Drs. Engen & Pizzini
Call: (509) 326-4445

Post-op Instructions

Scaling & Root Planing Post-Op Instructions

  • Do not eat or drink anything hot while you are still numb to avoid burning your mouth. Be careful not to bite your cheek or tongue.
  • If needed, you make take an aspirin-free pain reliever, such as Tylenol or Advil for any discomfort (aspirin pain relievers may cause bleeding). You may take 1-2 tablets before your anesthetic wears off, as the first few hours are the most sore. Expect tenderness or soreness, but not pain.
  • Rinse your mouth with warm salt water (one teaspoon salt per cup of warm water) as needed for the soreness unless you have had an extraction.
  • In the event of bleeding, isolate the area and apply pressure with dampened gauze pads or a moist tea bag for 20 minutes.
  • Brush gently before going to bed. Add flossing the second day and the rubber tip stimulator the third day. It is extremely important to keep all areas clean even though it may cause some discomfort. The cleanliness will promote rapid healing and provide you with the best results from the curettage.
  • After the anesthesia has worn off, you may eat and drink anything comfortable to you.
  • If anything unusual comes up or you have any questions, do not hesitate to call our office.

Periodontal Surgery Post-Op Instructions

  • Do not rinse your mouth the day of the surgery unless otherwise instructed to do so.
  • Place a cold pack against the side of your face adjacent to the area of the surgery as soon as possible. Hold it on for 10 minutes, then take it off for 10 minutes, etc… for at least the first 2 hours. It is not beneficial to use an ice pack after about 6 hours have elapsed. The purpose of the ice pack is to help minimize the swelling.
  • Do not eat or drink anything hot for the first 6-8 hours following surgery. Heat can contribute to bleeding and can soften the protective dressing that may have been placed over your gums.
  • Keep taking nourishment. Try not to skip a meal. Begin by eating soft foods or liquids, but return to your normal diet as soon as possible. You will feel better, have more strength, less pain and heal faster if you continue to eat.
  • You may notice that sutures and/or dressing have been placed in your mouth. We will remove these in 7-14 days.
  • If you take your first pain pill, which has been prescribed for you, BEFORE your anesthesia wears off you will be more comfortable. If you do not think your prescription is necessary, you may use an aspirin-free pain reliever, such as Tylenol.
  • Beginning the day after surgery, rinse your mouth 8-10 times with warm salt-water solution (one teaspoon salt per full glass of warm water). You will also start using Peridex mouth rinse if it has been prescribed for you.
  • It is very important to keep the surgical area clean in order to promote healing. The day after surgery, start using the extra soft toothbrush and start flossing. You may use the soft brush for the first 10-14 days. Thereafter use your regular brush.
  • Keep physical activity to a minimum the first 24 hours to help prevent bleeding. Also, rest is important in the healing process.
  • If you use an electric toothbrush, discontinue for 4 weeks from the surgery date. If you had a bone graft, discontinue the use of your ultrasonic toothbrush for 8-10 weeks.
  • In case of bleeding:
    • Slight oozing is to be expected for several hours (oozing is a little blood mixed with your saliva).
    • In the event of more significant bleeding, try to isolate the source of the bleeding and apply steady pressure to the area with dampened gauze for 10 minutes. Repeat if necessary.
    • Pressure with a dampened tea bag may be useful if bleeding is persistent.
    • If this is unsuccessful, feel free to call Dr. Engen at the office , or if after hours call our emergency numbers.
  • Explanation of symptoms that may occur:
    • Swelling of some extent occurs following nearly every periodontal surgical procedure and is a normal occurrence. It will probably reach its peak after about 3 days and thereafter begin to subside.
    • Swelling of some extent occurs following nearly every periodontal surgical procedure and is a normal occurrence. It will probably reach its peak after about 3 days and thereafter begin to subside.
    • Stiffness of the jaws is also natures way of splinting and resting the part that needs to be repaired and usually relaxes in 4-6 days.
    • Do not be alarmed if discoloration of the cheeks occur. Black and blue marks or yellowish discoloration is caused by bleeding internally into the cheeks. It will disappear in 7-10 days
    • Do not clench or grind your teeth. This will cause discomfort to be more significant because it causes the ligament surrounding the teeth to swell.
    • Other teeth in the surgical area may seem sore. This is due to the edema or swelling taking place in the area. This edema has a hydraulic effect of pushing the teeth out of the socket causing them to hit prematurely. As the edema clears, the teeth will pull back into the socket and the soreness will subside.

Extractions Post-Op Instructions

  • Do not rinse your mouth for the first 24 hours. This can cause the blood clot to dislodge and cause bleeding.
  • Dot not eat or drink anything hot for 6-8 hours following an extraction. Heat can also contribute to bleeding.
  • Place a cold pack against the side of your face adjacent to the area of the surgery as soon as possible. Hold it on for 10 minutes, then take it off for 10 minutes, etc… for at least the first 2 hours. It is not beneficial to use an ice pack after about 6 hours have elapsed. The purpose of the ice
  • pack is to help minimize the swelling.
    Keep taking nourishment. Try not to skip a meal. Begin by eating soft foods or liquids, but return to your normal diet as soon as possible. You will feel better, have more strength, less pain and heal faster if you continue to eat.
  • Keep physical activity to a minimum the first 24 hours to help prevent bleeding. Also, rest is important in the healing process.
  • Slight oozing is to be expected for several hours (oozing is a little blood mixed with saliva). If bleeding should occur, hold pressure on the extraction socket by biting down on several slightly moistened gauze pads for 15-20 minutes.
  • Do not do anything that will create a negative pressure in your mouth (sucking through a straw, inhaling on a cigarette).
  • If you have any concerns, feel free to call Dr. Engen at the office or if after hours call our emergency numbers.

Gingival Grafting Post-Op Instructions

  • Do not rinse your mouth the day of the surgery unless otherwise instructed to do so.
  • Do not eat or drink anything hot for the first 6-8 hours following surgery. Heat can contribute to bleeding and can soften the protective dressing that may have been placed over your gums.
  • Keep taking nourishment. Try not to skip a meal. Begin by eating soft foods or liquids, but return to your normal diet as soon as possible. You will feel better, have more strength, less pain and heal faster if you continue to eat. Avoid contact with the grafted area.
  • You may notice that sutures and/or dressing have been placed in your mouth. If gut sutures were used, they will dissolve in 6-8 days, along with the clear adhesive dressing.
  • If a pain pill has been prescribed for you, take the first one BEFORE your anesthesia wears out. Or you may take an aspirin-free pain reliever, such as Tylenol.
  • It is very important not to disturb the graft during healing. DO NOT BRUSH THE GRAFT SITE FOR 5 DAYS. Then you may very gently brush the teeth only using the extra soft toothbrush that you may have been given (stay away from the graft). After 2 full weeks, you can brush the teeth and gums still using the extra soft toothbrush. After 3 weeks, no special care is needed. Brush the graft area as you would any other areas. It is very important to keep it clean.
  • Keep all physical activities to a minimum the first 24 h ours to help prevent bleeding.
  • Slight oozing is to be expected for several hours (oozing is a little blood mixed with your saliva).
  • In the event of more significant bleeding, determine whether it is the graft site or the palate (donor site) that is bleeding. Apply pressure with a dampened gauze pad or a moistened tea bag on the palate. This should stop any bleeding from the palate. If it is bleeding from the graft site, DO NOT apply pressure to the graft or the graft could fail. Gauze can be placed on either side of the graft, but not over the graft.
  • If the above treatment is unsuccessful, feel free to call us at the office or after hours using the emergency numbers.


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Office Location

  • Spokane
  • 9911 N. Nevada #110
  • Spokane, WA
  • 99218
  • Map & Directions
  • Call: (509) 326-4445