Post-Operative Instructions for a Free Gingival Graft

Q: What is the white film on my graft?

The whitish or yellowish layer that forms on the graft after a few days is a normal part of the healing process called a fibrin layer. It acts as a natural bandage. Do not disturb it.

Q: My palate is very sore. How long will it last?

The donor site on the roof of your mouth is typically the most uncomfortable part of the healing process. It can feel like a bad pizza burn and may take 1-2 weeks to feel significantly better. Wearing your protective stent as much as possible will greatly improve your comfort.

Q: When will the graft look like normal gum tissue?

The graft will go through several stages of healing. It may look red, white, or bumpy for the first few weeks. It typically takes 1-2 months for the tissue to mature and start blending in with your surrounding gums, with full cosmetic integration taking several months.

Surgical Care Instructions

Pain Management

Post-operative discomfort will come primarily from the roof of your mouth (the donor site), not the graft site itself. The key is to stay ahead of the pain.

Scheduled Regimen (As Prescribed): Take 600mg of Ibuprofen (Advil, Motrin) AND 500mg of Acetaminophen (Tylenol) together, every 6 hours for the first 24-48 hours.
Protective Stent: We have likely provided you with a clear protective covering (stent) for the roof of your mouth. Wear this continuously for the first 24 hours, including while you sleep. After that, wear it as much as possible for comfort, especially while eating.
IMPORTANT DISCLAIMER: Only take medications as specifically prescribed by our office. Do not take Ibuprofen if you have kidney disease or Tylenol if you have liver disease. Please follow your personalized instructions.
Prescription Pain Medication: If prescribed, use this only if the scheduled regimen is not providing adequate relief. Remember that narcotics like Vicodin or Percocet already contain Tylenol. DO NOT take additional Tylenol with your prescription.

Bleeding Control

Minor oozing of blood from the roof of your mouth is normal for the first 24 hours. The graft site itself should have minimal bleeding.

For the Palate (Donor Site): If you notice bleeding, apply firm, direct pressure to the roof of your mouth using the provided gauze or a moistened black tea bag for 30-45 minutes.
For the Graft Site: Do not apply pressure to the graft site. Minor oozing should stop on its own.
Pillowcase Pro-Tip: Use an old or dark-colored pillowcase for the first night. A small spot of blood from drooling is normal and not a cause for alarm. A saturated pillow indicates active bleeding and you should contact us.

Swelling Management

Swelling is normal for the area where the graft was placed (e.g., your lower lip or cheek) and will peak on the third day.

Ice Packs (CRITICAL): For the first 24 hours ONLY, apply an ice pack to the outside of your face over the graft area for 20 minutes on, then 10 minutes off.
Elevation: When resting or sleeping, keep your head elevated with an extra pillow to help minimize swelling.

Oral Hygiene/Site Care

This is the most critical part of your recovery. You have two sites to care for, and the graft site is extremely delicate.

The Graft Site (Recipient Area)

ABSOLUTELY DO NOT touch, pull, or disturb the graft area. Do not pull your lip or cheek out to look at it for at least two weeks, as this can stretch the tissue and cause the graft to fail.
DO NOT brush or floss the graft site until we specifically instruct you to do so (usually after 2-3 weeks).
You may notice the graft turning white or yellow after a few days. This is a normal part of healing and is not a sign of infection.

The Roof of Your Mouth (Donor Site)

Keep the protective stent clean by rinsing it with cool water.
Avoid touching the donor site with your tongue or any utensils.
After 24 hours, you can gently rinse the area with the prescribed medicated rinse or a warm salt water solution.

Dietary Recommendations

Your diet must protect both the graft and the donor site.

First 24-48 Hours: Stick to a cool, liquid or non-chew diet. Good options include smoothies (no straws!), yogurt, and lukewarm soups.
First Two Weeks: A soft diet is required. Avoid chewing on the side of your mouth where the graft was placed.
Foods to Avoid: Do not eat anything hard, crunchy, crumbly, spicy, or sticky that could injure or stick to the surgical sites.

Activity Restrictions

Avoid all strenuous physical activity, exercise, or heavy lifting for at least one week. Increased blood pressure can cause bleeding and jeopardize the graft.
Do not smoke. Smoking will cause the graft to fail.
Be careful when smiling or making exaggerated facial expressions to avoid stretching the graft site.