After Dental Implant Surgery
Instructions following Dental Implant Surgery are often individualized because there are many different surgeries and scenarios that may have been used in your particular case. Follow any instructions given by your surgeon before following these general instructions below.
Do not disturb the wounds or any stitches placed. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment (post) protruding through the gum tissue, or there may be no sign of anything having been done except for the stitches.
Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a moist gauze pad or tea bag placed directly on the bleeding wound with firm pressure for 30 minutes. If bleeding continues please call for further instructions.
Swelling is a normal occurrence after surgery. However, it is highly variable and in part depends on the actual procedure done. If there were many implants placed or concurrent bone grafting procedures, there is more likely to be swelling. To minimize swelling, apply an ice or cold compress to the jaw, cheek or lip in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours.
If you had stitches placed in your gums they will dissolve and fall out on their own in approximately 1 to 2 weeks. You may experience a few drops of blood in your saliva or minor discomfort when this occurs. If they come out earlier it is not usually a concern unless persistent bleeding occurs. They are harmless if swallowed.
In most cases, straight-forward implant surgeries result in minimal disruption of normal routine and the surgical area can simply be avoided for several days. More complicated cases may require more specific instructions. Drink only liquids after general anaesthesia or IV sedationfor several hours. Do not use straws, as the sucking motion can cause more bleeding by dislodging the blood clot. Following this, you should eat soft foods (pudding, yogurt, soups, pasta, well-cooked veggies) by chewing away from the surgical sites. Because of the ‘freezing’ it may be difficult to judge temperature for the first few days, so be careful with hot food/liquid. High calorie, high protein intake is very important.
Try to avoid tough or crunchy foods (e.g. potato chips, raw vegetables) until healing seems complete, or be very careful to avoid the surgical sites. You may experience some difficulty swallowing in the first few hours because of the freezing, and for the next several days due to the discomfort. Your food intake may be limited for the first few days, but try to maintain a normal intake. You should prevent dehydration by taking fluids regularly. At least five to six glasses of liquid should be taken daily. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.
You should begin taking pain medication as instructed. You may have been given a dose before surgery even began, and in this case just take the next dose as instructed. For moderate pain, 1 or 2 Regular Tylenol™ (325 mg) or Extra Strength Tylenol™ (500 mg) may be taken every 3-4 hours if you do not have any medical conditions that make it unwise (be sure to read the bottle, or check with us if there is any question). Acetaminophen is the generic name for Tylenol™. In general, do not exceed a total of 4000 mg for an adult unless instructed otherwise. Ibuprofen (Advil™ or Motrin™ may be taken instead of Tylenol, and often works better following oral surgery. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 4-6 hours as needed for pain. Again, be sure to read the bottle and not exceed the recommended dose in a day. You may have been given a prescription for ibuprofen or a variety of Tylenol (e.g. Tylenol #3), in which case do not take the over-the-counter variety. Do not take any of the above medications if you are allergic or have been instructed by your doctor not to take it.
If prescribed any antibiotics or mouth rinses (such as Peridex), be sure to take them as directed to help reduce the chance of infection. Not all patients will have such prescriptions, depending on the particular situation. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and contact the office.
Good oral hygiene is essential to good healing. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, especially after meals, for several days until the tenderness is gone. Brushing and flossing your other teeth is important, but avoid the surgical site(s) and stitches completely for a few days to allow initial healing, and then be very gentle with brushing these areas for 1 to 2 weeks. If you have a healing abutment (metal post) or an actual temporary crown (cap or artificial tooth) protruding through the gums, you may follow the same instructions and brush it gently after a few days.
Avoid flossing the healing abutment or temporary crown/cap until instructed to do so.
Keep physical activities to a minimum immediately following surgery. How much to limit and for how long increases as the complexity of the procedure(s) increases. If you over-exert, throbbing or bleeding may occur. If this happens, you should discontinue exercising immediately. How long you must restrict your activity depends on the extent of surgery. Keep in mind that you may not be taking normal nourishment initially. This may weaken you and further limit your ability to exercise.
Avoid smoking and second hand smoke until the area are completely healed over. This could take 2-3 weeks. If you cannot hold off until then, it is in your best interest to avoid smoking as long as possible after the surgery, and then to minimize it. Smoking has been well proven to lead to many complications, such as implant failure and infection, and causes prolonged pain and time to heal.
If you had a ‘sinus lift’ procedure where the floor of the sinus in the upper jaw was elevated to allow for implant placement, you should avoid any activities that cause excess pressure or suction in the mouth or nose for about 10-14 days. In particular, avoid forceful sucking or blowing from either the mouth or nose, woodwind instruments, scuba diving, and if possible airline travel due to the pressure changes. Also, if you must sneeze, open your mouth widely and “let it go” rather than trying to hold it in. You can discuss this with your surgeon if in question.
Partial dentures, ‘flippers’, or full dentures should not be used after implant surgery unless approved by your Citadel Surgeon. They often need to be modified. In general, if the prosthesis puts pressure on the surgical areas or is sore to wear, it should be left out until modified or evaluated.
If you feel the area was getting better for a couple days and now is getting worse (pain and/or swelling), you may have an infection. Other signs are pus coming from the surgical area, or swollen, boggy gum tissue overlying the location of the implant. It is important you call the office if you think you may have an infection.
Your case is individual. No two people or mouths are alike. Do not accept well-intended advice from friends. Discuss your questions or concerns with the persons best able to effectively help you: your Citadel Surgeon.
With any questions or concerns, please seek our advice. Your care is our privilege.
