IF YOU ARE HAVING A LIFE THREATENING EMERGENCY OF EXCESSIVE SWELLING, DIFFICULTY BREATHING AND/OR EXCESSIVE BLEEDING, CALL 911 IMMEDIATELY AND HAVE THEM TAKE YOU TO A HOSPITAL. DO NOT TRANSPORT YOURSELF. IT IS BEST NOT TO HAVE SOMEONE TRANSPORT YOU TO THE HOSPITAL IN CASE YOU GO INTO AN EXTREME EMERGENCY ON THE WAY TO THE HOSPITAL.

IF I HAVE SEEN YOU FOR ANY TREATMENT RESULTING IN ANY OF THE ABOVE PROBLEMS, CALL ME ASAP AND LET ME KNOW.

IF YOU ARE HAVING A NON-EMERGENCY PROBLEM OF ANY OF THE ABOVE CONDITIONS, PLEASE CALL THE OFFICE. IF WE ARE NOT THERE, PLEASE CALL MY EMERGENCY PAGER NUMBER (650) 430-0186.

GENERAL INFORMATION
Pain (or “Discomfort” as we like to call it)

Pain is normally due to pressure. The majority of pain treatment is to reduce the cause of the pressure. Most of the time, infection is the cause of the pressure. Inflammation inside the tooth puts pressure on the nerve creating a toothache. The best form of pain management is an anti-inflammatory (ie: Advil/Mortin). If you are not able to take an anti-inflammatory due to an allergic, heart and/or bleeding condition, then take acetaminophen (Tylenol) instead. An antibiotic is also recommended IF an infection is present. Narcotic pain relief is usually indicated post-surgery.
Pain Management

It is best to take the type of pain medication and the amount that best manages your pain level. For mild to moderate pain due to inflammation or infection, an anti-inflammatory is best. For moderate to severe pain due to extensive swelling and/or surgery, a combination of an anti-inflammatory and a narcotic is best. The rule of thumb on how much narcotic you need to take is if you feel ‘high’ or getting nauseous, you are taking too much narcotic. Reduce the dose or stop all together.

Swelling

Swelling may occur due to inflammation, excessive bleeding and/or an infection. Trauma is best reduced with a cold compress and an anti-inflammatory. Excessive bleeding is usually stopped with firm pressure to the area. Sometimes a suture is needed to help control the bleeding. An infection is best reduced with an antibiotic and possible a warm compress. The warm compress usually brings the infection ‘to a head’ so that it will be able to drain. Sometimes the area will start to drain on its own. Other times drainage need to be initiated by the doctor. Swelling is not to be taken lightly. The doctor must be informed of any sudden change in the swelling.

Instructions for patients after Periodontal Surgery

Bleeding:

Some slight bleeding may occur for the first four to five hours after the operation. This is not unusual. If bleeding continues, apply firm pressure for 20 minutes with a piece of gauze or a damp tea bag. Repeat if necessary. Under no condition should rinsing be used to stop the bleeding. If the bleeding persists, please call.

Discomfort:

Some discomfort and pain is to be expected when the anesthesia wears off. If you have been given a prescription or medication for pain, please take it as directed on the container. Some root sensitivity is to be expected.

Dressing:

Some material may have been placed around your teeth. This is a surgical dressing, or packing and acts as a bandage. It will become hard in about 2 hours. Do not drink anything warm in this period. During the week following the surgery, the periodontal dressing, or part of it, may fall out. We would like the dressing to remain in place for about 24 to 48 hours. If it falls out sooner or causes great discomfort, please call.

Swelling:

In some cases, swelling is to be expected. You should use ice packs on the outside of your face, 15 minutes on – 15 minutes off, for the next four hours after surgery, in order to limit the swelling. Infection occasionally occurs following surgery. The signs and symptoms of infection may include a few or all of the following: swelling days after the surgery, fever, pain, exudate, and/or difficulty on opening the jaw or swallowing. If you feel you are developing an infection or abnormal swelling, please call.

Home Care:

Optimal oral hygiene is VERY IMPORTANT during the healing phase. If a surgical dressing was placed, brush the tops of the teeth over the dressing. If no dressing was placed, gently use a soft brush over the treated areas. Try and remove the plaque and debris as best as possible. Follow the instructions given by the doctor. Brush your tongue for additional comfort. Rinsing with a mouthwash or warm salt water, beginning the second day, often decreases any bad taste or odor during the first week or two and helps make the mouth feel fresher.

Eating:

Nutrition is important following surgery. Attempt to follow your regular diet. You may wish to eat soft foods for the first couple of days. Avoid hard, sharp foods, such as chips, french bread, rolls and spicy foods. Fluids are necessary for your health so be sure to drink plenty of liquids.

Smoking:

AVOID SMOKING. Smoking may delay healing.

Emergency Numbers:

Please try to contact the doctors at the office first. Dr. Stephen John (650) 430-0186 Pager