressure is sufficient to stop any bleeding. Once the bleeding has stopped, try not to disturb the area.

5. Call me (647-669-3671).

6. If you are unable to reach me (or anyone at our office) and the bleeding does not appear to subside, you should go to the nearest hospital.

Brushing

• Tonight, do not brush your teeth.

• Tomorrow morning, if your bleeding has stopped, you can brush your teeth but not in the area of the surgery. If you still have some bleeding tomorrow morning, you should brush your teeth at a later time when the bleeding has stopped.

• You should not brush the area of the surgery until you come back for a follow up appointment – typically, 1-2 weeks later.

Rinsing

• Starting tomorrow (and only after your bleeding has stopped), you should rinse your mouth gently with salt water. Take a glass of warm water, add 2 spoons of salt, and mix it. You can rinse several times a day and after every meal. If you notice significant bleeding after rinsing, stop rinsing and resume it at a later time when the bleeding has stopped.

Swelling

• Swelling is normal after a surgical procedure. Typically, swelling starts the day after surgery and peaks on the second day after surgery. It will then subside over the next couple of days. Large swellings are uncommon, but may occur. Swelling may occur anywhere on the face – under the eye, around the nose, in the cheek or under the jaw.

• Apply ice/cold pack 20 min on, 20 min off for the rest of the day to keep the swelling down.

Looking at the surgical site

• Despite understandable curiosity, do not put fingers in your mouth and look at the area of the surgery. This area needs time to heal undisturbed. Stretching the lip to look at the area may cause the stitches to come apart and may cause you to require additional surgery.

Infection

• Infection may occur after any surgical procedure. The detailed instructions given to you in this letter should help minimize the chances of an infection happening.

• If you were given antibiotics, it is very important that you take them as prescribed. Some minor stomach upset is common after all medications, and you should continue taking the antibiotics.

• If you develop itching or redness on the body, this may indicate an allergy to an antibiotic. In this case, stop taking the medication and contact our office.

Eating/drinking

• You should wait for numbness to go away before eating and drinking anything.

• Eat on the side that is away from the surgery.

• Your diet is strictly soft diet. That means – nothing hard, nothing chewy, nothing crunchy. You may only eat soft things – bananas, ice cream, soup, cream cheese, cottage cheese, yogurt, shakes, soft bread etc. Eating hard foods may cause the stitches to come apart and may cause you to require additional surgery.

Stitches

• After several days, you may notice stitches being “loose”. This is normal. The stitches will be removed when you return for your follow up appointment.

Dressing

• A dressing was placed to protect the wound. The dressing serves useful purpose only for the next couple of hours. It may fall out or pieces of it may fall out. That is normal. However, you should not touch the dressing and you should not try to dislodge it. When you return for your follow up appointment, the dressing will be removed if it is still present.

• Exercise and vigorous activity should be postponed for several days. If you notice bleeding during a physical activity, stop the physical activity immediately.

Going to work

• Most people are able to return to work the day after surgery.

• However, it is a good idea to warn your workplace about the possibility that you may miss a couple of days of work after the procedure.