After Gum Recession Surgery

POST-OPERATIVE INSTRUCTIONS FOR SOFT TISSUE AND ALLOGRAFT

The following information has been prepared to help answer some of your questions about postoperative care. Please read them thoroughly. If you still have concerns and you don’t see the answer to those, please call the office directly during business hours (954-723-7771) or Dr. Montamarta’s personal cell phone (954-682-4323). You may also want to text in case he is unavailable to take your call right away.

POST-OPERATIVE CARE AND MAINTENANCE

You might have a glue-like bandage covering some of your gums and teeth. Do not brush the side of your teeth where the procedure was done. Do not chew with those teeth either. Doing so might hurt/damage the surgery and therefore the results. If you notice food debris around the surgical area or attached to the glue/stitches, use a cotton swab (Q-tip) to remove it gently. Be careful not to pull on the glue or the stitches. Also refrain from pulling on your lip to visualize the area, as you may be accidentally pulling on the stitches and the gum tissue. Dr. Montamarta will inform you if it is safe to brush the area at your postoperative visit. We might give you a post-operation toothbrush then, to be used on the area treated only. This brush is more like a mop and helps while not hurting the surgical site. It is not a good regular toothbrush and should be avoided on the rest of your teeth. The rest of your teeth may be brushed the way you normally do, with your regular manual or electric toothbrush.

Do not use a WaterPik or similar until you return for your evaluation. Dr. Montamarta will let you know if this is safe based on your healing. Also refrain from flossing close to the gum line until then. You will likely have a prescription of chlorhexidine (Peridex). Apply this to the areas treated by soaking a gauze or cotton pad in it and holding it at the area treated for 20 seconds. By doing this, and not rinsing, you will avoid unnecessary staining of your teeth. Rinsing your mouth out (not swishing) with warm saltwater is acceptable.

Rest is important. Avoid excessive physical activity for 48 hours. Lifting objects, walking stairs, etc. are examples. You may resume normal activities after 48 hours, except intense exercise (running, lifting weights, etc.)

You may experience a slight feeling of weakness and elevation of temperature (one degree is normal). Do not be concerned, as this is to be expected.

MEDICATIONS

Use all medications as directed. Usually antibiotics are started the day before the procedure. Certain anti-inflammatories (steroids) are usually started the day before the procedure. Make sure all medications you take are listed on your file, in case they interact with the ones prescribed by us. It is always a good idea to eat before taking medications. This applies to those started before the procedure, as well as to the ones to be taken after. Due to the soft diet, we don’t recommend taking medications together. Patients have reported significant nausea for hours when both antibiotics and painkillers are taken at the same time. Give priority to pain medications first and allow two hours to take an antibiotic if it’s due. For female: please take into account antibiotics decrease the efficacy of contraceptive medications.

SWELLING

it is unlikely, but it may occur. Apply cold packs (ice or similar) on the side of the face where the procedure was done. Keeping ice for an extended time might be uncomfortable. The trick is to keep the area constantly cold (less swelling= less pain). This may be accomplished by placing those packs on and off the first day, taking short breaks in between. If swelling occurs, you might see a discoloration or bruising of the skin, face and neck. Not to worry, this will disappear, but it may take longer than expected. If swelling is present after 48 hours, replace the cold packs for warm compresses. Applying cold after two days may actually be detrimental. Swelling may be aggravated by excessive physical exercise or constant chewing. Therefore, a soft diet is highly recommended until it subsides. Sleeping the first two nights propped up (inclined) will also help reduce swelling.

BLEEDING

Occasional bleeding is expected the first 24 hours. It will be mixed with your saliva and might appear worse than it is. Avoid rinsing excessively, spitting, drinking from a straw and hot (temperature) foods and drinks. If constant bleeding occurs, soak a gauze pad (2 x 2) in iced water and place it firmly over the bleeding site until it stops. It may take over 10 minutes for this to happen. If this does not stop the bleeding, please call Dr. Montamarta. As mentioned before, sleeping the first two nights with your head propped up will reduce the chances for bleeding.

PAIN

Unless you have had an allergy or reaction to either medication, it is best to take one ibuprofen 800 mg together with two Tylenol 500 mg (always after food, remember). This is by far the most effective way to control discomfort and pain. If you are proactive and follow this routine every four hours the first day, you will likely have no pain at all. In most cases, it works better than narcotics (Vicodin, Percocet, etc.). Pain is usually gone by the second day. If you need to take a narcotic, we recommend breaking the pill in half and taking it with food. If pain persists after one hour, eat some food again and take the other half. NEVER TAKE A NARCOTIC IF YOU HAVE TAKEN THE IBUPROFEN/TYLENOL COMBINATION ALREADY. In case of doubt, text or call Dr. Montamarta. In most cases, and unless you have had a reaction to it, you may take Benadryl prior to bedtime to help you rest. Do consult with Dr. Montamarta prior to doing this.

DIET

Eat only liquid and soft foods the day of the procedure. If discomfort is still present the second day, stay on this diet as it will help you heal faster. Regular foods are acceptable after 48 hours unless instructed otherwise. Always make an effort to chew away from the area treated. Remember: chewing a lot will give you more pain, swelling and possibly bleeding. Citric juices, carbonated beverages or acidic foods like tomatoes, may affect the healing. Avoid spicy foods as well.

RISK FACTORS

If you have been provided or you have a nightguard, you should wear it during healing time. Dr. Montamarta will inform you about the length of this period. It is critical to allow your teeth to rest protected for a few hours (while sleeping) to maximize the results of the procedure. If you smoke, complications may arise including higher pain rates, slow healing and infections. Though we don’t expect anyone to quit (ideal), it is best to minimize smoking as much as possible.