After Placement of Dental Implants
BLEEDING: Expect to have some bleeding from the surgical site postoperatively. You might be asked to bite down on some gauze after the surgery, changing it every 15 minutes for no longer than 2 hours. If profuse bleeding continues after the 2 hours of using gauze then you may place a moist tea bag over the surgical site for 20 minutes. Occasionally after implant surgery the blood clot can form over the metal abutment that is protruding through the tissue. If this happens, take a damp piece of gauze and wipe the clot away. Then place another piece of damp gauze over the abutment and apply pressure with your thumb and index finger on the sides of the abutment. If the bleeding continues after doing this a few times, then give us a call.
RINSES: Begin the day of surgery, rinse gently, using ½ oz. Periogard / Peridex mixed with ½ oz. water solution. This is important for healing and hygienic purposes. These rinses should be repeated 4 times a day (after every meal and at bedtime) and continue until the postoperative visit. The first two days avoid swishing vigorously and spitting. Rather, hold the liquid in your mouth, tilt your head back and forth, and let the liquid fall into the sink. Tooth brushing can be resumed immediately just avoid brushing too aggressively around the surgical sites. The use of a Q-tip dipped in this solution (begin the day after surgery) to keep the surgical site clean is helpful if using your toothbrush is too uncomfortable. At time of implant surgery an abutment is usually placed over the implant and protrudes through the gum tissue. Do not use an electrical tooth brush over the abutment while it is in the mouth.
DIET: It may be necessary to eat soft foods such as soup that is cooled to room temperature, Jello, cereal, eggs, or yogurt for several days. Some of the liquid diet preparations are helpful, such as Ensure, Carnation Instant Breakfast, or protein shakes/smoothies. You will feel better, have more strength, less pain, and heal faster if you continue to eat a healthy diet. Follow the rule: If your mouth hurts, then continue with soft foods.
FLUIDS: Fluids are very important, especially after an intravenous anesthesia, even though it may be uncomfortable. An adult should consume two to three quarts of fluids every day. Avoid alcoholic beverages for the entire time you are on prescription medication and avoid using straws and drinking carbonated beverages for at least 48 hrs, or longer if a sinus lift/push up procedure was performed (see back page for sinus precaution). Hot beverages may promote bleeding, so room temperature or colder beverages are recommended the day of surgery.
REST: It is always important to get plenty of rest with any surgery or illness. Please remember not to lie flat for 24 hrs. Stay propped up at a 45-degree angle in a recliner or by use of pillows. This will help reduce swelling, bruising, and bleeding. Avoid vigorous activity such as exercising or lifting heavy objects for 5-7 days after a bone graft or multiple implant surgery. Avoid vigorous activity for 2-3 days after only 1-2 implants have been placed. Resume exercise only if you are not experiencing symptoms.
SUTURES: The incisions are closed with sutures. The sutures are usually either dissolvable or non-dissolvable or a combination of both types. The dissolvable sutures take about 5-7 days to dissolve. If sutures are still present at the postoperative visit, the doctor or the assistant may remove them.
SWELLING: Some swelling is to be expected following surgery, sometimes up to one week after surgery. To help control this, apply an ice pack on the outside of your face near the area of the surgery for 20 minutes, remove for 20 minutes. Repeat this alternating process for the first 24-48 hours. After 48 hours, ice packs should be discontinued and moist heat (i.e., warm moist wash cloth) should be applied at 20 minutes intervals. Continue this until swelling has subsided. Once swelling peaks (after 48hrs) it can take up to a week for it to go down. Please call if swelling occurs several days/weeks after surgery. You can expect bruising to appear 2–3 days after surgery, the amount of bruising depends on the extent of the surgical procedure. Areas of probable bruising would include the face, chin, neck, and chest. Use ice packs on the day of surgery and the day following surgery. After 48 hours use warm, moist heat every day until the bruising dissipates (may take up to a week). This process will help reduce the amount and duration of bruising.
BRUISING: You can expect bruising to appear 2-3 days after surgery, the amount of bruising depends on the extent of the surgical procedure. Areas
of probable bruising would include the face, under the eye, chin, neck, and chest. Use ice packs on the day of surgery and the day following surgery.
After 48 hours, use warm, moist heat every day until the bruising dissipates (may last about a week) . This process will help reduce the amount and
duration of bruising.
PAIN: The amount and duration of pain varies per patient. If you are having more pain than can be controlled with Ibuprofen (or similar over-the counter pain medications) or with the prescription pain reliever your doctor gave you, you should call the office.
DENTURE/PARTIAL DENTURE/FLIPPER: Usually can be worn if it does not interfere with the incision. The doctor will check prosthesis, relieve any pressure points and determine whether it can be worn after surgery.
Antibiotics (e.g., Pen VK, Amoxicillin, Clindamycin, E-mycin, Z-pak): Alcoholic beverages should be avoided while taking this type of medication. Please call our office if you develop abdominal pain, cramping, a rash, shortness of breath, or diarrhea lasting longer than 8–12 hours.
Ibuprofen: Take this WITH FOOD. This medication will alleviate mild to moderate discomfort and swelling. Do not take this at the same time as the stronger pain medication (if one was prescribed).
Pain medication (e.g., Vicodin, hydrocodone, Percocet, oxycodone): These are very strong narcotic pain medications and should be used if the ibuprofen alone is not effective. These medications should be TAKEN WITH FOOD and should not be taken any sooner than 1.5 hours after you have already taken the ibuprofen. Please note that Viicodin and Percocet contain Tylenol. If you are not able to take Ibuprofen or only have Tylenol (acetaminophen) at home then you should not take the narcotic (Percocet/Vicoden) any sooner than 6 hours after taking Tylenol. This stronger medication is not needed by many patients. However, if it is required after the local anesthetic wears off (in the early evening), this medication can be taken, but is rarely needed beyond the third day. The patient should refrain from operating a motor vehicle if he/she is taking this medication.
SINUS PRECAUTIONS: Please follow sinus precautions for 2-3 weeks, but only if you have had a sinus lift/sinus push up procedure (in the upper jaw):
• Avoid blowing your nose.
• Try to sneeze with your mouth open.
• Do not spit or cough forcefully.
• Do not drink through a straw.
• SCUBA diving and flying in pressurized aircraft should be avoided.
• Avoid bearing down during exertion, lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action, or any other activity that increases nasal or oral pressure.
• The doctor may also recommend a nasal decongestant to help drain and reduce pressure in the sinuses (e.g., Mucinex, Sudafed, or Coricidin).
FEVER: Patients should not expect to have a fever, but if you do and it is over 101 degrees Fahrenheit, you should call the office and let us know.
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