Post-Op Care

For the best treatment outcome please follow the pre-surgical instructions. Please read all of the post surgical instructions that pertain to your procedure. Our team members are available to answer any specific questions or concerns.

PRESURGICAL INSTRUCTIONS

Please read the following instructions carefully to prevent complications and to ensure the best outcome 

  1. Please maintain your excellent level of oral hygiene, both prior to and after surgery.
  1. On the day of surgery take your daily-prescribed medications, unless specifically instructed not to.
  1. BLOOD THINNERS: Please consult Dr. Roberts for instructions regarding prescribed blood thinners, such as Aspirin, Coumadin, or Plavex.  One week prior to surgery avoid anti-inflammatories:  Ibuprofen (Advil), Naprosyn, (Aleve), Aspirin (Anacin). Avoid Vitamins: A, E, Niacin, Fish Oils and Ginko-biloba. These medications can cause excessive bleeding, swelling, and bruising. Tylenol is OK.
  1. If you are diabetic you may need to reduce your insulin the day of surgery. Please consult Dr. Roberts for specific instructions.
  1. If you are not having sedation, we recommend a light meal prior to surgery.
  1. Inform Dr. Roberts if you suspect you clench your teeth. Clenching irritates nerves, causing increased pain on the third day following surgery.  Muscle relaxers may be needed in addition to pain medication to reduce pain from clenching.

 

IF YOU ARE HAVING SEDATION

  1. You will need an adult companion to drive you home and stay with you a few hours until the sedation wears off. NO cab, Uber or Lyft can take you home!
  1. To avoid nausea, do not have anything to eat four hours prior to surgery. You may drink clear liquids up to 2 hours prior to surgery.  Hydrate with water day prior to surgery.
  1. Do not wear contact lenses during the surgery. Sedatives can make your eyes dry.
  1. Avoid Diuretics (eg. water pills, HCTZ) the day of surgery. This will minimize the urge for bathroom breaks.
  1. Please wear short-sleeved We will have warm blankets available to keep you warm during your procedure.

 

FOLLOWING SURGERY:

  1. Most people use pain medication the first day but often report they did not need any more after 24 hours. For several weeks following surgery, teeth may be sensitive to cold and gums may be tender when eating or brushing.  Swelling and/or bruising can occur.  Take the pain medications recommended by Dr. Roberts
  1. For the first day we recommend that your diet consist of cold and soft foods. The next day you may eat whatever is comfortable, but most patients stay on a semi-soft, bland diet for at least a few days.
  1. Some of our patients have found that the homeopathic remedy Arnica SinEcch & Arnica Cream has been beneficial in minimizing bruising and swelling.  Starting the day prior to surgery, please take the SinEcch as directed on the dose pack dispensed at your pre-op appointment.
  1. Because our main concern is your personal comfort, we invite you to tell any of our team members if there is something special we can do to make your experience more pleasant.

Gingival Graft Postoperative Instructions

Please read the following instructions carefully.

They will help you to heal quickly & prevent complications.

Activity should be kept to a minimum during the first 48 hours.  Strenuous physical activity may increase swelling.  Minimize talking and facial expressions that pull lips and cheeks.

Ice packs should be placed on the face, adjacent to the surgical site during the first 24 hours (15 min. on, 15 min. off) will help to minimize swelling. Ice chips or iced beverages held in the mouth will also help.  Some swelling is normal and tends to peak on the 3rd day, subsiding over the next few days.

Bleeding or oozing will occur during the first 24 hours (protect your favorite pillow with an old towel).  Persistent bleeding is usually associated with unwanted “liver” clots.  These are sticky, grape jelly looking clots that cover the teeth or wound and should be wiped away with a tissue or wash cloth before applying firm pressure (a moist tea bag works great).

Heavy bleeding is not common but can occur, most often from the palate. Avoid vigorous rinsing, spitting, and the use of a straw in the first 5-6 days.   You may find the week following surgery was uneventful then suddenly the palate erupts like a nose bleed, filling the mouth with blood.  But just like the nose bleed, this frightening event can be handled with direct pressure.   Rinse your mouth with cold water then, use your thumb to firmly press a wash cloth or tea bag against the bleeding site for at least 10 minutes.  Stay calm.  Bleeding will stop sooner if your heart rate is slower.

Medications should be taken as directed.  Call the office if your discomfort is much worse than you anticipated.

Discomfort should improve after the first 12-24 hours.  Pain that starts on day 3 or during the night is a common sign of clenching or grinding.  These are destructive habits that can cause severe pain by irritating nerves in the wound area.  The whole jaw, side of face, even the ear may ache.  Wear your night guard if you have one.  Sleep on your back to reduce your tendency to clench.  During the day focus on keeping your teeth apart by positioning tongue tip on the palate behind the front teeth so the lower jaw drops slightly.  Take an anti-inflammatory such as Aleve or Advil.  If pain persists, call the office.  You may require a prescription for a muscle relaxer.

Bruising may occur a few days following surgery and can take 7-10 days to fade away.  Use ice during the first 24 hours following surgery. Use the homeopathic remedy Arnica SinEcch that was dispensed to you as directed on the dose pack.  Have some fun and make up a good story about how you got the bruise.

Eat what feels comfortable.  During the first day cold food will help to reduce bleeding, warm food is alright but hot food or beverages will dilate blood vessels so avoid them.  Foods to consider: smoothies or milk shakes (no straw), yogurt, eggs, pastas, mashed potatoes, warm chicken soup, and plenty of liquids.  Stay away from small seeds and acidic foods.

Palatal Numbness may occur along the donor site on the palate.  Normal sensation usually returns in a few weeks or months. Occasionally patients describe a small patch of gum on the palate that feels “shiny” or altered for longer than a year.  This will not impact function or speech.

Palatal stent is the thin plastic cover provided to minimize bleeding by compressing the donor site.  It also protects the palate during eating, and it prevents your tongue from playing with the palatal sutures.  For best healing, wear the stent during the first 5 days, (longer if you would like).  The palate heals faster with it in. Remember the stent is for your comfort so if it becomes uncomfortable or annoying, it may be removed and the palate will still heal.  Remove and clean your stent frequently.

Oral Hygiene is initially accomplished using the ultra soft tooth brush, taking care to avoid touching the grafts during the first 10 days.  Use the Chlorhexidine mouth rinse twice daily by dabbing the surgical sites with a cotton swab or rinsing with a small cap full for 60 seconds.  Brush and floss the uninvolved teeth.  Ask your surgical nurse before resuming electric brushing.

Smoking retards wound healing and reduces tissue coverage over roots.  Avoid smoking for at least 6 weeks.  If quitting is out of the question, limit yourself to less than ½ a pack per day.

Sutures on the palate and around some of the teeth are dissolvable so they will fall out between days 3-7.  The tiny sutures around the graft are usually not dissolvable so they will be removed at your follow up visit.  These sutures are often looped around the teeth so you may feel them with your tongue.

 

To reach Dr. Roberts after hours call (760) 815-7386.

IMPLANT POSTOPERATIVE INSTRUCTIONS

Please read the following instructions carefully.

They will help you to heal quickly & prevent complications.

Activity:  Reduce your activity immediately after surgery, but resume as soon as you feel back to normal. Most patients can resume high impact activity within 2-3 days post surgery.

Healing:  To ensure a successful result, implants require 2-3 months for bone to grow strong against the implant surface.  During this critical time, it is important that the implant is not moved, wiggled, pressed on, or chewed on.  (Healing principles are similar to a broken leg requiring the stabilization of a cast.)  Avoid chewing over the implants.  Avoid clenching, which may flex the jaw- bone away from an implant.  If there is a history of clenching a muscle relaxer maybe prescribed.

Temporary Replacement Teeth:  Wear your provisional as directed.  Avoid putting pressure on the implant. Remove your provisional frequently in order to clean away plaque and food debris.  Acrylic provisionals may be soaked weekly for 10 minutes in distilled white vinegar to dissolve calcium deposits. 

Cleaning the mouth:  Surgical areas should be brushed gently at first, using the ultra soft brush provided.  More aggressive brushing can resume in 10-14 days after surgery.  If you were given a prescription mouth rinse, use a cotton swab to wipe the implant and surrounding areas.  Avoid peroxide and over the counter mouth rinses during the first 2 weeks, they may dissolve blood clots and rinse away bone graft material.  Brush and floss normally all areas not involved in surgery.

Discomfort:  Following all types of surgery you can expect some discomfort.  Over the counter anti-inflammatories like Advil, Motrin, Ibuprofen, and Aleve tend to work the best and can be taken in conjunction with prescribed pain medication.  Consider taking pain medication with milk or other food to help prevent nausea.  If nausea develops, reduce or eliminate the pain medication and try to eat a small portion of mild food such as yogurt. 

Fever beginning the second or third day after surgery may indicate infection.  Call the office immediately for instructions @ 760-944-7844

Swelling:  Although uncommon, some individuals experience swelling and bruising that may last 5-10 days.  To minimize your risk of swelling immediately after surgery, apply the ice pack to your face, 15 minutes on and 15 minutes off for 24 hours.    Cold packs are most beneficial during the first 24 hours after surgery.

Numbness:  Local anesthetic wears off in 1-4 hours.  Numbness or tingling around the lower lip that occurs beyond 12 hours should be reported to Dr. Roberts immediately.

Bleeding:  There will often be a small amount of bleeding after surgery.  The cold water and/or ice pack will minimize bleeding.  Avoid smoking, spitting, vigorous rinsing, or sucking actions. Also avoid alcohol or peroxide mouth washes, they dissolve blood clots.

Eating:  Eat only cold or room temperature soft foods the day of surgery.  After the first day, eat whatever is comfortable; stay on a soft, but balanced diet.  Avoid hard or chewy foods, especially popcorn and anything with small seeds.  Recommended supplements: Vitamins C, B complex, & E, Coenzyme Q10, and Calcium.

Antibiotics: Take antibiotics as directed until they are ALL GONE.  If you have an adverse reaction such as itching, nausea, or excessive diarrhea, discontinue the antibiotics and call the office.

Smoking retards wound healing and reduces bone formation in the extraction socket.  Avoid smoking for at least 6 weeks.  If quitting is out of the question, limit yourself to less than ½ pack per day.

 

Telephone:  Office (760) 944-7844 or Dr. Robert’s Cell Phone (760) 815-7386

Post-Op Instructions After LANAP 

The First 7 Days After Treatment: Do not disturb the gum line! 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”.

*Use the Ultra-Soft toothbrush provided to brush the teeth only. AVOID the gum line!

*Rinse with Chlorhexidine.

*Take any prescribed medication according to directions.

* Eat foods with a “mushy” consistency.

“Mushy” Diet Suggestions

  • Anything put through a food blender
  • Cream of Wheat, Oatmeal, Malt-O-Meal
  • Mashed Avocado, Applesauce
  • Mashed Potatoes or Baked Potatoes- OK with butter/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 NUTS
  • Eggs any style with cheese and avocado
  • Jell-O, Pudding, Ice Cream, Popsicles
  • Milk Shake/ Smoothies- DO NOT blend with berries containing seeds
  • Ensure, Slim Fast, Nutritional Drinks

 

7-14 Days After Treatment:

* Soft foods can be introduced such as Pasta, Fish, Diced Chicken or Steamed Vegetables.

*Use the Ultra-Soft toothbrush provided to brush the teeth only. AVOID the gum-line!

*Rinse with Chlorhexidine

 

For 6 Weeks AVOID: SMOKING, Chewing Gum, Candy, Cookies, Chips, Nuts, anything hard or crunchy, anything that has seeds or hard pieces, Meat that shreds and can lodge under the gum and between teeth, raw vegetables or salad

Week 6 Resume Flossing or Inter-proximal brushes

Week 8 Resume Electric Toothbrush

Week 12 Resume Water-Pik

 

Reach Dr. Roberts after hours at (760) 815-7386

Periodontal Surgery Postoperative Instructions

Please read the following instructions carefully.

They will help you to heal quickly & prevent complications.

Activity:  Reduce your activity immediately after surgery, but resume as soon as you feel back to normal. Most patients can resume high impact activity within 2-3 days post surgery.

Cleaning the mouth:  Surgical areas should be brushed gently at first, using the ultra-soft brush provided.  More aggressive brushing can resume in 10-14 days after surgery.  If you were given a prescription mouth rinse, apply as directed.  Avoid peroxide and over the counter mouth rinses during the first 2 weeks, they may dissolve blood clots and rinse away bone graft material.  Brush and floss normally all areas not involved in surgery.  If periodontal packing was placed, gently brush around the dressing.

Discomfort:  Following all types of surgery you can expect some discomfort.  Over the counter anti-inflammatories like Advil, Aleve, Ibuprofen and Motrin tend to work the best and can be taken in conjunction with prescribed pain medication.  Consider taking pain medication with milk or other food to help prevent nausea.  If nausea develops, reduce or eliminate the pain medication and try to eat a small portion of mild food such as yogurt.

Ice packs should be placed on the face, adjacent to the surgical site during the first 24 hours (15 min. on, 15 min. off) will help to minimize swelling. Ice chips or iced beverages held in the mouth will also help.  Some swelling is normal and tends to peak on the 3rd day, subsiding over the next few days.

Bleeding:  There will often be a small amount of bleeding after surgery.  The cold water and/or ice pack will minimize bleeding.  Avoid smoking, spitting, vigorous rinsing, or sucking actions. Also avoid alcohol or peroxide mouth washes, they dissolve blood clots.  Heavy bleeding:  1. Rinse with cold water 2. Look for and wipe away any dark blood clots from the surface of teeth or gums. 3. Apply firm pressure for at least 10 min. using a cold moist wash cloth   4. If bleeding continues, call the office.

Fever beginning the second or third day after surgery may indicate infection.  Call the office immediately for instructions @ 760-944-7844. 

Eating:  Eat only cold or room temperature soft foods the day of surgery.  After the first day, eat whatever is comfortable; stay on a soft, but balanced diet.  Avoid hard or chewy foods, especially popcorn and anything with small seeds. Recommended supplements: Vitamin B complex, C, E, Coenzyme Q10, and Calcium.

Dressing:  Dressing (putty like material) is occasionally used to protect the surgery site during the first few days of healing.  Some or all of this material may dislodge prior to your 1st follow-up appointment.  There is no need for alarm, this will allow you access to begin gently brushing the surgical site.

Antibiotics:  If antibiotics are prescribed, take them as directed until they are ALLGONE.  If you have an adverse reaction such as itching, nausea, or excessive diarrhea, discontinue the antibiotics and call the office.

Smoking:  Please do NOT smoke during the 1st month following periodontal surgery.  Nicotine constricts blood vessels, compromises the immune system, and is an irritant to healing tissue. Any reduction in smoking will improve healing.

Telephone:  Office (760) 944-7844 or Dr. Roberts Cell Phone (760) 815-7386

PINHOLE SURGICAL TECHNIQUE POSTOPERATIVE INSTRUCTIONS

For Ideal Results Adhere to the Following Instructions.  Any pressure on the treated gum during the first 3 weeks, firm food or brushing, will cause gum shrinkage and root exposure.

Home Care Instructions:  Brush the teeth that were treated with the ultra-soft tooth brush provided for 3 weeks only on the tooth surfaces avoiding the gums.  Use the Chlorhexidine mouth rinse twice daily by gently soaking the surgical site with a cap full for 30 seconds.  Continue to brush the remaining teeth that were not treated with a regular soft tooth brush. Avoid vigorous rinsing, flossing, oil pulling, waterpick or electric toothbrush in the entire mouth for 3 weeks.  Avoid a waterpick and electric toothbrush on the treated site for 6 weeks.

Diet:  Eat soft foods for the first 3 weeks. Cold soft foods the first day will help to reduce bleeding. Foods that are recommended: soft pasta, soft rice, soft steamed veggies, soft boiled chicken, eggs, Avocado, mashed potatoes, sweet baked potatoes, and soups.  For the next 3 weeks AVOID foods that contain seeds such as raspberries, strawberries as well as popcorn, nuts, and anything hard and chewy. Chew on the untreated side of your mouth.

Activity:  Activity should be kept to a minimum during the first 4 days. Strenuous physical activity may increase swelling. Minimize talking and facial expressions that pull the lips and cheeks. Try avoiding pulling on your lip to look. Pulling on the surgical site can hinder healing.

Swelling:  Ice packs should be placed on the face, adjacent to the surgical site during the first 24 hours (15 min. on, 15 min. off) will help minimize swelling. Ice chips or iced beverages held in the mouth will also help.  Some swelling is normal and tends to peak the 3rd day, subsiding over the next few days.

It is typical for your face to feel very full or stretched tight during the first 10 days adjacent to the surgical site. Appling a damp warm wash cloth on the face adjacent to the surgical site a few times a

day 48-hours post-surgery will help the healing process.

Bruising:  Bruising may occur a few days following surgery and can take 7-10 days to fade away.  Arnica may help to reduce bruising and swelling.

Bleeding:  Bleeding or oozing will occur during the first 24 hours (protect your favorite pillow with an old towel).

Medications:  Take as directed.

Discomfort:  Pain should improve after the first 12-24 hours. Pain that starts on day 3 or during the night is a common sign of clenching or grinding. These are destructive habits that can cause severe pain by irritating nerves in the wound area. The whole jaw, side of face, even the ear may ache. A nightguard or a muscle relaxer may be needed to minimize pain from clenching.  Call the office if you experience these symptoms.

Smoking: Avoid smoking for 6 weeks.  Smoking prolongs wound healing and reduces coverage over the roots.

Sutures:  There may or may not be sutures placed in the surgical site.  If so the sutures will be removed at your follow-up visit.  Try not to move the sutures with your tongue.

To reach Dr. Roberts after hours call 760-815-7386.

ROOT PLANING POSTOPERATIVE INSTRUCTIONS

Please read the following instructions carefully.

They will help you to heal quickly & prevent complications.

Discomfort:  Gums may feel tender and bruised for a few days following root planing.  Over the counter pain medication is usually sufficient.  Teeth may become sensitive to cold.  Cold sensitivity is reduced by good oral hygiene.  If sensitivity persists longer than 2 weeks we can prescribe a desensitizing tooth paste or concentrated fluoride.

Oral Hygiene:  Good oral hygiene is especially important for optimal healing during the 4 weeks following root planing.  During the first two days, you may want to soften your tooth brush by running it under hot water.  Floss gently during the first week.  Avoid using a water pick during the first week to give the gum time to tightly seal to the teeth.  An electric brush can be used as soon as it is comfortable.

Eating:  To prevent biting tongue or lips, wait for numbness to wear off (1-4hrs) before eating.  Avoid foods with fibrous skins or hulls that can get stuck under the gum.  Eat a healthy diet.  Consider taking Vitamins B complex, C, and E, and Co-enzyme Q 10 to supplement your diet.

Medications:  If given prescriptions, take as directed.

Smoking retards wound healing and inhibits the immune system.  Avoid smoking for at least 6 weeks.  If quitting is out of the question, limit yourself to less than ½ pack per day.

Bleeding:  A small amount of bleeding or oozing is common during the first 24 hours.  If bleeding persists:  1. Rinse your mouth with cold water.  2. Wipe away any dark blood clots from the surface of the teeth or gums.  3.  Apply firm pressure for at least 10 min. using a cold moist wash cloth or tea bag.  4.  If bleeding continues, call the office @ 760-944-7844.

POST-OPERATIVE INSTRUCTIONS FOR SURGERY IN OR NEAR THE MAXILLARY SINUS

Medications:  Avoid infection by taking all antibiotics as directed.

Activity:  Activity should be kept to a minimum during the first 4 days. Strenuous physical activity may increase swelling.

Swelling:  During the first 24- hours (15 min. on, 15 min. off) application of ice packs on and off the face on the treated side as well as cold water in the mouth will constrict blood vessels and minimize swelling.  Arnica cream rubbed on the face may reduce swelling.  After 48-hours warm moist heat on the face and warm water in the mouth will dilate blood vessels which will help to move swelling out of the facial tissues.  Swelling will peak 2-4 days following the surgery.

Sinus Pressure:  Excessive sinus pressure may open the wound.  During the first 2 weeks AVOID forcefully spitting, sucking or nose blowing.  If you sneeze let it out DO NOT pinch your nose that could create back pressure into the sinus.

Diet:  Eat only soft foods for several days, chew on the untreated side of your mouth.

Bleeding:  Slight bleeding from the nose is not uncommon for several days after surgery.

Special Home Care Instructions During the first 2 weeks:  Allow the wound to heal undisturbed.  Only use the Ultra Soft Brush on the teeth adjacent to the wound.  Brush and floss the unaffected areas as normal.   Use only the mouth rinsed prescribed or given to you.  Gentle salt water rinses may also be used.  Avoid waterpick or vigorous rinsing of any kind.

Please keep our office advised if any changes occur in your condition, especially if drainage or pain increases.

 

To reach Dr. Roberts after hours call 760-815-7386.

TOOTH EXTRACTION POSTOPERATIVE INSTRUCTIONS

Please read the following instructions carefully.

They will help you to heal quickly & prevent complications.

Activity:  Reduce your activity immediately after surgery, but resume as soon as you feel back to normal. Most patients can resume high impact activity within 2-3 days post surgery.

Healing:  After a tooth is extracted the socket fills with a blood clot, the site slowly heals by a process of bone breakdown and build up.  During the next few months the extraction site will shrink and remodel, often resulting in a concavity in the ridge, termed ridge atrophy.

Rinsing:  Avoid any vigorous rinsing during the first 2 weeks to give the epithelium time to cover the extraction socket.

Dry Socket:  This is a severe bone ache that results if the blood clot or bone graft is rinsed out of the socket, exposing the unprotected bone.  Dry Sockets almost never occur in bone-grafted sockets because the graft protects the bone.

Eating:  During the first 24 hours, do not eat or drink anything too hot.  Heat dilates blood vessels resulting in more bruising and bleeding.  Drink cold beverages.  Foods to consider: smoothies or milk shakes, (no straw) yogurt, eggs, pastas, mashed potatoes, warm soup, and plenty of liquids.  Avoid eating on the extraction site.

Ice Packs placed gently externally over the extraction site during the first 24 hours (15 min. on, 15 min. off) will help to minimize swelling.  Ice chips or iced beverages help in the mouth as well.  Some swelling is normal and tends to peak on the third day.

Bleeding or oozing will occur during the first 24 hours (protect your favorite pillow with an old towel).  Persistent bleeding may require biting on a moist tea bag placed over the extraction socket.

Oral hygiene is initially accomplished using a soft toothbrush and gently brushing around the extraction site.  Avoid electric brushes or water picks for 2 weeks to allow the gum to heal over.

Smoking retards wound healing and reduces bone formation in the extraction socket.  Avoid smoking for at least 6 weeks.  If quitting is out of the question, limit yourself to less than ½ pack per day.

Sutures (if used) will dissolve in 3-7 days.  Loose strands can be snipped short or allowed to fall out on their own.

Discomfort tends to be mild and improves after 24 hours.  Pain that starts on day 3 or during the night is a common sign of clenching or grinding.  These are destructive habits that can cause severe pain by irritating nerves around the surrounding teeth.  If there is a history of clenching a muscle relaxer maybe prescribed.  The whole side of the face, even the ear may ache.

 

Inform the office if pain persists at (760) 944-7844 or Dr. Roberts cell phone 760-815-7386