Instructions After Laser Periodontal Surgery

Post-operative care instructions for laser periodontal surgery, covering diet (liquid for 4 days, soft foods for 10 days), activity restrictions, pain management, antibiotic options, and signs of infection to watch for.

One of the most important results of laser surgery is the blood clots that form following surgery. It is extremely important not to dislodge the tiny clots that form in and around the gums.
Absolutely NO BITING or CHEWING on the side of the surgery for the next two weeks
NO SMOKING or ALCOHOL for 2 weeks.
Smoking and alcohol delay the healing process and predisposes you to infection, which can result in failure of the surgery.
The longer you go without smoking, the better your chances of healing ideally.
Follow the diet instructions (details on other side)
Liquid/blended diet for the first 4 days
Fork soft / mushy for 10 days thereafter
Smart food choices during the second phase of recovery.
Apply ice pack to outside of face, 20 minutes on, 20 minutes off, every hour until bedtime. No need to ice beyond this time frame. Icing reduces minor swelling and discomfort.
DO NOT BRUSH near the surgical area for the next two weeks. Brushing will dislodge the blood clots and disrupt the healing. Brush, floss/waterpik everywhere else as normal.
Avoid using a straw for 1 week. This could disrupt the blood clots around the teeth.
No exercise/heavy lifting for the next 72 hours. This will reduce bleeding and minimize swelling.
Elevate your head with an extra pillow when you sleep for the next 48 hours. This will minimize swelling and potential bleeding.

Slight bleeding/oozing is normal for the first 48 hours.
Do NOT apply wet gauze to the surgical area as this can disturb the blood clots around the teeth
Avoid spitting and vigorous rinsing of the mouth, as this will aggravate the site and increase bleeding.
Spaces may develop between your teeth - this is NORMAL
Occurs from a reduction is gum inflammation. Spaces usually fill in over time
Gums may change color - gray, yellow, red, blue/purple, and "stringy" - this is a NORMAL response to laser treatment
SIGNS OF INFECTION that would indicate an immediate phone call to our office:
Pain or swelling that increases after the first 4-5 days
Pus or yellow discharge from the surgical site
Swollen glands under jaw or neck area
A general feeling that something is wrong

Liquid diet (blended foods) – creamy soups (lukewarm) or smoothies for the first 4 days. NO STRAW!!
Fork soft food for next 10 days - eggs, oatmeal, pasta, lukewarm soup, mashed/baked potatoes, ensure/slim fast, cottage cheese, oatmeal ice cream, yogurt, pudding, Jell-o
Do NOT eat - berries with seeds, popcorn, nuts, sandwiches, salads/raw vegetables, chips, meat that shreds, or anything that can lodge under the gum and between the teeth. Avoid hot temperature food and drink
Chew on the opposite side

Take medication even with minimal pain as it is easier to prevent pain than decrease it.

Ibuprofen 600mg (Rx) and Tylenol 500mg (over the counter):
Take together every 6 hours for 3-4 days, then as needed

One of the Following Antibiotics Will Be Prescribed:

Amoxicillin 500 mg: 3 times/day (every 7-8 hours) for 7 days
Amoxicillin 875 mg: 2 times/day (every 12 hours) for 7 days
Cefdinir 300 mg: 2 times/day (every 12 hours) for 7 days
Azithyromycin 250 mg 2 times/day for the first day, 1 time/day for the next four days
Metronidazole 500 mg: 3 times/day (every 8 hours) for 7 days

Post Operative Care Following Gingival Graft Procedures

As explained to you prior to the appointment, the success of this procedure will rely heavily on good home care. It is for this reason that these instructions should be followed closely. You will have multiple follow-up appointments to help with your recovery.

Brushing and flossing – Resume normal brushing and flossing in the areas that were not worked on today. AVOID THE SURGICAL AREA until given specific brushing instructions at your follow-up appointment. You may notice a white film over the surgical site – this is completely normal.
Mouthwash – Avoid regular mouthwash such as Listerine or Scope. ONLY use the Saline/saltwater rinse as directed beginning the morning after the procedure after each meal. NO VIGOROUS RINSING OR SPITTING!
Homemade Saline Solution – 1 cup (240 ml) distilled water (warm), 0.5 tsp (2.5 g) salt. Mix ingredients together.
Electronic toothbrushes – DO NOT use electric toothbrushes such as Sonicare or Oral B for 4 weeks after the procedure around surgical site.
Water Pik – DO NOT use a Water Pik around surgical site for at least 6 weeks following surgery.

Pain Medication – If you were given 600mg Ibuprofen at the time of surgery, non-steroidal medications such as Advil or Aleve aspirin are not to be taken within 6 hours. If you experience pain prior to this, Tylenol (extra strength, regular, or with codeine) can be taken. A prescription for pain medication will have been provided by your doctor – please follow instructions for them.
Antibiotics – If you were prescribed antibiotics by your doctor, please be sure to follow instructions and know that you are to complete the full dose.

First 24 hours – adequate nutrition is essential for normal healing. Following surgery, your diet should be restricted to cool foods – yogurt, smoothie, and milkshakes. Dietary supplements such as Instant Breakfast or Ensure are good choices. AVOID PEROXIDE, ALCOHOL, CARBONATED BEVERAGES, AND DRINKING THROUGH A STRAW.
After 24 hours – gradually progress to soft foods such as cooked vegetables, baked fish, tuna, pasta, rice, mashed potatoes and meatloaf, which are easily chewed and swallowed. DO NOT SKIP MEALS. If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster.

NO HARD FOODS, NO FOOD WITH CRUNCHES OR SEEDS SHOULD BE EATEN.

After 24 hours – You may return to your regular schedule, but avoid strenuous activities such as heavy lifting, jogging, exercise programs, etc. for three weeks following surgery. Avoid talking a lot or expressive facial movements which can move the graft and interfere with healing, resulting in less than favorable outcome.
Rest – Plan to rest at home the remainder of the day of surgery. You may read, watch TV or work at your desk at home. When sleeping, elevate your head to decrease swelling.

Periodontal Post-Operative Instructions

Although not all of the following pertain to every type of surgery, you may find these instructions helpful.

You should avoid eating and drinking for at least 2 hours after surgery. Smoking is not recommended, especially during the healing time. Do not rub your face in the area of the surgery or pull on your cheeks or lips to look at the surgical sight. Complete healing of the soft tissues occurs in 6-8 weeks.

On the day of surgery, teeth should NOT be Brushed with toothpaste, just a wet toothbrush. Twenty-four hours after surgery, brushing and flossing of teeth and mouth rinsing should be resumed, but do NOT brush or floss on the surgical site or near the dressing. Frequent gentle rinsing of the mouth with warm salt water will aid the healing process and also help keep the mouth clean. Resume brushing and flossing of the surgical site after 6 weeks or when the Dr. clears you for it. If further cleaning of the area of dressing seems indicated, it can be swabbed gently with a cotton tipped applicator (Qtip) dipped in water.

Do NOT rinse mouth for the first few hours after surgery. Slow oozing (bleeding) may occur for several hours. If bleeding is excessive:

a. Apply wet gauze or a tea bag moistened in warm water on each side of bleeding area and hold with continuous pressure for 30 minutes and avoid spitting. Repeat if necessary.
b. Place an ice pack against cheek or jaw on and off alternately every 20 minutes for 3-4 hours.
c. Sit up in bed or prop head up with 2 or 3 pillows
d. If bleeding still continues call Dr. Reza.

Eating should be avoided for at least 2 hours following surgery. For the first day following surgery, it is best to restrict yourself to cold fluids or very soft cold foods that require little or no chewing (for example: cottage cheese, yogurt, ice cream, mashed potatoes). Do not suck through a straw. Stay away from drinks with a fizz or acid like soda. Chewing on the dressing will probably loosen or break it off. For the second day following surgery, warm, soft foods such as soup are recommended. NO HARD FOOD SHOULD BE EATEN. NO FOOD WITH CRUNCHES OR SEEDS SHOULD BE EATEN. When you must chew, chew on the side of your mouth that was not operated on.

Restorative Post-Operative Instructions

Your tooth and surrounding gum tissue may feel numb for several hours after treatment. Avoid chewing until the numbness has completely worn off to prevent accidentally biting your cheek, lip, or tongue.
Mild soreness or sensitivity is normal for a few days, especially to cold, pressure, or around the gums. This should gradually improve. Over-the-counter pain relievers such as ibuprofen or acetaminophen may be taken as directed unless otherwise instructed by your doctor or physician.
Your gums may be slightly irritated from the procedure. Warm salt water rinses (1 teaspoon salt in a glass of warm water) 2–3 times daily can help soothe the area.
If your bite feels uneven, the crown feels too high, or you experience persistent pain, sensitivity, swelling, or difficulty chewing, please contact our office promptly. Small bite adjustments are sometimes needed and are usually quick and simple.
Continue brushing and flossing normally around your crown. Excellent home care is essential for the longevity of your restoration.

If you received a temporary crown:

Avoid sticky or very hard foods on that side (gum, caramel, nuts, hard candy, ice, etc.).
Brush normally, but when flossing, slide the floss out to the side rather than pulling upward or downward to help avoid dislodging the temporary crown.
If the temporary crown comes off, please contact our office as soon as possible to have it recemented.
If the temporary crown comes off and the tooth is sensitive, you can place tooth paste or Fixodent inside the temporary crown to suction it in place until you are able to come in to have it recemented.

If you have any questions or concerns, please contact our office. We are happy to help!

Post-Op Instructions

Instructions After Laser Periodontal Surgery

Post Operative Care Following Gingival Graft Procedures

Periodontal Post-Operative Instructions

Restorative Post-Operative Instructions

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