Periodontal Post-Op Instructions
Smokers/Tobacco Users Warning:
Tobacco has a negative effect on gums and makes gum disease worse. Any type of smoking and/or chewing tobacco will have an adverse effect on the progress of your healing and may cause the gum disease to re-occur after treatment. If you are a smoker or chew tobacco, we highly recommend not to do so while you are healing or anytime after that.
General Guidelines for All Procedures:
Do not chew on hard, sticky or chewy foods for at least 24 hours. Never chew on ice. Avoid aggressive chewing and sticky foods such as “hard tack” candies that can loosen or damage a restoration. Carefully follow all guidelines provided by the doctor and staff, and make sure to practice good oral hygiene.
Additional instructions following various types of treatment are listed below. In the event of an emergency, please call our office. If you are experiencing a serious or life-threatening emergency, please call 911 or visit the nearest emergency room.
- Start Peridex the night of the procedure and continue using for 10 days.
- No brushing the LANAP treated area(s) for the first 10 days. On day 11, LANAP treated areas should be brushed as follows:
- Upper arch: bristles placed at the gumline and sweep downward
- Lower arch: bristles placed at the gumline and sweep upward (do not scrub or force bristles into gumline!)
On day 11, start using interproximal brushes in LANAP treated areas (Proxibrush). No electric toothbrush for 30 days. After 2 months, you can resume regular brushing and flossing (modified Bass technique-45 degree angle toward the gumline).
- Do not be alarmed with any color changes or appearance of gum tissue following laser therapy. Gum tissue can turn gray, yellow, red, blue, purple and “stringy”—this reflects a normal response to laser treatments.
- Do not apply excessive tongue or cheek pressure to the treated area.
- Do not be alarmed if one of the following occurs:
- Light bleeding
- Slight swelling
- Some soreness, tenderness, or tooth sensitivity
- Medicinal taste, from Peridex or Perioguard
- Swelling may occur. To keep this at a minimum, gently place an ice pack on the outside of the face for 20 minutes each hour until you retire for sleep that night. Do not continue using the ice bag beyond the day of the periodontal surgery.
- Some oozing of blood may occur and will appear to be greatly exaggerated when it dissolves in saliva. Determine the side of oozing and place pressure on this area. If you cannot locate the origin of the bleeding, rinse your mouth gently with iced water and apply a wet tea bag to the general area.
- Please call our office so that we may render further treatment if any of the following occurs:
- Prolonged or severe pain
- Prolonged or excessive bleeding
- Considerably elevated or persistent temperature
- If medication has been prescribed, please take it exactly as directed. If antibiotic pills are prescribed, the entire bottle or prescription should be taken for the stated number of days or weeks. If you are not allergic to ibuprofen (Motrin®, Advil®, Nuprin®), we will most likely prescribe it primarily to minimize tissue swelling and local inflammation that is a natural side effect of minor surgery. Ibuprofen is also good to reduce post-operative pain and sensitivity. Ibuprofen is non-narcotic and does not affect your ability to drive. Never place aspirin directly on the tissue of a painful area.
- Reduce physical activity for several hours following the surgery to maximize healing.
- Try to keep your mouth as clean as possible in order to help the healing process. Only brush and floss the untreated area of your mouth. Do not brush or floss the treated area for 7–10 days or as directed by your doctor.
- You may spit, and gently rinse your mouth the day of treatment. Rinse your mouth gently three times a day with Peridex or Perioguard. In between Peridex/Perioguard rinses, rinse your mouth gently three times a day with warm salt water (a half teaspoon of salt dissolved in an eight ounce glass of warm water). For the next several days, rinse with both Peridex/Perioguard and salt water as previously mentioned but vigorously.
- You will be on a liquid diet for three days, then a diet of “mushy”/soft foods for four days, and then a diet of smart food choices for the remainder of the month. It is very important to maintain a good food and fluid intake. Try to eat soft but nutritious food such as eggs, yogurt, cottage cheese, etc., until you can comfortably return to a normal diet. Please refer to the Post-LANAP Treatment Diet Instructions below.
- Avoid spicy or excessively hot foods during the initial three-day liquid diet period.
- When eating, do not chew on the side of your mouth that has been treated.
- Do not be alarmed that, beginning just two weeks after therapy and extending as long as one year or more, the teeth may become sore and tender as the bone and ligaments around the teeth regenerate and become more firm. This is a sign of healing, but it also indicates the presence of a bite imbalance that may need to be adjusted.
- Spaces between your teeth can result from reduction of inflammation, swelling and the removal of diseased tissue after the LANAP treatment. These spaces usually fill in over time and, again, bite adjustment is critical to making sure the teeth and the “papilla” is not traumatized and can regrow.
- After you complete the program, you will be provided with a list of dentists that are trained using the PerioLase laser and perform the LANAP treatment for follow-up care and periodontal maintenance visits. This is extremely important to preserve the work that has been done.
- The first 3 days following laser therapy, follow only a liquid-like diet to allow healing. Anything that could be put into a blender to drink is ideal. The purpose of this is to protect the clot that is acting as a “Band-Aid®” between the gums and the teeth. Do not drink through a straw, as this creates a vacuum in your mouth that can disturb the “Band-Aid”. Take daily vitamins.
- For the next four days after treatment, foods with a “mushy” consistency are recommended:
- Anything put through a food blender
- Cream of Wheat, oatmeal, Malt-O-Meal
- Mashed avocado, applesauce
- Mashed potatoes or baked potatoes with butter or sour cream
- Mashed banana or any mashed/blended fruit except berries with seeds
- Broth or creamed soup
- Mashed steamed vegetables
- Mashed yams, baked sweet potato or butternut squash
- Cottage cheese cream or soft cheese
- Creamy peanut butter (no solid pieces)
- Eggs any style, with or without melted cheese
- Omelets can have cheese and avocado
- Jell-O, pudding, ice cream, yogurt
- Milkshakes/smoothies—DO NOT blend with berries containing seeds
- Ensure, Slim Fast nutritional drinks
- DON’T: chew gum, candy, cookies, chips, nuts, anything hard or crunchy, anything that has seeds or hard pieces, raw vegetables/salad, or meat that shreds and can lodge under the gum and between teeth
- Starting 7–10 days after treatment, soft foods may be allowable. The time to start on soft foods is dependent upon the loss of the white material that appeared around your teeth following LANAP treatment. (You were introduced to this material by your doctor or doctor’s assistant during your follow-up visit immediately following your initial treatment session. It was explained to you that you must leave this material alone until it naturally heals and disappears.) Once the white material has disappeared, then soft foods can be introduced. Soft foods have the consistency of pasta, fish, chicken or steamed vegetables. You may then gradually add back your regular diet choices.
- Please remember that even after ten days, healing is not complete. The first month following treatment you should continue to make smart food choices. Softer foods are better.
- Take daily vitamins!
- You may experience some cold and heat sensitivity for the first 24 hours. Do not eat, drink, chew or consume hot foods or beverages until the numbness has worn off following anesthetic.
- Avoid vigorous physical exercise and foods that are extremely hot or spicy for the first 24 hours, and do not consume alcoholic beverages or smoke for at least 48 hours.
- Some bleeding following a deep cleaning is normal, but if you experience excessive bleeding, please call our office.
- You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by your doctor as needed.
- A warm salt water rinse, approximately one teaspoon in an eight ounce glass of water, three times a day can be helpful.
- Brush and floss gently following a deep cleaning, resuming normal brushing and flossing when the soreness is gone.
- Follow any other instructions provided by our office on your visit. Please take all medications as prescribed.
- Some pain, bleeding, swelling and seeping are normal following oral surgery. A cold compress placed on the face near the extraction site for 30 minutes every 5–10 minutes on the day of your surgery can be helpful. This will help reduce pain and swelling.
- Do not miss your follow up appointment(s) with your dentist and do not probe the area with your tongue or fingers.
- Please do not touch your lips to see or feel the area treated.
- Avoid brushing your teeth near the surgery site but brush and floss the rest of your mouth as instructed by the office.
- You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by your doctor as needed. A warm salt water rinse, approximately one teaspoon in an eight ounce glass of water, three times a day can be helpful.
- For the first 24 hours, you may experience some cold and heat sensitivity.
- Do not eat, drink, chew or consume foods or beverages that are extremely hot or spicy until the numbness has worn off following the anesthetic.
- Avoid vigorous physical exercise for the first 24 hours and do not consume alcoholic beverages. Smoking complicates healing and you are asked not to smoke after the procedure.
- Do not brush, rinse or spit. Do not use a straw for drinking.
- During the first few days after surgery, a diet of liquids and soft foods such as soups, yogurt, juice and smoothies are recommended.
- If you experience excessive bleeding or discomfort after 48–72 hours, please call our office immediately.
- Follow any other instructions provided by the office on your visit. Please take all medications as prescribed including the mouth rinse and antibiotics if they have been prescribed.
- After your procedure, please do not disturb the area.
- Avoid forcefully rinsing or spitting.
- Some bleeding is normal for the first 24 hours. Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding. If bleeding continues, please call our office.
- Please take all medications, including mouth rinses, as prescribed.
- Warm salt water rinses (one teaspoon of salt in a cup of warm water) can be used 4–5 times a day after meals.
- Brush your teeth with a soft manual toothbrush. Do NOT brush the surgical sight.
- Swelling and bruising may occur. The use of ice packs following your surgery will help diminish the swelling you may experience in the next 48–72 hours. Applying ice for 15–20 minutes followed by resting the same amount of time works very well.
- Drink plenty of fluids. Stay away from spicy foods. Also avoid sharp and crunchy foods like tacos, chips and nuts. Tobacco and alcohol should not be used. Alcohol should not be used in combination with pain medications nor antibiotics.
- Keep physical activities to a minimum immediately following surgery.
- If a surgical bandage was used, it is desirable for it to remain in place for 24 hours. Do not remove it; it will come off when ready. Once removed, you can begin cleaning the wound gently with a cotton swab dipped in a mouth rinse.
- After your procedure, please do not disturb the area. Avoid forcefully rinsing or spitting.
- Some bleeding is normal for the first 24 hours. Biting on a gauze pad placed directly on the wound for 30 minutes will help reduce bleeding. If bleeding continues, please call our office.
- Please take all medications, including mouth rinses, if prescribed.
- Swelling and bruising may occur. The use of ice packs following your surgery will help diminish the swelling you may experience in the next 48–72 hours. Applying ice for 15–20 minutes followed by resting the same amount of time works very well.
- After 24 hours, brushing and oral hygiene procedures should be done as usual in all untreated areas. In the treated areas, please limit your oral hygiene to brushing using a soft manual toothbrush. Avoid dental flossing in treated areas during the first week following surgery. No undiluted mouthwash, salt water or peroxide rinses should be used during the first week following surgery.
- Drink plenty of fluids. Stay away from spicy or acidic foods. Also avoid sharp and crunchy foods like tacos, chips and nuts. Tobacco and alcohol should not be used. Alcohol should not be used in combination with pain medications nor antibiotics.
- Keep physical activities to a minimum immediately following surgery. Avoid strenuous activity for 2–3 days.
- After your procedure, please do not disturb the area for as long as possible. The area should be protected for the first six weeks after surgery.
- Avoid forcefully rinsing or spitting for at least one week.
- Some bleeding is normal for the first 24 hours, and bleeding from the roof of the mouth may even continue for longer. Placing direct pressure on a gauze pad placed directly on the wound for 30-45 minutes will help reduce bleeding. If bleeding continues, please call our office.
- Please take all medications, including mouth rinses, as prescribed.
- Do not rinse at all for 48 hours following the procedure. Warm salt water rinses (one teaspoon of salt in a cup of warm water) or mouthwash can be used 4–5 times a day starting on day three.
- Brush your teeth with a soft manual toothbrush. Do NOT brush the surgical site.
- Swelling and bruising may occur. The use of ice packs following your surgery will help diminish the swelling you may experience in the next 48–72 hours. Applying ice for 15–20 minutes followed by resting the same amount of time works very well.
- Drink plenty of fluids. Stay away from spicy foods. Also avoid sharp and crunchy foods like tacos, chips and nuts. Tobacco and alcohol should not be used. Alcohol should not be used in combination with pain medications nor antibiotics.
- Keep physical activities to a minimum immediately following surgery.
- If a surgical bandage was used, it is desirable for it to remain in place for 24 hours or more. Do not remove it; it will come off when ready. Once removed, you can begin cleaning the wound gently with a cotton swab dipped in a mouth rinse.
- No brushing over surgical site(s).
- No flossing (Waterpik® only from tongue-side on low).
- No touching with finger or any other device or object.
- Do not lick surgical area.
- Do not use cotton swabs, cloth or any soft or hard object to clean the area.
- Do not sleep with hands under the cheek where surgery was done.
- No facial massages for three weeks or massage that area of the face for any reason.
- No looking. Do not obsess over or question doctor about appearance of gums for six weeks. You cannot look without pulling cheek.
- Rinse only with lips apart. Sloshing only.
- No making “chipmunk cheeks” when you rinse.
- Do not play wind instruments for three weeks.
- Do not suck on straws.
- Do not blow balloons.
- No spitting.
- No mints over surgical area.
- No smoking, chewing tobacco, cigar, pipe or recreational marijuana. Please consult doctor if you use marijuana for medical purposes.
- Wear prescribed bite appliance 24 hours a day, if instructed. Check with doctor about any other appliances (e.g., retainers, Invisalign®, Perio-Protect, etc.).
- No clenching or grinding of the teeth.
- No heavy lifting that requires clenching of the teeth.
- No heavy aerobics or vigorous dancing or physical activity for three weeks.
- Ice over area at 10-minute intervals for the first 48 hours to minimize swelling.
- Do not be alarmed about soft swelling or bruising for the first week.
- Do not eat crunchy or sticky food that can get stuck on or in between your teeth.
- Expect cold sensitivity for six weeks or longer. Do report sensitivity during check-up appointments.
- Pain control: take one each of acetaminophen (Tylenol®) and NSAID (Motrin or Advil) at the same time, subject to other instructions by your doctor.
- Call doctor immediately if you have unexpected pain, heat or continuous bleeding from surgical site.
- Patient must return to our office 24 hours after surgery, one week after surgery, three weeks after surgery and six weeks after surgery.
- After the sixth week, you may brush the surgical area with a special extra-soft brush dispensed or ordered by this office for six months.