Pre-operative Instructions

What You Should Know

Is this going to be a terrible experience?

The answer is no.  It is natural to think about what can go wrong.  These procedures are very safe and side effects are minimal.  The doctors at Legacy Periodontics & Implants have completed well over 4,000 of these procedures and is very confident in the techniques.  Most patients anticipate severe discomfort after surgery, which is generally not true.  We will give you the medications necessary to reduce swelling, pain, prevent infection, and help keep things clean.  Our patients comment that the procedure was not nearly as bad as they imagined.   Remember, the benefits of keeping your own teeth are extensive and although they need some work now, the end result will be well worth it!

MAKE SURE WE KNOW THE FOLLOWING!

  • Your normal medications and that you will be taking them unless otherwise instructed by your doctor/surgeon
  • If you are taking aspirin daily
  • If you are on blood thinners
  • If you are diabetic or have special diet restrictions
  • If you have a prosthetic joint less then 2 years old
  • If you have an artificial heart valve or history or endocarditis
  • If you have been on bisphosphonates for osteoporosis, longer than 5 years

Sensitivity

Expect to have some sensitivity of the teeth after surgery.  The procedure will remove all plaque and tartar (calculus) from the root surfaces, which may increase your sensitivity to extremes of hot, cold, and/or sweets.  Our recommendation is to avoid very hot or very cold foods/beverages for a couple of weeks after surgery.  In most cases, the sensitivity will subside and return to normal after a few months.  Sensitive toothpaste can help during these phases.  Our office can also prescribe various medications that can help with long-term sensitivity.

Clenching or Grinding of Teeth

After surgery, the teeth may feel a little loose due to minor swelling.  This may trigger a clenching or grinding episode, usually at night making the teeth feel sore.  The process usually is self-limiting; symptoms should get better in a few weeks and go away after a few months.  If your symptoms get worse or are not getting better let us know. If you cannot control the clenching/grinding habit then a bite appliance to be worn at night may be prescribed.

Infection

Our experience shows that there is a low risk of infection associated with periodontal surgery.  If bone grafts are part of your treatment plan then antibiotics will be prescribed as a preventive measure.  Routine periodontal surgery does not require antibiotic coverage.  If you notice an elevation in temperature, drainage or significant swelling, please call the office.  Remember, swelling after the procedure is normal and usually peaks about 4 days after surgery.  This usually resolves in a week or so.

Gum Tissue Appearance

If surgery is planned for your front teeth to correct damage due to your gum disease, shrinkage in the gum tissue may occur when the swelling goes down.  This may leave dark spaces between the teeth and the teeth may look somewhat longer.  Rest assured, we will do his best to minimize these changes, and protect your smile.  In some cases, if surgery is planned for the front upper teeth, and you have crowns, the margins of the crowns may be exposed after surgery.  This is usually not a problem if you don’t show too much teeth during smiling.  If you display a lot of gum tissue during smiling, the crowns may need to be remade to have a nice aesthetic result.

Smoking

Besides all the long-term health effects that smoking can have on your body, it can dramatically impact on the stability of your teeth.  Study after study has shown that patients who smoke can end up with significantly less teeth than non-smokers.  Post operative sensitivity is also higher in smokers and healing is slower.  Do what you can to kick the habit.  We can start you on a smoking cessation programs too.

Numbness

There is a very, very low risk of permanent numbness to the gum tissues or skin surface after periodontal surgery.  In most cases, this is a temporary phenomenon and has a very low incidence.  We will do everything possible to limit the possibility of this happening.

Follow-up Appointments

It is important that you return for the following post-surgery appointments:

Removal of Sutures and Initial Healing Evaluation

This visit is usually two weeks following surgery unless indicated otherwise by the doctor.  The visit is usually 30  minutes.  In many cases the sutures dissolve on their own.  Loose sutures may be trimmed at home if they are bothering you.

Evaluation of Result After Surgery (1st “cleaning” after surgery)

This visit takes place six (6) weeks following surgery.  At that time we will re-measure the treated area, polish your teeth (may have staining from the rinse used after your surgical procedure) and confirm that you are stable.  Since personal oral hygiene is compromised while the sutures are in place, a professional cleaning will aid in the healing process by keeping bacteria from getting back under the gums.  This is usually a one-hour visit and may be in addition to your normal cleaning schedule.

Periodontal Maintenance “Cleanings”

Because periodontal disease is a chronic condition our goal is to control the disease; we can’t cure it.  Your body has demonstrated that it needs help in keeping destructive bacteria from getting back into your gums.  Once you are stable, professional dental cleaning and examination at regular intervals is critical.

Some patients have questioned why they need to return to our office.  Since we have extensive experience treating patients with severe forms of periodontal disease and in  detecting early changes, you will have better long-term stability if you remain under our care for periodic professional cleanings.

Depending upon the severity of your case, Dr. Wolf may recommend that you have your teeth cleaned every 3 – 4 months.  These cleanings will alternate with Your Family Dentist. Together we can protect your gums and teeth. The following is an example of an alternating cleaning schedule:

  • January – Cleaning with Dentist
  • April – Cleaning with Periodontist
  • July – Cleaning with Dentist
  • October – Cleaning with Periodontist

Working Together with your Dentist

It is very important that your Family dentist see you for cleaning visits on an alternating basis.  Both of our offices will provide a professional tooth cleaning at these visits, however, in our office the focus is definitely the gum tissues and health of the bone.  The focus of the cleaning and check-up at your general dentist will be to ensure that crowns, bridges, and fillings are healthy.  If a restoration is not healthy, your general dentist may recommend replacement of the restoration or placement of a dental implant.

Home Care

Adequate home care after any periodontal treatment is crucial if you want the results to last!  Removing the plaque at home will help in preventing destructive bacteria and calculus from reforming between cleaning visits.   We will continue to help you with home care and provide tips and techniques for getting the best results; please ask for help if you need it!

Remember, your long-term periodontal health is directly dependent upon how you take care of your teeth at home and maintain your cleaning visits with us and your dentist!