AFTER GINGIVAL GRAFT SURGERY
The plastic palatal stent is used to cover the wound on the palate. The purpose is to control bleeding and to protect the open wound during the initial stages of healing. It should not be removed during the first 24 hours. After that time, it can be removed regularly to rinse with the prescribed mouthwash while avoiding any trauma to the raw tissue site on the palate. It is very important that the stent is reinserted, as contamination of the site especially during eating may result in considerable discomfort. If bleeding occurs under the stent, thumb pressure against the palate for 20 to 30 minutes will usually stop the bleeding. Some oozing is normal for the first two days after surgery. The stent is usually worn for one week or until the palate is comfortable.
The degree of discomfort, experienced post-op varies greatly on an individual basis. Most discomfort can be controlled by 400-600mg of Ibuprofen (2-3 tabs Advil) taken every 6-8 hours. If this proves to be inadequate, a prescription for a stronger analgesic may be issued and should be used as directed. Clenching and grinding is the most common cause of pain post-operatively.
In some cases, swelling is to be expected. To help alleviate this, ice packs may be applied to the outside of the face over the area of the surgery for ten minutes on, and ten minutes off for the balance of the day and all of the second day. Ice cubes in a plastic bag can serve as an icepack. If swelling and discomfort persist, warm wet compresses and warm salt water rinses may be used over the area on the third and subsequent days. Flying within a few days of surgery is associated with a greater risk of swelling and post-operative complications.
Do not be concerned if traces of blood are noted in the saliva for several hours after the operation. Do not rinse too vigorously for the first two days as disruption of the clot may occur. It is best to avoid hot foods or fluids until the second day following surgery. If continuous, excessive bleeding occurs, please contact the office. Some individuals do experience discoloration of the skin/bruising following this procedure. This is a result of bleeding into the soft tissues and will disappear within a week. You may also note that the graft site appears very white, this is a normal occurrence and should not cause concern.
Periodontal Dressings (pack)
Some grafting procedures do not utilize periodontal dressings. The sutured tissue is very delicate and should not be disturbed by food, brushing or even pulling the lips to view the area. If a periodontal dressing has been used, it will become firm in about an hour and should not be disturbed while it is setting. It should remain in place until your next appointment when it will either be removed or replaced. Small particles of the dressing may chip off but this is of no consequence unless it causes discomfort. You may note that the graft appears white after the first few days. This is a normal healing response.
The success of the surgical procedure is greatly dependent on maintaining meticulous oral hygiene. In the first week following surgery, you will be required to gently rinse the surgical site with the prescribed mouthwash. Peridex/Periogard prevents plaque from forming and you should use this rinse as often as you eat thus preventing debris from lodging around the sutures. After a few weeks of use you may note slight staining of the teeth, like tea or coffee stain, this is a side effect from using the mouthwash and the stain can easily be removed. You may also note altered taste sensation that usually lasts 1 – 2 weeks. Elsewhere throughout the mouth you can use a toothbrush etc. taking great care not to overlap onto the surgical site.
Antibiotics may be prescribed depending on the surgical procedure. It is important that these antibiotics be taken completely as directed.
It is necessary to maintain an adequate diet after surgery but you are required to eat softer foods. You can chew on the opposite side of the mouth and should avoid extremely hard or spicy foods. Below you will find a list of foods that do provide nourishment with little if any chewing necessary for swallowing. Do not use a straw.
• Custards or puddings
• Malted Milk and Shakes
• Chopped or ground meat
• Food supplement such as Metrecal or
Carnation Instant Breakfast
• Ice Cream
• Pasta / Rice
You will assist in the healing response by observing the following procedures:
1. Maintain meticulous oral hygiene
2. Refrain from smoking
3. Attempt to maintain a high protein diet
4. Avoid vigorous exercise, get as much rest as possible