Post-Op Instructions

If you have just had surgery completed for the reduction of periodontal pocketing and/or replacement of bone in an area where pathology existed or had a procedure in conjunction with end osseous dental implant surgical placement with or without platelet addition to the bone graft, you will be advised of the particular procedure and pertinent directions relative to your treatment modality. Whether you were put to sleep for this procedure or if you were only given local anesthesia, the post-operative directions remain the same.

You will have several sutures (stitches) placed at the surgical site. These sutures may or may not be resorbable. If you have been told that you have received external silk sutures, they have to be removed by us. The sutures will cause a pulling of your tissue over the bone grafting site. Since the bone graft site will have approximately 15% more bone fill than what was naturally there, it is imperative that you do not pull up your lips or cheeks to show or examine the area. The undue pressure will cause the sutures to widen away from the surgical site, expose bone, create more pain and delay healing dramatically. This delay can lead to the need for the area to be sutured again when you are seen for your one-week post surgical evaluation. The sutures will remain in place between 14 and 21 days, depending on the size of the graft, the severity of the pathology, and the condition of the tissue being sutured.

Your doctor will tell you what time period to expect. Remember that nothing is etched in stone, and the doctor may extend the time before your sutures are removed to assure adequate healing and to avoid surgical regression.

You also may have a periodontal pack placed over the surgical site. The pack is pink in color, impregnated with antibiotic and will protect the surgical site from infection as well as any wash out of the particulate bone utilized to restore your jaw. The pack should be left in place for as long as possible. If a pack is placed, the doctor will remove the packing on your one-week follow-up and decide if the packing should be replaced or kept off. Usually, the packing is kept on for seven to ten days. You must return to the office if your pack falls off before you are seen for your one-week follow up.

Your maintenance during healing has to be completed carefully. You can brush in every area where the periodontal pack is not placed. It is imperative that you use NOTHING ASTRINGENT, such as mouth wash or antiseptic solutions, during the healing period of your bone graft. Listerine, Viadent and any other potentially caustic agent can RUIN your bone grafting procedure. If contaminated, it may require a replacement bone graft. The doctor and our staff will reiterate this with you at, during and after your bone graft surgical procedure. After the first stages of healing are satisfactory, we will deliver and instruct you on how to use normal saline (with or without the addition of salt) and irrigation syringes for cleaning of the surgical site.

Since bone grows and heals slowly and requires conditions conducive to a proper environment and blood supply, it is imperative that immediately after your bone graft, you alter your diet. This means that you should not eat anything that is too large, too hot or too sticky. Your food should be tepid or on the cool side. Any food too hot will have a deleterious affect on your surgical procedure. Common sense must be used in determining what should or should not be done. If, for some reason, you have a question about any post-surgery matters, please call the office, and we will inform you of the proper action to take.

Smoking after any oral surgical procedure will ALWAYS delay or badly disrupt normal healing due to a decrease in oxygenation of the tissue that is healing. Smoking should be stopped for the first 7 to 10 days to allow for adequate initial tissue closure. Complete epithilization (closure) and healing normally takes a minimal of 21 days from the day the surgery was completed. That is under ideal healing conditions and with no other underlying systemic causes, such as diabetes melitus, etc.

Bone grafting is a very predictable surgical procedure when done correctly and patient cooperation is adhered to. Please try to be reasonable in understanding that this procedure has inherent risks associated with it as stated in your informed consents. Some of these risks are also pertinent to your post-operative care.

We want nothing more than a perfect outcome in regards to your surgical procedures to rehabilitate your bone. This is only attainable with proper cooperation from you, the patient. Always feel free to communicate with us any time to make sure the procedures you have had completed are properly maintained. No question is ever perceived by our office as being silly or unreasonable. We would rather have questions answered immediately than invite the chance of the procedure not going as planned. This is especially true in regards to omissions that are preventable.

Please also remember, as stated above and as outlined on your informed consents, that there are some occasions that no matter what is done, the outcome is not perfect. There are even infrequent instances when a surgery may have to be redone and it is neither the doctor's nor the patient’s fault.

Thank you.