Gum graft
post-operative instructions - Michael Edwards,DMD
Antibiotic If an antibiotic has been prescribed, start taking it the first day (unless directed
otherwise)and use to completion. You can reduce stomach upset by taking with food and/or
plenty of liquid.
Ibuprofen Unless you have a reason you can’t take ibuprofen (such as an allergy to ibuprofen
or aspirin,or a stomach ulcer), take 800mg of ibuprofen at a time, 3 times per day. Start the day
of the gum graft surgery, and take for the next 2 days. After that you can still take it as needed
or pain.
Do not use ibuprofen for more than one week.
Pain pills or ointment Take one pain pill as soon as you can after surgery. It will usually work
better if taken before the numbness wears off. After that, take only as needed. Take any
narcotic pain pills with food and/or plenty of liquid. Do not drive after taking any narcotic pain pill
and do not take them with sleeping pills or alcohol. Orabase with benzocaine can be dabbed on
the palate as a numbing ointment.
Ice bag Use a cold pack (a plastic bag of frozen peas works well) to the face over the area
where the procedure was done for 10 minutes at a time, twice an hour, for the first 6 hours. You
can periodically use an ice bag the rest of the day of surgery and the next day. If you use the ice
bag as directed, you should have less swelling than you would have otherwise. The less
swelling, the less pain. Do not use hot packs or a hot water bottle.
Sleep somewhat inclined For the first 2 nights after the procedure, sleep in a recliner chair or
with your head propped up with some pillows. A recliner is better. If you keep your head above
your heart level for the first 2 days, it will significantly cut down on post-op swelling. The less
swelling, the less pain.
Swelling Most people get some swelling and, if they do, it usually happens about 48-72 hours
after the surgery. Using the ice bag and sleeping inclined as directed above will help a great
deal with keeping it to a minimum.
Liquid in the brown jar is chlorhexidine (Peridex®), a topical antiseptic. Use a Q-tip to apply it.
The ear cleaning Q-tips work best, as they are very absorbent and hold a good size drop of
liquid. Apply about 3 times/day for 3 weeks to the surgical site by dabbing the soaked in
chlorhexidine Q-tip to the surgical area. Do not scrub it in. During the 1st 3 weeks, whenever you
do start any tooth brushing in the surgical site, dip the toothbrush in the chlorhexidine, as well. If
you run out, call us to pick up more. Once this liquid is applied, do not eat, drink or rinse out for
30 minutes.
Use a regular toothbrush in the non-surgical areas.
Oral hygiene Do not use a water-pik or an electric toothbrush around the graft area for 4 weeks
after the procedure. After that, it should be OK. Around the area of the graft, for the first 7 days,
do not brush,even with a hand held regular toothbrush. You can brush the areas not worked on.
After 7 days, a soft toothbrush gently used around the tooth/teeth where the graft was placed is
OK. Do not floss around the tooth/teeth worked on for 1 week, so you don’t accidentally take out
any of the stitches. After 2 weeks, there should be no oral hygiene restrictions, except for water-
piks & electric toothbrushes.
Stitches and glue The stitches around the tooth/teeth grafted usually last about 5-7 days. The
stitches are all dissolvable, meaning they will eventually fall out on their own. There is a glue
layer over the graft and stitches. Do not pick it off; it will fall off on it’s own. When something
around the graft site falls off (5-7 days) after the procedure and it is hard, it’s the glue, not the
graft.
Stent The protective stent (plastic covering) made for the roof of the mouth is for your comfort
only. It is recommended that you use it for at least the first 2 weeks if you feel comfortable with
it. It can be worn when drinking or eating soft foods, or all the time. Take it out when
brushing/cleaning your teeth and try to have it out when sleeping. The topical numbing ointment
(Orabase with benzocaine) should be applied to the palate side of the stent only if needed.
Brush it clean and run it under cold water a few times a day.
Salt-water rinses Rinse your mouth out (don’t swish) with warm salt water (1/2-tsp. salt in 8-
ounce glass of warm water). Hold this in the mouth for 30 seconds and spit out. Repeat. Do this
4-5 times per day for 7 days. Start day after the procedure.
Exercise Avoid strenuous exercise for the first 7 days. Strenuous physical activity may increase
postoperative pain or cause post-operative bleeding and swelling. Less activity equals less pain.
Touching the surgical site It is important that the surgical site remains undisturbed during the
initial stages of healing. We recommend that you avoid stretching your mouth to look at the site,
use caution when washing your face, and avoid playing with your tongue on the surgical sites.
Bleeding “Pink” saliva is normal for a few days. If you get any bleeding, the usual source is the
donor site (roof of the mouth). Many patients will have some. Wipe it clean of any “blood clots”
first. It has to be thoroughly cleaned first. Then apply gentle (it doesn’t need to be real hard)
pressure to the palate (roof of the mouth) for 10 straight minutes with a soaking wet tea bag
(black tea works the best), or a soaking wet gauze pad, or a clean washcloth, etc. Be sure it is
soaking wet. If it is not, the clot will stick to it and start bleeding again when you pull it away. If it
just won’t stop, call.
Food Stay on a soft diet, chew away from the grafted tooth/teeth and avoid any foods that
would be more likely to get stuck in the gum graft site, such as corn, popcorn, nuts, and seeds
(fruits like strawberries have seeds). Do this for up to 2 weeks. Citric juices, carbonated
beverages or acidic foods, like tomatoes, may make it hurt, but won’t damage the graft healing
though. For the first 7 days avoid really hot foods or drinks. Several glasses a day for the 1st
week or 2 of a nutritional food supplement (Carnation Instant Breakfast drink, Ensure, Slim-Fast,
etc.) is advisable as a food supplement. Ensure makes a product called Glucerna for diabetics.
After 2 weeks, there should be no eating restrictions. Nothing but light sucking with a straw for
the 1st week. No milkshakes with a straw for 2 weeks.
Smoking Graft failure rates triple with smoking within the first 7 days after the graft procedure.
Smoking causes more post-operative pain, as well. If you do smoke, keep it 5 cigarettes or less
per day and only smoke half the cigarette. No cigars or pipes.
Aspirin Unless you have a special medical reason for taking aspirin (tell us at least a week
ahead of time if this is the case), do not take aspirin products for 7 days prior thru 7 days after
the graft procedure. Aspirin can cause bleeding.