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Geoffrey R. Bauman, DMD, MS | Bone Grafting with a Membrane in Newark

Geoffrey R. Bauman, DMD, MS / Board Certified,  American Board of Periodontology
Fellow, Midwest Implant Institute



Bone Grafting with a Membrane

Considerations for the graft area:  Movement of the graft is detrimental to the graft and may cause it to be lost.  Therefore you should avoid talking as much as possible for the first 2 days and minimize talking for the next 8 days after the surgery.   Avoid touching the graft area with your tongue.  Do not rub your cheek or lip over the area of the graft.  Try not to sleep with pressure on the area where the graft was placed.   If you find that you have to sneeze or cough, try not to hold it in as this may spike your blood pressure and increase the risk of bleeding.  If some of the stitches start to hang down and you can’t tolerate them, you may call to come in sooner  to have them removed.  You may notice that the outer portion of the graft turns white or yellow after a few days.  This is a normal development as some of the outer layers of the graft heal.

            Medications: Some discomfort should be expected post-surgically; however, the dentist will have given you prescriptions or recommended non-prescription medications to control pain.  Take the medication as directed.  Even a doubling of the recommended dose can cause severe problems.  Take your first dose of ibuprofen or Tylenol before the numbness wears off.  If the ibuprofen is not adequate, then start taking the narcotic in addition to the ibuprofen (don’t stop taking the ibuprofen).  Do not take Tylenol in addition to the narcotic as there is already Tylenol in the narcotic pill).   If a narcotic (Percocet, Synalgos, Vicodin, Tylenol #3) was prescribed and you find you do not need to take it, return it to a local take-back site if one is available or dispose of it in the toilet (FDA considers these "dangerous drugs" and expeditious destruction is essential).   Do not save this medication for pain at a later date.  Narcotics can be detected by blood or urine test and you may be prosecuted for taking the drug without a current prescription.  Most pain medications have the potential to cause nausea and vomiting.  This effect is decreased by taking the medications with 8 oz of fluid. With narcotics, it helps to remain still (even walking around can be a problem) to prevent nausea.  If nausea ensues with narcotics, you must stop taking them. It will only get worse otherwise.  The antibiotic (usually Doxycycline or Amoxicillin) must be taken to prevent infection in the graft site.  You must take the antibiotic until it is all gone unless you develop some side effect from the medication.  For women taking the birth control pill, be aware that antibiotics may disrupt the effectiveness of the pill, so you should not rely on the birth control pill to be effective until after the second full menstruation after you discontinue the antibiotic.  Doxycycline may cause a rash or severe sunburn if the skin is exposed for more than 15 minutes to direct sunlight.  Antibiotics can sometimes encourage vaginal yeast infection which may require treatment.

            Home care:  Do not perform any brushing or flossing until the second day after the surgery.  On the second day, you may begin brushing and flossing all the areas of the mouth not involved with the surgery.  You will be given a mouthwash (Peridex or Listerine) to use in the surgical area in the morning and evening after you have brushed and flossed the non-surgical areas.  However, do not vigorously rinse with this or any other liquid.  Just allow it to pool over the surgical site for about 1-2 minutes and then spit out.

            Diet:  Your diet should include the equivalent of 8 glasses of water per day (anything except for alcohol or soft drinks during the first 4 days).  1000 mg of vitamin C may be helpful for healing.  For the first day, just liquids up to a milk shake/pudding consistency.  2nd day soups with soft vegetables, rice, short noodles, etc;  on the 3rd day, you may start some softer foods such as baked potatoes, ground beef, etc., in very small bites and always chew on the opposite side from the surgical areas.  If you are not careful you might knock the dressings loose and cause severe pain and bleeding. Continue that softer diet through the first two weeks.  There may be no chewing on the graft side, and no eating of potato chips or sharp foods that could penetrate the gums at all for 4-6 months after the surgery (ask the doctor). 

            Smoking/alcohol: Smoking causes blood vessel constriction and alcohol causes dehydration which which are both harmful to healing and it is best that you not smoke or drink for as long as possible after the procedure, especially during the first week.

            ExerciseAvoid heavy physical exercise for at least 3 days after surgery.  After that play it by ear.