Following your gum grafting post-op instructions carefully helps protect the newly placed tissue and gives the graft the best opportunity to heal successfully.

At W Plus Dental in Washington, DC, we provide personalized post-operative instructions based on the type of graft performed, the location of the treatment, and your individual needs. The information below offers a general overview of what you may experience after gum graft surgery. Always follow the specific directions given to you by your dental provider, even when they differ from general recommendations.

What Is Gum Graft Surgery?

Gum graft surgery is a periodontal procedure used to add tissue to an area where the gums have become thin or receded. Depending on the technique used, the tissue may come from the roof of your mouth, another area of your gums, or a medically processed donor source.

The graft is carefully positioned over or around the affected area and secured with sutures. This can help:

• Cover or protect exposed tooth roots
• Reduce tooth sensitivity
• Thicken thin gum tissue
• Improve the appearance of an uneven gumline
• Lower the risk of additional gum recession
• Support the long-term health of the tooth

What to Expect After Gum Graft Surgery:

1. Discomfort & Medications:

• After surgery, it is normal to experience some discomfort, including pain and sensitivity, which may last for several weeks. For sensitivity, gently rinse with warm salt water twice daily for at least one week.
• Take your prescribed pain medication as directed by your doctor, preferably with food or milk to avoid nausea or stomach irritation. If nausea occurs, reduce or stop the pain medication and try eating a small portion of mild food, like yogurt. If you experience itching or a skin rash from any medication, discontinue use immediately.
• Avoid aspirin or any medications containing aspirin, as they can increase bleeding.
• If discomfort or swelling increases after day 4, contact the office, as this could indicate infection.
• Common Question:
  • Can I take my regular medications?
    • Yes, unless you were specifically instructed to make changes to your regular medication dosing.

2. Swelling

• Swelling and bruising are common and may occur after surgery. Swelling should begin to subside after 3–4 days. If swelling worsens after day 4, contact our office.
• Keep your head elevated above your heart for the first 24 hours (use extra pillows while sleeping).
• An ice pack should be used to minimize swelling. Place the ice pack in contact with the skin, 20 minutes on, 5 minutes off, for the first 24-48 hours after surgery.

3. Bleeding

• Mild bleeding or oozing is normal for the first 24–48 hours.
• Avoid anything that could dislodge the clot: No forceful spitting, rinsing, drinking through a straw, or blowing your nose. If you notice large blood clots or a steady flow of blood (beyond minor oozing), contact the office immediately.
• Common Questions:
  • How much bleeding is normal?
    • Light oozing or pink saliva is normal; heavy bleeding is not.
  • What should I do if it keeps bleeding?
    • Apply moist gauze or a tea bag with firm, direct pressure to the area for 30-45 minutes at a time (tannic acid in tea helps with clotting) and stay upright. If the bleeding continues, call the office.

4. Sutures

• Sutures (stitches) help stabilize the tissue for proper healing. Do not pull or play with sutures using your tongue, fingers, or toothbrush.
• Sutures may be dissolvable or require removal at your follow-up visit. We will inform you if and when they need to be removed. Do not attempt to remove your sutures; if they are loose/irritating, please call the office.

5. Graft Appearance

• The graft may look white, gray, or red during healing—this is normal.
• Avoid pulling your lip to look at the graft. Disturbing the area will impact the blood supply to the healing graft.

6. Oral Hygiene

• Day of surgery: Do not brush, floss, rinse, or use any oral care products.
• Day after surgery: Resume brushing and flossing only in areas that were not treated.
• For the first two weeks: Do not brush, floss, touch the surgical site, or use over-the-counter mouthwashes.
• After 2 weeks: Use a soft toothbrush and brush teeth only, avoiding the gums.
• Common Questions:
  • What toothpaste should I use?
    • Use a gentle, non-whitening toothpaste. Avoid whitening, tartar-control, or charcoal toothpastes, as they can be too abrasive and may irritate healing tissue.
  • Can I use an electric toothbrush?
    • Yes, but NOT on the surgical site. You can use it on the rest of your teeth. Avoid using an electric toothbrush directly over the surgical area for about 2–4 weeks, or until we confirm healing is progressing well.
  • When can I start brushing the surgical site?
    • We’ll let you know at your follow-up appointment when it’s safe to begin. This is typically after your    sutures are removed and healing is progressing well.
  • Can I floss/use my WaterPik on the surgical areas?
    • Wait to use anything to clean between your teeth until cleared by your doctor, usually 4-6 weeks.

7. Diet

• Eat a soft diet high in protein and nutrients (e.g., eggs, yogurt, soup, bananas, fish, protein shakes). Avoid hard, sticky, crunchy, spicy, or “sharp” foods (such as chips, nuts, toasted bread, gummy candies, fibrous meats, raw vegetables), and any foods with small particles.
• On the day of surgery, avoid hot food and drinks. We suggest choosing cool, soft foods such as smoothies or ice cream during this time, as they can feel soothing and help keep inflammation down.
• Wait until the numbness wears off to eat, as you can unknowingly damage the site. The local anesthetic typically wears off within 2-4 hours. If numbness or tingling persists for over 24 hours, please let us know.
• Drink plenty of liquids, but don’t use a straw! Use a spoon if drinking a smoothie or milkshake.
• It is important to maintain a diet with a normal calorie level and high in protein, minerals, and vitamins to support postoperative healing. Post-surgically is not the time to start a diet. This can have detrimental effects on healing and lessen the chances of success of the surgical therapy.

8. Physical Activity

• Rest is very important for proper healing.  No physical activity for the first 2 weeks. You should avoid:
  • Strenuous exercise or heavy lifting
  • High-intensity workouts
  • Bending over frequently
  • Activities that significantly raise your heart rate or blood pressure
• These types of activities can increase bleeding, swelling, and discomfort at the extraction site.
• Common Question:
  • Is it okay to run errands or go out socially during recovery?
    • Yes, as long as you feel comfortable. Keep activities light and avoid overexertion. A good rule of thumb is to listen to your body. If throbbing, bleeding, or increased swelling occurs when you become more active, it’s best to slow down and allow more time for healing.
  • What if my job requires a lot of talking or meetings?
    • Extended talking can strain the surgical area in the early days. Try to limit long conversations or meetings
    • during the first week if possible.

9. Night Guards / Retainers / Dentures

• Please bring your appliance with you to your surgical appointment so we can evaluate it and make any necessary adjustments before surgery.
• Common Questions:
  • Can I wear my appliance right after surgery?
    • Only if your doctor has specifically approved it—otherwise, avoid wearing it until cleared.
  • Why does it need to be adjusted?
    • Even slight pressure on the graft can interfere with healing and impact the final result.
  • What if it feels uncomfortable after surgery?
    • If your appliance feels tight, rubs, or causes discomfort, stop using it and contact our office.

10. Smoking / Alcohol

• Do not smoke in any form, including cigarettes, vaping, marijuana, or any other substances, until after your sutures have been removed to ensure the best healing and success of your surgical procedure. Nicotine reduces blood flow and oxygen delivery to tissues, and marijuana and other substances negatively impact healing.
• All intake of alcohol should be stopped until 2 days after you have finished taking all medications related to this procedure. The combination of alcohol and certain medications is not recommended.

11. Important "DO NOT'S"

• Do not use straws or create suction in the mouth (for example, sucking on candies)
• Do not pull your lip to look at the surgical site or touch the site with fingers or tongue
• Do not spit forcefully or rinse aggressively
• Do not eat any hard, crunchy, sticky, or spicy foods
• Do not smoke or vape

12. Follow-Up Visits

Your follow-up appointments are an important part of your recovery and treatment success. Please return for re-evaluation as instructed and keep all scheduled follow-up visits directed by your doctor. During these appointments, we will assess your healing, address any concerns, and confirm that your recovery is progressing as expected.