Surgical & Laser

Years ago periodontal surgery was considered an ordeal. Things have changed! Today there should be no pain involved during surgery, and the postoperative discomfort is minimal. New and sophisticated medications ensure you a smooth procedure.

For surgeries that last an hour or longer, most patients prefer a light sedation. The oral medications we use are Xanax, Valium, and Triazolam. Inhalation of nitrous oxide gas is available, and intramuscular Demerol may be used if anxiety is high. Intravenous sedation by anesthetist Robert Rota, RN, CNA is available by special arrangement. This is not general anesthesia, and is extremely safe. We have done thousands of sedations without incident. Your heart and blood oxygen levels are monitored during the procedure to ensure your safety. With sedation, an hour procedure seems like 5 minutes, and you are not even aware of the local anesthetic when it is given. Of all the additions to modern periodontics, this is the most significant for patient comfort. If sedation is used, you must have a driver. If your driver does not stay for the surgery, he/she must be back 15 minutes before the scheduled appointment end.

Postoperative discomfort has been dramatically reduced with the use of NSAIDS (non-steroid anti-inflammatant drugs). These drugs, such as Naprosyn and Motrin, stop the formation of the chemicals the body normally produces that cause heightened pain. NSAIDS are not narcotics, so you can function normally when taking them. Generally, NSAIDS are started the morning before surgery, and taken for three days. After this time no prescription medications are normally needed. In addition to the NSAIDS, a narcotic is often recommended for the first day. It is used along with the NSAID, and will eliminate any "breakthrough" discomfort. Generally these medications are not needed more than the first day, if at all.

Some patients, especially implant and regeneration cases, are given antibiotics to take after surgery. It is important to take the prescriptions as directed, to optimize healing.

A prescription mouthwash is often prescribed after surgery, and may be used for 2-10 weeks. It is much more effective than any over-the-counter mouthwash, and kills bacteria throughout the mouth. During the first 3-10 days there is generally a periodontal dressing over the operated area (similar to putty or chewing gum), and using the mouthwash keeps the dressing clean.

At 7-14 days any dressing is removed, along with sutures that may have been placed. The area is cleansed, and postoperative care of the area reviewed. This appointment generally lasts 15-30 minutes, and should not cause discomfort.

With most cases it is important to keep all bacteria away from the surgical site for 8-10 weeks. To help ensure optimal plaque control, polish appointments are sometimes scheduled every 2-3 weeks. The prescription mouthwash may also be continued during this time. We have found that careful control of plaque during the healing phase greatly enhances surgical results.