Dental Implant aftercare instructions

Take care to only have cold drinks and do not eat until the local anaesthetic has worn off. Avoid hot drinks or hot food for 24hrs and do not ‘swill’ liquid over the area. Try not to disturb the area with your tongue or fingers. Do not undertake strenuous exercise for the next 48 hours (lifting heavy things / running / gym).

 

You may have some swelling and/or bruising following your treatment – this usually reaches a peak 2 to 3 days later. This is quite normal and both will subside naturally after a few days. Swelling can be reduced with ice packs wrapped in a towel. Hold on the cheek area for a maximum of 10 minutes at a time with 20 minutes break. After 24 hours gentle heat is more beneficial. Sleeping propped up slightly on 2-3 pillows may also help.

 

Pain should not be a big problem. Although you may be sore for a few days after any surgery in your mouth, this can be easily managed with simple analgesics (pain killers). You should take these regularly at the maximum stated dose for the next 2 days after your surgery. Take whatever painkillers you normally take for headaches, aches and sprains (Ibuprofen and Paracetamol make a good combination) and take your next dose before the local anaesthetic has completely worn off.

 

If after a few days you experience increasing pain and swelling, you must return to the surgery as soon as possible so that we can ensure you are not beginning to develop an infection.

 

If you have a denture that covers the surgical area please wear it as little as possible for the next week to protect the surgical site during its initial healing period. You should always leave the denture out at night.

 

The stitches are dissolvable but often remain for around 2-3 weeks, if they are uncomfortable or annoying, you may contact us to remove them.

 

Some minor bleeding after surgery is normal. If this persists, apply pressure by biting down over the area on a dampened gauze swab or clean handkerchief for 60 minutes whilst sitting upright. Do not keep checking or changing the gauze. You should contact us if bleeding persists for any reason after applying pressure in this way.

 

If you have been given a course of antibiotics to take after your surgery, please ensure that you complete the course.

Cleaning

Successful oral surgery depends on keeping the mouth as clean as possible.

 

Please start to use the mouthwash you have been given on the evening of your surgery and continue for 1 week. This is very important. You should gently bathe the surgical site by holding approximately 15ml over the site (the equivalent of half a cap-full) for at least 1 minute, 3 times a day, for 7 days.

 

You should also start cleaning your other teeth as normal with a toothbrush, starting on the evening of your surgery. Avoid the surgical site for the next few days, but then begin to carefully clean this area as well when tenderness permits.

 

Hot salt mouthwashes (a cup of hot water with a teaspoon of salt) are very beneficial for healing in the next week but taste awful. Ensure that the mouthwash is not so hot that it scalds and then hold the hot mouthwash over the surgical site until it cools. Repeat as often as possible.

 

Try to keep food away from the surgical area for as long as possible. Rinse following eating to keep the area clean.

 

You are advised not to smoke as this severely limits healing in the mouth.

 

We want your recovery to be as smooth and pleasant as possible. It is vital to follow these instructions very carefully – if you have any concerns or questions regarding your progress, please do not hesitate to contact us. An out of hours contact number is always available on our answer phone.

After Dental implants with bone grafting and/or sinus lift procedures

The placement of a bone graft for ridge augmentation or sinus lifting can be very simple or may be complicated depending on the circumstances of your case. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed.

What to expect following surgery:

Bleeding: Small amounts of blood in the saliva can make your saliva appear quite red. This is normal and may be noticed the rest of the day after the procedure. Spontaneous nose bleeding can be normal for a few days as well.

 

Pain: Moderate discomfort may be noticed when the anesthetic first wears off, and may continue for several days.

 

Swelling: Some swelling and discoloration of the lip and/or cheek may occur and may last for a few days.

 

Sensation: There may be a temporary loss of feeling in the gums in the operated area. The teeth may also feel loose for a time. The teeth may be sensitive to hot and cold temperatures.

What to do following the surgery

Bite on the gauze pad placed over the surgical site for 30 minutes. After this time, the gauze pad should be removed and discarded and replaced by another gauze pad. Refer to the section on BLEEDING for specific details. After leaving the office, rest and avoid strenuous activities for the remainder of the day. Keeping blood pressure lower will reduce bleeding and aid healing.

 

Take non-aspirin painkillers every 3 to 4 hours for 24-48 hours to maintain comfort. Take it before the anesthesia wears off. If pain medication is prescribed, take it as you need it. Don’t exceed the dose on the label. Taking with food or milk will help reduce upset stomach. Avoid driving or operating heavy machinery when taking pain prescriptions. Do not drink alcohol while taking prescription pain medications.

 

Nausea is most often caused by taking pain medications on an empty stomach. Reduce nausea by preceding each pain pill with soft food and taking the pill with a large glass of water. Applying an ice bag to the face over the operated area will minimize swelling. Apply for 15 minutes, and then remove for 15 minutes. Continue this for the first day. Eat soft foods for the first 2 – 4 days. Maintain a good, balanced diet. Drink plenty of water. Do not drink through a straw. Avoid alcohol for 48 hours. Avoid chewing directly over the operated area. Brush all of your teeth after each meal. Avoid the operated area for the first day. Take care to avoid pulling the sutures. Do not rinse vigorously; do not use a Waterpik®.

 

A saltwater solution (1/2 teaspoon salt + 1/2 teaspoon soda + 8 ounces warm water) held in your mouth for 2 to 3 minutes every hour might make your mouth more comfortable. If your sinus was involved in the procedure, you should avoid blowingyour nose or playing a wind musical instrument for one week. Use of decongestant medications might be recommended. Avoid lifting the lip with your fingers to look at the area. It is possible to accidentally tear the sutures, open the incision, and delay healing.

 

Smoking should be stopped following surgery. The cigarette smoke chemicals in your body will substantially reduce healing and success of the surgery. If you were given an antibiotic prescription, take all of them as directed until they are gone. Women: some antibiotics can reduce the effectiveness of birth control pills. Use alternate birth control methods for two months. You may be instructed to use a prescription antimicrobial mouth rinse. Return to your dentist’s office for removal of the sutures or follow-up checks as directed.

After Sinus Lift

The following information applies when upper jawbone height or width have been lost. The graft is placed to help restore your jawbone in preparation for possible implant replacement of the missing tooth or teeth.

 

You have had a Sinus Lift Augmentation procedure in your upper jaw. This procedure regains lost bone height in the area of your first and second molar and occasionally second premolar. It is an important procedure as it allows implant placement in an area that could not be implanted otherwise because of insufficient bone height due to an enlarged sinus. The bone that has been grafted is most commonly a combination freeze-dried bone, artificial synthetic bone and/or your own bone. Because of this you may have two post-surgical wounds: the donor site and the recipient site.

DO NOT UNDER ANY CIRCUMSTANCES BLOW YOUR NOSE FOR THE NEXT FOUR (4) WEEKS

DO NOT UNDER ANY CIRCUMSTANCES BLOW YOUR NOSE FOR THE NEXT FOUR (4) WEEKS. This may be longer if indicated. You may sniff all you like but NO BLOWING.

 

Do not blow your nose or sneeze holding your nose. Sneeze with your mouth open. Do not drink with straws and do not spit. Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided. Decongestants will help reduce pressure in the sinuses. You may also be given a prescription for antibiotics. Please take these as directed. Anything that causes pressure in your nasal cavity must be avoided. Avoid bearing down as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure. Smoking must be stopped.

Please call your dentist if you have

  • uncontrollable pain
  • excessive or severe bleeding
  • marked fever
  • excessive warm swelling occurring a few days after the procedure
  • reactions to medications, especially rash, itching, or breathing problems

Bleeding

A certain amount of bleeding is to be expected following surgery. On the skin where the surface is dry, bleeding clots in 10 minutes. In the mouth where things are wet, it takes 6-8 hours for the clot to gel up and the bleeding to subside. Slight bleeding or oozing causing redness in the saliva is very common. For this reason, the gauze will always appear red when it is removed.

 

Saliva washes over the blood clots and dyes the gauze red evening after bleeding from the sockets has actually stopped. Rinsing gently or wiping any old clots from your mouth first and then placing a gauze pad over the area and biting firmly for sixty minutes may control excessive bleeding. Repeat as necessary.

 

If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a blood clot by contracting bleeding vessels. This can repeated several times.

 

To minimize further bleeding, sit upright, do not become excited, and maintain constant pressure on the gauze (no talking or chewing) and avoiding exercise. If bleeding does not subside after 6-8 hours call your dentist for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved.

 

The swelling will not become apparent until the following day and will not reach its maximum until 2-3 days post-operatively.

 

The swelling may be minimized by the immediate use of ice packs. Sealed plastic bags filled with ice, ice packs or a frozen bag of peas wrapped in a washcloth should be applied to the side of the face where surgery was performed.

 

The ice packs should be applied within 20 minutes on/20 minutes off for the afternoon and evening immediately following your extraction. After 24 hours ice has no beneficial effect.

 

Thirty-six hours (36) following surgery the application of moist heat to the side of the face may help some in reducing the size any swelling that has formed.

 

If swelling of the jaw stiffness has persisted for several days, there is no cause for alarm. Soft, puffy swelling that you can indent with your finger after oral surgery is very normal.

 

Bright red, rock hard, hot swelling that does not indent with finger pressure, which is getting bigger by the hour, would suggest infection. This usually would develop around 3-4 days after surgery, when you would expect swelling to be going down, not up. If this should occur, please call your dentist.

Temperature

A temperature >38,3C° several days after surgery especially if accompanied by the rock hard swelling and increased pain, is usually indicative of infection. You should call your dentist for instructions if this should occur.

 

Two Paracetamol tablets or 2-4 Ibuprofen every 4-6 hours will help moderate a temperature.

 

A temperature >38,3C° several days after surgery especially if accompanied by the rock hard swelling and increased pain, is usually indicative of infection. You should call your dentist for instructions if this should occur.

Bruising

When the bone requires smoothing to allow for the fit of the denture, there is a good chance there will be some bruising on the surface skin over the area. The most common location is over the upper canine teeth (on the cheek below the eye).

 

Bruising might not be obvious for a day or two. By the time it reaches the surface it may have already turned from purple to green to yellow in color.

 

Over several days the yellow color will settle down the neck to about the nipple line of the chest before it disappears.

Pain

Pain or discomfort following surgery is expected to last 4-5 days. For many patients, it seems the third and fourth day may require more pain medicine that the first and second day. Following the fourth day pain should subside more and more each day.

 

Many medications for pain can cause nausea or vomiting. It is wise to have something of substance in the stomach (yogurt, ice cream, pudding etc.) before taking prescription medicine/over the counter medicines (aspirin/ibuprofen). Even coating the stomach with Pepto Bismol or milk of magnesia can help prevent or moderate nausea.

 

For moderate pain one or two tablets of Paracetamol or extra strength Paracetamol may be taken every 3-4 hours or ibuprofen 200mg tablets (2x200mg=400mg or 4x200mg=800mg) to be taken every 3-4 hours.

 

DO NOT DRIVE AN AUTOMOBILE OR WORK AROUND OR OPERATE HEAVY MACHINERY IF YOU ARE TAKING PRESCRIPTION PAIN MEDICINE.

 

Alcohol and prescription medicines do NOT mix!

 

If prescription pain medications are required beyond 4 days, further treatment may be indicated, please call your dentist and discuss your situation with us.

Antibiotics

Antibiotics are NOT given as a routine procedure after oral surgery. The overuse of antibiotics leading to the development of resistant bacteria is well documented so careful consideration is given to each circumstance when deciding whether antibiotics are necessary. In specific circumstances, antibiotics will be given to help prevent infection or treat and existing infection.

 

If you have been placed on antibiotics take the tablets or liquid as directed. You should take them on schedule until they are completely gone.

 

Discontinue antibiotic use in the event of a rash or other unfavorable reaction. You should call your dentist to report any such finding or if you have any questions.

Diet

Drink plenty of fluids. Try to drink 5-6 eight-ounce glasses first day.

 

Drink from a glass or cup and don’t use a straw. The sucking motion out the healing blood clot and start bleeding again.

 

Avoid hot liquids or food while you are numb so you don’t burn yourself.

 

Soft foods and liquids can be eaten on the day of surgery. The act of chewing doesn’t damage anything, but you should avoid chewing sharp or hard objects at the surgical site for several days.

 

Returning to a normal diet as soon as possible unless otherwise directed. You will find eating multiple small meals is easier than three regular meals for the first few days.

 

You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

 

If you suddenly sit up or stand up from a lying position you may become dizzy. Therefore, immediately following surgery, if you are lying down make sure you sit for one minute before standing.

Oral Hygiene

Good oral hygiene is essential to proper healing of any oral surgery site.

 

You can brush your teeth the night of surgery but rinse very gently. Vigorous rinsing should be avoided until the next day following surgery.

 

The day after surgery you should begin rinsing at least 5-6 times a day especially after eating. Salt water (cup of warm water mixed with a teaspoon of salt) is ideal but plain water is also ok.

 

Mouthwash has an alcohol base to it so it may be pretty ‘zingy’ when it comes in contact with fresh oral wounds. After a few days, dilute the mouthwash in the half with tap water and rinse out your mouth. This will make it taste and smell better; you can gradually build up to full strength mouthwash as you more comfortable.

Smoking

NO smoking for 48 hours after surgery. Smoking retards healing dramatically. Nicotine constricts blood vessels, which slows the formation and expansion of the healing blood clot in the socket. This leads to painful complication called ‘Dry socket’.

 

After 48 hours, if you feel you need so much as one Paracetamol or aspirin to control pain you should avoid any smoking of any kind. This usually reflects that the clot has not grown enough to cover all the exposed bone in the socket. The exposed bone is filled with raw nerve endings. Until the nerve endings are covered with a healthy blood clot, they will cause pain. Smoking will just slow down this process significantly and make the pain even worse.

 

Therefore, if there is any question about smoking… DONT DO IT!

Activity

You should keep physical activities to a minimum for 6-12 hours following surgery.

 

If you are considering exercise, throbbing or bleeding may occur. If this occurs you should discontinue exercising.

 

Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise.

Please book a review appointment in 2-3 weeks.

Please do not hesitate to call us should you have any questions or concerns

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