After Placement of Dental Implants
Home Instructions After Dental Implant Surgery
After dental implant surgery, do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing cap (abutment) protruding through the gingival (gum) tissue. In some implant procedures a temporary tooth or set of teeth may be attached to or resting over the new implant(s).
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills rapidly with blood) can be controlled by biting on a gauze or tea bag placed directly on the bleeding wound for 30 minutes. If bleeding continues, please call for further instructions.
The body responds normally to a surgical procedure by swelling. This is an inflammatory response that can last 72 hours. The first 24 hours after surgery you may have mild to moderate swelling. On the second day the swelling is more pronounced and it will start to diminish on day three. To minimize swelling apply an ice bag, or a plastic bag or towel filled with ice, on the cheek in the area of surgery. Apply the ice 20 minutes on then 20 minutes off, as much as possible. Using ice compresses for the first 48 hours will give you the greatest benefit. Ice will continue to be helpful over the three day 72 hour period. Ice will minimize swelling and bruising, it will also alleviate the pain. If the area has been bone grafted apply near the area, usually above it but not directly on the area.
Drink plenty of fluids. Avoid hot liquids or hot foods for 48 hours. Room temperature or cold foods and liquids are recommended. You may have extended numbness and eating may be difficult. It is advisable to avoid eating in the area immediately around the implant surgical site. Soft food and liquids may be eaten on the day of surgery, but not on the implant site. No carbonated drinks are allowed for 6 weeks. Gradually return to a normal diet unless otherwise directed. In the case of full mouth implants where teeth are attached the day of surgery a continued light diet is recommended for 90 days unless your Doctor recommends differently.
It is always advisable to stay ahead of pain. Most of the time you will have lingering numbness from the anesthetic when you leave the office. This numbness may last for several hours. Most patients have some level of post surgical soreness, others may have more intense pain. You should begin taking pain medication as soon as you begin to feel uncomfortable. For some it will begin just as the anesthetic starts to wear off while others may not feel it until much later. All oral pain medications can take up to an hour to work. It is advised to take your pain medication before pain completely sets in.
If you had IV anesthesia where you are put to sleep, the Anesthesiologist usually gives pain medication in your IV called Toradol. You will be advised if this medication is administered. Toradol is a powerful NSAID (non steroidal anti-inflammatory drug). You will not be able to take another NSAID by mouth for six hours after surgery. You may take Tylenol or the narcotic pain medication we have prescribed but not any Advil Dual Action, regular Advil, Motrin or Aleve.
If you did not have IV anesthesia then you may take OTC (over-the-counter) medications or prescriptions anytime after surgery.
Pain medication can be either OTC (over-the-counter) or by prescription. There are several choices depending upon what you can take. Until recently narcotics have been the primary medication for treating post surgical pain. If you can take Tylenol and Advil products we recommend the OTC Advil Dual Action for mild to moderate dental pain. For severe pain you will be prescribed a narcotic pain medication. Generally severe pain only lasts for 24 hours then we recommend using OTC medications. Advil Dual Action, Advil, Tylenol, Motrin or Aleve instead of a narcotic pain medication.
OTC medications are generally three types: Advil Dual Action which is a combination of Acetaminophen and NSAID. Acetaminophen (Tylenol) and NSAIDs (Regular Advil, Motrin, Aspirin or Aleve). The regular 325mg aspirin promotes excessive bleeding and is not recommended. Whatever you take closely follow the recommended dosages on the bottles.
Do not take any of the above medication if you are allergic to them, or have been instructed by your Doctor not to take it. Do not drive an automobile or work around machinery while taking the narcotic. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.
If you were given IV antibiotics or taken a loading antibiotic dose by mouth prior to surgery. Your next antibiotic dose will be the day after surgery. Be sure to take the prescribed antibiotics as directed to help prevent infection.
Good oral hygiene is essential to good healing. The day after surgery, use the prescribed Peridex Oral Rinse an hour after you brush your teeth and just before bed. The Peridex should be used twice daily; Be sure to swish for at least 30 seconds then spit it out. Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day as well, especially after meals. Brush your teeth while staying clear of the surgical areas.
Keep physical activities to a minimum immediately following surgery. If you exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment. This may weaken you and further limit your ability to exercise.
Wearing your Prosthesis
Partial dentures, flippers, full dentures and attached teeth are usually placed at the time of surgery. Ideally all removable prosthesis are to be continuously worn for 48 hours before removal. When they are removed they will need to be cleaned off and immediately inserted again. Continue to wear them daily. After the 48 hours of continual wear you can remove them for sleeping. In the case of attached teeth: These are teeth which are not removed but actually connected to the implants. You may brush the teeth, just not the gums.
For all removable prostheses (partial dentures, flippers, and full dentures): Your next visit post surgery will usually be a post operative appointment 2 weeks from the day of surgery. If you have any sore spots or difficulty with the prosthesis please contact the office so we can see you sooner.
In the case of attached teeth (All-On-Four or more): Your next appointment following surgery will be the following day. Then usually one followup appointment every one to two weeks following surgery until week six. Usually after week six your next appointment is six weeks later for a followup CBCT scan and impressions.