Post-operative Instructions

The following post-operative instructions apply to specific surgical procedures. They are provided to assist your post-surgical experience and inform you of situations that may require special attention.

For your convenience, we have made the post operative instructions specific for each of the surgical procedure available in a PDF format that can be downloaded.

POST OPERATIVE INSTRUCTIONS FOLLOWING PERIODONTAL SURGERY

    1. Following periodontal surgery, you are likely to experience discomfort as the local anesthetic wears off. Please take the pain relief medication as prescribed.
    2. Immediately following your operation, you should apply an ice pack to the surgical side of your face at 20 minute intervals for the first 72 hours. An ice pack will be provided at the end of your surgery.
    3. Abstaining from smoking for 6 weeks following surgery will dramatically improve healing, post operative convalescence and improve your surgical result. Smoking exerts profound negative effects on tooth survivability!
    4. Please limit yourself to a soft diet initially and avoid hot foods.  As healing progresses, you may then eat any non irritating foods.
    5. For a few hours after you leave the office, you may notice that your saliva is slightly pink in color. This is normal.  Should significant bleeding occur:
      • Do not rinse your mouth
      • Apply pressure at the site with a moist gauze
      • Apply an ice pack
      • Limit activity. Excessive exertion of any type is to be avoided.
    6.   The day of surgery please avoid:
      • Smoking
      • Sucking on the area
      • Excessively hot drinks (room temperature)
      • Alcohol for 48 hours
      • Do not use a straw (suction) as this may stimulate bleeding.
    7. The periodontal dressing, if placed, should not be disturbed. If the dressing falls off after the first 24 hours this is not a cause for concern. Simply continue with the post operative protocol as recommended.
    8. You may gently brush the surgical site. The roots of the teeth were uncovered during surgery. You may experience temporary sensitivity to hot and cold, to tooth brushing and to certain foods.  Should these symptoms develop, please notify our office so that and a desensitizing treatment can be arranged and/or desensitizing medications prescribed. Once the sutures are removed, it is essential to keep the surgical site clean. Bacterial plaque if allowed to remain on your teeth and gums will increase your sensitivity and the risk of developing infection. Failure to adhere to the recommended oral hygiene regime may cause your sensitivity to worsen rather than improve.
    9. If a Chlorhexidine rinse (Peridex®) has been prescribed, rinse or swab the surgical site 3 times daily in the morning, midday and evening for 6 weeks following surgery.
    10. The teeth in the area of the surgery may seem looser initially. Once complete healing is achieved, mobility should return to pre-surgical levels. Try to ignore the feeling of looseness and avoid developing the habit of moving the loose teeth with your tongue, fingers or gritting or grinding your teeth.  It is possible to cause further loosening of your teeth with such habits.

**PATIENTS ARE ADVISED NOT TO OPERATE A MOTOR VEHICLE OR MACHINERY FOR 24 HOURS FOLLOWING ANY PROCEDURE WHERE SEDATION HAS BEEN EMPLOYED**

Should any issues or concerns arise, please call the office.  Irrespective of the hour, do not hesitate to contact Dr. Novack and advise him of your concern. After hours you may contact Dr. Novack at:

Text Dr. Novack at (416) 230-4617

Home (416) 510-2208

Email Dr. Novack at drnovack @rogers.com

Alternately you can call the Dental Emergency Service at (416) 485-7121

POST OPERATIVE INSTRUCTIONS FOLLOWING GUM GRAFT SURGERY

  1. Following periodontal surgery, you are likely to experience discomfort as the local anesthetic wears off. Please take the pain relief medication as prescribed.
  2. Immediately following your operation, you should apply an ice pack to the surgical side of your face at 20 minute intervals for the first 72 hours. An ice pack will be provided at the end of your surgery.
  3. Abstaining from smoking for 6 weeks following surgery will dramatically improve healing, post operative convalescence and smoking exerts profound negative effects on graft survivability!
  4. Please limit yourself to a soft diet initially and avoid hot foods.  As healing progresses, you may then eat any non irritating foods.
  5. For a few hours after you leave the office, you may notice that your saliva is slightly pink in color. This is normal.  Should significant bleeding occur:
    • Do not rinse your mouth
    • Apply pressure at the site with a moist gauze
    • Apply an ice pack
    • Limit activity. Excessive exertion of any type is to be avoided.
  6. The day of surgery please avoid:
    • Smoking
    • Sucking on the area
    • Excessively hot drinks (room temperature)
    • Alcohol for 48 hours
    • Do not use a straw (suction) as this may stimulate bleeding.
  7. The periodontal dressing, if placed, should not be disturbed.  If the dressing falls off, after the first 24 hours, this is not a cause for concern. Simply continue with the postoperative protocol as recommended.
  8. If a Chlorhexidine rinse (Peridex®) was prescribed, rinse for a 3 full minutes pre-operatively. Post-operatively, rinsing should be avoided initially as it may cause bleeding. Instead, simply swab the surgical site with Peridex® 3 times daily in the morning, midday and evening for 6 weeks following surgery.
  9. Do not brush or disturb the graft sites until the sutures are removed. At that time, Dr. Novack and his staff will instruct you on the appropriate techniques to optimize healing.
  10. The teeth in the area of the surgery may seem looser initially. Once healing is complete, mobility should return to pre-surgical levels. Try to ignore the feeling of looseness and avoid developing the habit of moving the loose teeth with your tongue or fingers or of gritting or grinding your teeth.  It is possible to cause further loosening of your teeth with such habits.
  11. Exercise places a strain on our body. To foster optimum healing, avoid all exercise for the first 2 weeks following surgery. Thereafter, strenuous exercise ideally should be avoided for 6 weeks following surgery.

The roots of your teeth were uncovered during surgery. You may experience temporary sensitivity to hot and cold, to tooth brushing and to certain foods. Should these symptoms develop, please notify our office so that a desensitizing treatment can be arranged and/or desensitizing medications prescribed. Once the sutures are removed, it is essential to keep the exposed root areas absolutely clean. Bacterial plaque if allowed to remain on your teeth and gums will increase your sensitivity and risk the development of infection. Failure to adhere to the recommended oral hygiene regime may cause your sensitivity to worsen, rather than improve.

**PATIENTS ARE ADVISED NOT TO OPERATE A MOTOR VEHICLE OR MACHINERY FOR 24 HOURS FOLLOWING ANY PROCEDURE WHERE SEDATION HAS BEEN EMPLOYED**

Should any issues or concerns arise, please call the office.  Irrespective of the hour, do not hesitate to contact Dr. Novack and advise him of your concern. After hours you may contact Dr. Novack at;

Home (416) 510-2208

Text Dr. Novack at (416) 230-4617

Email Dr. Novack at drnovack @rogers.com

Alternately you can call the dental emergency service (416) 485-7121 

POST OPERATIVE INSTRUCTIONS FOLLOWING IMPLANT SURGERY

  1. Following implant surgery, you are likely to experience discomfort as the local anesthetic wears off. Antibiotics and pain relief medication have been prescribed. PLEASE TAKE AS DIRECTED.
  2. Immediately following your operation, you should apply an ice pack to the surgical side of your face at 20-minute intervals for the first 72 hours. An ice pack will be provided at the completion of your surgery.
  3. Please limit yourself to a soft diet initially and avoid hot foods.  As healing progresses, you may then eat any non irritating foods.
  4. Abstaining from smoking for 6 weeks following surgery will dramatically improve healing, post operative convalescence and smoking exerts profound negative effects on implant survivability!
  5. Please limit yourself to a soft diet initially and avoid hot foods.  As healing progresses, you may then eat any non irritating foods.
  6. For a few hours after you leave the office, you may notice that your saliva is slightly pink in color. This is normal.  Should significant bleeding occur:
    • Do not rinse your mouth
    • Apply pressure at the site with a moist gauze
    • Apply an ice pack
    • Limit activity. Excessive exertion of any type is to be avoided.
  7. The day of surgery please avoid:
    • Smoking
    • Sucking on the area
    • Excessively hot drinks (room temperature)
    • Alcohol for 48 hours
    • Do not use a straw (suction) as this may stimulate bleeding.
  8. You may gently brush the surgical site.
  9. A Chlorhexidine rinse (Peridex®) has been prescribed. Rinse or swab the surgical site daily in the morning, midday and evening for the 6 weeks following surgery.
  10. The teeth in the area surrounding the surgery may seem looser initially. Once healing is complete, mobility should return to pre-surgical levels. Try to ignore the feeling of looseness and do not develop the habit of moving the loose teeth with your tongue, fingers or gritting or grinding your teeth.  It is possible to cause further loosening of your teeth with such habits.

**PATIENTS ARE ADVISED NOT TO OPERATE A MOTOR VEHICLE OR MACHINERY FOR 24 HOURS FOLLOWING ANY PROCEDURE WHERE SEDATION HAS BEEN EMPLOYED **

Should any issues or concerns arise, please call the office.  Irrespective of the hour, do not hesitate to contact Dr. Novack and advise him of your concern. After hours you may contact Dr. Novack at;

Home (416) 510-2208

Text Dr. Novack at (416) 230-4617

Email Dr. Novack at [email protected]

Alternately you can call the dental emergency service (416) 485-7121

Pain Medications

Some measure of discomfort is to be anticipated for at least the first week following surgery. Dr. Novack will prescribe appropriate medication to ease your post-surgical recovery period. Please take the medication prescribed as directed. It is best not to take pain medication with food. Nausea may develop if pain medication is taken on an empty stomach.

Note: When taking any prescribed medication containing acetaminophen (i.e. Tylenol, Tylenol with Codeine or Percocet), do not take additional Tylenol because of the risk of exceeding safe levels. Please contact the office should you have any questions.

Antibiotics

If an antibiotic has been prescribed, remember to take the antibiotic as directed until completed. Please alert the office should you develop sensitivity. It is generally recommended not to take antibiotics on an empty stomach, as nausea may develop. If antibiotics are prescribed for your planned surgery, please consult with the office regarding the timing of taking the antibiotics and other prescribed medications.

For women currently taking birth control pills, be advised that antibiotics can interfere with the effectiveness of oral contraceptive medication. It is recommended that you consider other contraceptive options for the following month.

Swelling

Swelling represents a normal physiologic response following any surgical procedure and will typically increase for 2-3 days following the procedure. To minimize swelling, an ice pack will be provided at the completion of your surgical procedure. Place the ice pack over the outside surgical cheek area 20 minutes on and 20 minutes off. Continue applying ice packs for the first 3 days following the procedure as regularly as possible. When resting or at bedtime, it is helpful to keep your head elevated with the use of 2-3 pillows to help reduce potential swelling.

Bleeding

A small amount of bleeding is entirely normal following surgery. To minimize bleeding;

– Do not rinse your mouth.

– Keep your head elevated when lying down (2-3 pillows).

– Should bleeding persist, apply moistened gauze or a moistened tea bag to the surgical site with constant moderate pressure for 30 minutes.

– Don’t hesitate to call the office should any concerns develop. After hours, text Dr. Novack‘s emergency number or emergency email address should bleeding issues or other concerns arise. 

Dressing – Periodontal Pack

In certain instances, a periodontal pack (dressing) may be placed to better control the position of the gum tissue to optimize your surgical result. In addition, the dressing can act as a bandage to protect the surgical site in the hours immediately following surgery. Beyond the first 24 hours following surgery, should the dressing-periodontal pack fall off, this is not a cause for concern. Simply continue with the postoperative protocol as recommended.

Diet – Nutrition

Until comfortable, try to limit chewing on the side where surgery was performed. Should a periodontal pack be used, avoid hot foods and liquids for approximately 1 hour following surgery to not soften the dressing. A soft diet is recommended initially. Please refer to our Periodontal Health Through Nutrition Form which provides valuable information on food group choices and how best to improve healing through nutrition. Remember, optimum nutrition is essential to promote healing.

Smoking

There exists irrefutable evidence that smoking will negatively impact healing following periodontal surgery. Smoking results in slower rates of healing, increased pain and increased risk of infection. The effect of smoking negatively impacts on healing and has been shown to compromise the surgical result. Smoking should be avoided especially during the critical 6 weeks following surgery.

Alcohol

Do not consume alcohol while taking prescription pain medications. Alcohol has a prejudicial effect on our healing response. It is recommended to refrain from the consumption of alcohol for the first two weeks following surgery.

Rinsing

A chlorhexidine mouth rinse (Peridex®) will be prescribed to reduce oral bacteria levels and the risk infection. Rinse for a full 3 minutes pre operatively. Immediately following surgery, to reduce the potential for bleeding from the surgical site, avoid rinsing. Instead, simply swab the surgical site 3 times daily in the morning, midday and evening. Dr. Novack will advise when it would be appropriate to discontinue the use of the chlorhexidine mouth rinse.

Brushing

Do not brush the surgical site until the sutures have been removed or alternatively, only when instructed by Dr. Novack. We encourage you to continue normal brushing and flossing in other areas following surgery. Remember, a clean mouth will heal more rapidly, with reduced pain and achieve an improved surgical treatment result.

Sensitivity and Suture Removal

You may notice a slight increase in sensitivity in the tissues surrounding the sutures approximately 10 days following surgery. As the tissues heal, a process called wound contraction occurs causing the tissues to pull against the sutures. This is entirely normal and not a cause for concern.  It is advisable that you take ibuprofen (Motrin® or Advil®) or acetaminophen (Tylenol®) one hour prior to your suture removal appointment to minimize tenderness. If you are a patient for whom Antibiotic Pre-Medication is required, take the prescribed antibiotics 1 hour prior to your suture removal appointment.

Given the specifics of each surgery coupled with a patient’s unique response, feel free to discuss any element of these Post Operative Instructions directly with Dr. Novack.