Bone graft surgery can be used in a few different circumstances, including:
- After surgery to reduce periodontal pocketing
- After replacing bone where pathology caused a problem
- In conjunction with endosseous dental implant surgical placement
If bone graft surgery is necessary in your case, your dentist will discuss it with you and give complete directions to be followed after the surgery. You may be put to sleep for this surgery, or you may be able to go through it with local anesthesia only. Either way, your aftercare instructions should be the same.
In the area of surgery you will have a few stitches in place after the procedure. Some will dissolve themselves, but external silk stitches must be removed in our office. No matter what you do, do not pull back your cheeps or lips in attempt to look at the surgical site. The stitches pull on the tissue covering the bone grafting surgical site. The bone graft has about 15% more bone fill than what is normal for the body, so when you pull back the lips or cheeks you pull those stitches away from the bone graft. This exposes bone and leads t more pain. You can slow down the healing process by doing this and may even need to have the area sutured once again at your one week follow-up appointment.
Depending on how big the graft site is, the severity of the pathology, and the condition of the sutured tissue, you can expect to leave the stitches in for 2-3 weeks. Your doctor will give you an estimated time when the surgery is performed, but don’t be alarmed if they recommend a longer period of time than was initially recommended. They won’t remove the sutures until they are sure the area has healed and isn’t likely to regress.
If you are given a periodontal pack, make sure it stays in place until your one week follow-up appointment. These packs are saturated with antibiotics so the surgical siteis protected from infection, but they also stop the particulate bone used in your graft from washing away. These pink packs are designed to be worn for 7-10 days, so it is likely to be removed during the one week follow-up appointment. If it falls out before this appointment, come in so your dentist can have it put back into place.
You will be able to brush your teeth while recovering from the surgery, but areas where the periodontal pack is place must be avoided. You cannot use anything astringent like mouthwash or antiseptic solutions. These products will ruin the bone graft, requiring you to do the surgery all over again. This should be communicated to you before, during and after the surgery because it is so important.
After you have healed some you will be taught how to use normal saline and an irrigation syringe to clean the surgical site.
Bone does heal slowly and needs just the right conditions in order to heal properly. This means you have to watch what you eat after the surgery. Here are some things to consider when deciding what to eat:
- Don’t eat anything too hot. Keep it on the cooler side.
- Do not eat larger sized foods that require big bites and take small, cautions bites.
- Do not eat anything that is very hard or sticky.
Use common sense when determining what is safe for you to eat. If in doubt, call the office and ask before proceeding.
You cannot smoke after going through any type of oral surgery. The smoke will decrease the amount of oxygen going to the tissue and slow down the healing process. Smoking after any Oral Surgical procedure will ALWAYS delay or badly disrupt normal healing due to a decrease in oxygenation of the tissue that is healing.
Smoking will be off limits for at least a week, but consider putting down the cigarettes for three weeks if possible. This is the minimum amount of time it takes for the surgery to heal, though it can take even longer if you have underlying systemic issues like diabetes.
The results of bone grafting surgery are predictable and typically go very well when patients cooperate in the aftercare of the surgical site. Make sure you are familiar with all of the inherent risks that go along with this type of oral surgery and take the time to carefully consider the directions for care after the surgery. You will learn about the inherent risks when you give your informed consent for surgery.
We do everything possible to set you up for a successful surgery, but we need your cooperation when it comes to the recovery phase. There are no silly questions or unwarranted concerns when it comes to your recovery. If you have a worry or aren’t sure about something, just give us a call and ask our office staff. We much prefer to answer questions and set your worries at rest than to have something blown off or not asked with problems resulting.
Communicate with us and everything will go much smoother before, during and after the surgery!
As you learned in your informed consents, there is never any guarantee that everything will go perfectly smooth or as planned. From time to time a surgery does need to be done again and there is nothing we can do to stop that from occurring. The best we can do is assure you it doesn’t happen very often.
Thank you for your cooperation during the recovery phase!