REST: Limiting your physical activity is recommended after surgical treatment. Avoid excessive exertion including cardiovascular exercise for 24-48 hours after the surgery. If you feel well after this, you may then resume normal activities.

When you lie down, keep your head slightly elevated in the first 24 hours (an extra pillow or a thick book under the head of your mattress can help).

PAIN RELIEF: You will have been advised to use one of many different pain relievers available either over the counter (OTC) or by prescription. Pain levels vary a lot; do not worry if your pain peaks after 3-4 days, this is common. 400-600mg Advil or other forms of Ibuprofen effectively control pain when taken every 4-6 hours. If you have an intolerance to ASA or aspirin-like drugs, you should not use Advil. Acceptable alternatives include 325mg or 500mg Tylenol (OTC) or Tylenol/codeine (by prescription). A combination of Advil or Tylenol can improve your pain management. Do not exceed 2400mg of Advil (Ibuprofen) or 3000mg Tylenol within a 24-hour period.

Medications given at surgery: 500mg Acetaminophen (Tylenol) & 400mg Ibuprofen (Advil)

IF YOU HAVE HAD SURGERY INVOLVING YOUR SINUS: Please use a decongestant as directed by your periodontist. Minimize negative sinus pressure (minimize nose blowing, drinking through a straw) for 7 days. A nose bleed can occur after sinus elevation surgeries or extractions where there was root communication with the sinus floor. Please avoid nasal saline rinses. If you experience a post-surgical nose bleed, pinching your nostrils and tilting your head back will bring this under control.

ANTIBIOTICS: May be prescribed for some surgeries. It is important to take the full prescription as directed. Allergies/reactions: If you develop itching, a skin rash or swelling, immediately discontinue the drug and contact our office at 250-824-1724. If you experience difficulty breathing or swallowing, proceed to the hospital emergency department. Please contact our office if you experience symptoms such as increased pain and/or swelling after 5-6 days.

Probiotics can be taken in order to maintain a healthy gastrointestinal flora while taking antibiotics. Ideally, a probiotic should be taken in between antibiotic doses, and not at the same time as the antibiotic.

Recommendations: Florjen3 (please feel free to consult with your pharmacist or health food nutritionist for suitable alternatives).

If you are currently taking an oral contraceptive medication, be aware that antibiotics can interfere with birth control efficacy for one full cycle and that additional precautions are necessary.

ORAL HYGIENE: You must avoid brushing/flossing the surgical site until you are seen for your post-operative follow-up. Early brushing can break stitches prematurely or cause movement of the gum. You will rely on an antibacterial oral rinse given to you at the time of surgery to keep the area clean. You should rinse/swish for 30 seconds/spit out 2 times per day starting 24 hours after your surgery, or swab the site with a Q-tip dipped in the rinse. Do not swallow the rinse. You can also rinse with warm salt water during the day. 1 TSP of salt to 1 cup of warm water.

NUTRITION: Nourishment is important for the healing process. Eat foods that are easy to chew, and as much as possible, eat in areas away from the surgical site. Food supplements like protein shakes may be used as needed. You may chew on the opposite side of your mouth from your surgical site, and you should avoid hard or difficult to masticate foods. You should avoid alcoholic beverages if you have taken sedatives or have been prescribed narcotic medications or the antibiotic Metronidazole (Flagyl). Do not suck from straws during the first 48 hours as this can cause bleeding.

SWELLING/BRUISING: You may experience swelling. Swelling may be delayed and only start 1-2 days after surgery. You can expect that your swelling will peak at days 3-4, and then begin to dissipate. Swelling may be worse in the mornings because you have been lying down- this will reduce gradually after you get up. Swelling may be minimized by applying an ice-pack (or a bag of frozen corn or peas in a towel) on the outside of your face, adjacent to the treatment area, intermittently during the first six hours after your surgical procedure – 20 minutes on, 20 minutes off. Ice should not be used after the first 24 hours as it may extend the duration of swelling.

BLEEDING: Blood stained saliva may be expected after surgery. Your saliva may look light pink in colour -this is normal for the first day (24 hours) after the surgery. If bleeding continues (red stream), take a piece of gauze or a caffeinated tea bag (dampened with water) and apply it with pressure directly over the site for approximately 10-20 minutes. If bleeding does not stop after 2 attempts at this protocol, please contact Dr. Leziy. If you are unable to reach the periodontist, you should go to the nearest hospital emergency department.

STITCHES: Dissolving stitches are generally used, but non-dissolving ones are used in some procedures. Rate of dissolving may vary significantly from person to person, and depends on the type of stitch used. In some cases, stitches might start to fall out within 2-3 days. This is normal.

If non-dissolving stitches have been placed, you would have been advised of this and you would have been appointed to remove them approximately 2 weeks post-surgery. If a stitch comes loose and is bothersome, simply clip it off with small scissors, or call our office for assistance with this.

Medical glues are often used. These will gradually chip off in small fragments or come loose as a ‘purplish’

coloured sheet. This is normal.

PERIODONTAL PACK: A periodontal surgical dressing may be used to protect some surgical sites (palate donor sites for gum grafts or to cover flaps/sutures for pocket depth reduction surgery/bone grafts). Some

of the dressing may chip off. If the dressing comes loose, tease it off and discard. If a dressing is loose and you cannot remove it and it is bothersome, please call our office. If a periodontal dressing is placed, it will set and harden in place (looks like bubble gum). – for the first hour after this, please avoid hot foods and beverages.

ORAL SEDATION: If you have taken an oral sedative for your treatment, you are legally impaired for 24 hours. You cannot operate a motor vehicle or make any legal decisions. You must have an escort to and from your appointment and must have someone at home to accompany you for 12 hours after your appointment.

PALATAL STENT: If your treatment involved a gingival graft, we may have made a stent to cover the donor site/palate (roof of mouth). Leave the stent in place for 24 hours following the procedure. If the stent is comfortable for the next three days the stent should be removed only during your recommended salt water or chlorhexidine rinsing.

After this time, the stent may be worn as needed for comfort and removed for cleaning. Most patients find the stent to be helpful while eating and sleeping during the first week post-treatment. To clean the stent remove one side with index finger, run stent under hot water and rinse or use toothbrush to remove any debris.

PROBLEMS: Occasionally, minor complications may occur after surgery. Please do not hesitate to call our office (250-824-1724) if you are concerned about your situation.

Outside of office hours, you may reach our providers at the numbers below.

  • Dr. Sonia Leziy at 604-644-9857
  • Dr. Rouzbeh Memar at 778-723-3285
  • Dr. Mathieu Nault at 778-990-0442
  • Dr. Nathan Cain at 604-868-5301.