Instructions to Patients after Clinical Crown Lengthening

During today's visit crown lengthening was performed. To benefit most from the healing phase please follow post-surgical instructions below.

Periodontal Dressings (pack)

A periodontal surgical dressing may be placed following completion of the surgical procedure. It is a soft gum like material that is packed in around the teeth. It will become firm in about an hour and should not be disturbed while it is setting. The dressing 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. Should a sizable portion or all of the dressing come loose, gently ease it away from the sutures. Do not tug on it. If a sizable portion of the dressing comes off within the first two days or later and causes discomfort please call the office.

Sutures

Avoid disturbing the sutures that have been placed. Gently rinse the area with the prescribed mouthwash or warm salt water to keep the sutures free of plaque and food debris. The sutures are usually removed in 10-14 days however they may be left for a period of up to 30 days.

Pain

The degree of discomfort experienced after a surgery varies greatly for each person. Most discomfort can be controlled by 400-600mg of ibuprofen (2-3 tabs Advil every 6-8 hours or 220 mg Aleve every 12 hours). If this is not enough to control your discomfort take 500-1000 mg of Tylenol with your ibuprofen (2-3 tabs) or Aleve (220mg). Clenching and grinding is one the most common causes of pain post-operatively. Wearing your occlusal guard may help but in addition your doctor may prescribe a muscle relaxant to lower the impact of grinding your teeth. If you were prescribed a muscle relaxant it should be taken at bed time.

Swelling / Bruising

In some cases swelling and bruising is to be expected. Some individuals have a greater tendency to bruise than others and you may note discoloration / bruising in the cheek areas. This is as a consequence of blood leaking into the soft tissues. The color may change from purple - yellow as the blood breaks down. You can expect that it will disappear within a week or so. 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 ice pack. If possible, an elevated headrest (an extra pillow) should be used during the first two nights after your surgery, to reduce swelling in the surgical area. 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. (1 teaspoon of salt in 8 ounces of warm water, rinsing gently for 30 seconds 3x a day). Flying too soon after surgery is associated with greater risks of swelling and post-operative complications. An increase in swelling and throbbing has also been noted with intense physical activity.

Bleeding

Do not be concerned if traces of blood are noted in the saliva for several hours after the procedure. Do not rinse too vigorously for the first two days as disruption of the clot may occur. We recommend covering your pillow with an old towel for the first two nights. It is best to avoid hot foods or fluids until the second day following surgery. If continuous, excessive bleeding occurs, please contact the office.

Oral Hygiene

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 mouth wash. For the first 24 hours do not rinse. The prescribed mouthwash will prevent plaque from forming and you should use this rinse as often as you eat thus preventing debris from lodging around the sutures. Continue to use the mouth rinse until the sutures have been removed. Elsewhere throughout the mouth you can use a manual toothbrush and floss etc., taking great care not to overlap onto the surgical site. Do not use a power brush until indicated by the Doctor! Once the dressing has been removed, meticulous plaque control will be necessary to insure uneventful wound healing and prevent the development of root sensitivity.

Antibiotics

Antibiotics may be prescribed depending on the surgical procedure. It is important that these antibiotics be taken completely as directed.

Nutrition

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. Alcohol is fine in moderation. Do not drink while taking prescribe medications like narcotics and muscle relaxants. Below you will find a list of foods that do provide nourishment with little if any chewing necessary for swallowing. Do not chew gum. Do not use a straw.

Broths Soups Eggs Chopped or ground meat Yogurt Fish Pasta / Rice

Custards or puddings Smoothies/Protein Shakes Food supplement such as Ensure or Boost Ice Cream JELLO Protein smoothie

Tooth Sensitivity

Tooth sensitivity following surgery can be related to an inadequate level of plaque control. After the sutures have been removed you can begin using a soft toothbrush and interdental cleaning aides as directed by your doctor. Do not use an electric brush or other mechanical device until instructed. Individuals that have a tendency to grind their teeth should be aware that grinding or clenching following a surgical procedure, might also give rise to considerable discomfort. It is recommended following surgery to wear your night guard if you have one.

Healing

You will assist the healing response by observing the following procedures:

1. Avoid clenching and grinding
2. Avoid unnecessary muscle activity such as singing and excessive talking
3. Maintain meticulous oral hygiene
4. Refrain from smoking
5. Attempt to maintain a high protein & soft diet
6. Avoid vigorous exercise for the first week & get as much rest as possible
7. Avoid swimming and diving
8. Apply ice within the first 2 days
9. Use the prescribed mouthwash or warm salt rinses, beginning gently on the day after surgery. Rinse as often as you eat for 30 seconds. Continue regimen until your post-op appointment.

Questions or Concerns:

If you have any questions or concerns please do not hesitate to contact us:

Office Number: (206) 628-0404
Email: office@eperiodontist.com

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