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After Placement of Dental Implants

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment protruding through the gingival (gum) tissue.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing or redness in the saliva is not uncommon. Blood is like food coloring and a small amount will turn the saliva pink or red, possibly for several days.  Do not spit as this may stimulate bleeding.  Excessive bleeding (blood visibly welling up at the surgery site) may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad (folded to about one inch square) over the area and biting firmly for thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. To minimize further bleeding, do not become excited, sit upright, and avoid exercise. If bleeding does not subside, call for further instructions.  We are in the office until 4:30 p.m. – if possible, please call before this if you think there may be a problem.

If blood clots are present in the mouth as may occur after sleeping, wipe them gently away and treat any bleeding as previously described.

Swelling

Swelling is a normal occurrence after oral surgery, particularly if procedures in addition to implant placement were performed.  Many single implant surgeries will have only minimal swelling. To minimize swelling, apply an ice bag, or a plastic bag filled with ice and wrapped in a towel, on the cheek in the area of surgery. Apply the ice for fifteen minutes at a time with short breaks, as much as possible, for the first 36 hours.

Diet

If you have had general anesthesia or I.V. sedation, liquids should be taken initially, ideally water, until you are confident that nausea or vomiting will not be a problem. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away from the surgical sites. Soup, apple sauce, pudding, jello, ice cream/milk shake are easy items to start out with.  High calorie, high protein intake is important.  Nourishment should be taken regularly. You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. Avoid carbonated beverages for the first few days.  You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Never chew on the area of implant placement until approved by your doctor.

If a temporary tooth or denture has been placed, please do not chew with it.  It is not designed to tolerate chewing.

Wearing your Prosthesis

Unless otherwise instructed, partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 10 days or longer as per your doctor’s instructions. This was discussed in the pre-operative consultation.

Pain

Placement of dental implants, if there are no other simultaneous procedures, is generally much less painful than other procedures and much less than anticipated by the patient.  Often, prescription pain medication is not needed, but your doctor will have provided a prescription “just in case”.

The following information is for healthy adult size patients only with normal liver and kidney function and who are not taking other medications.  Please ask your doctor about dosing for children.  You may begin taking pain medication as soon as you feel the local anesthetic wearing off.  For mild to moderate pain, Ibuprofen (Advil or Motrin) may be taken.  Ibuprofen, bought over-the-counter comes in 200 mg tablets:  2-3 tablets may be taken every 6-8 hours as needed for pain.  Taking this medication every 6-8 hours for two days or more will greatly enhance the effects of the medication.  Patients who do this tend to have less pain than those who do not.  Tylenol may be taken instead of Ibuprofen, but be aware that your prescription pain medication may contain Tylenol also.  For severe pain, the prescribed medication should be taken as directed on the bottle, in addition to Ibuprofen or instead of regular Tylenol, unless otherwise directed.  The prescribed pain medicine will make you groggy and will slow down your reflexes, alertness, and concentration. Do not drive a vehicle, work around machinery or other dangerous areas such as a hot stove, and do not be responsible for child care. DO NOT drink alcoholic beverages. For most patients, pain or discomfort following surgery will subside each day after the 3rd day. If pain persists, it may require attention and you should call the office.  DO NOT take any of the above medication if you are allergic, have had a reaction to, or have been instructed by any doctor not to take it.

Maximum dose of Ibuprofen is 800 mg every six hours and 3200 mg in 24 hours.

Maximum dose of Tylenol is 1000 mg every six hours and 3000 mg in 24 hours.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection.  Call your doctor if you have a reaction or develop multiple unformed (watery) bowel movements.

Oral Hygiene

Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex (chlorhexidine) Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 30 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) may be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.  After initial healing, exposed healing abutments should be cleaned well enough to stay bright and shiny.  Do not use an electric toothbrush or water-pik for 4 weeks.

Activity

Keep physical activities to a minimum immediately following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you may not be taking normal nourishment. This may weaken you and further limit your ability to exercise, all of which may result in poor healing.

Nausea and Vomiting

Nausea and vomiting can occur due to a combination of altered diet, reaction to anesthesia, and medications (especially prescription pain medications).  In the event of nausea and/or vomiting following surgery, do not take anything by mouth, if possible, for about an hour, including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking food and the prescribed medicine.  Nausea due to medications is less likely if you have some food in your stomach.  You may call our office if the nausea and/or vomiting persists.

Allergic Reaction

Occasionally, an allergic reaction can occur to one of your medications.  Allergic reactions usually consist of itching, rash, or hives.  If such a reaction occurs, you should stop taking the medications and call our office.  Over-the-counter Benadryl may help alleviate these symptoms, but also will cause drowsiness.  If a severe reaction such as swelling of the face or neck or difficulty breathing occurs, contact your nearest hospital emergency department and/or call 911 immediately.

Other Complications

  • If numbness of the lip, chin, or tongue persists the day after surgery, as stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Numbness from the local anesthetic used during the procedure may last for 8-10 hours.  If numbness is persistent the day following implant surgery, please contact us right away, even if it is the weekend.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen may be taken to reduce a fever.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery and it may be difficult to take fluids following surgery. Taking pain medications can make you dizzy. You could get light headed if you stand up suddenly. Before standing up, you should sit upright for one minute then get up.
  • If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
  • Sore throats and pain when swallowing are not uncommon following surgery. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in a few days.
  • Stiffness of the jaw muscles may cause difficulty opening your mouth for a few days or more following surgery. This is a normal post-operative event which will resolve in time.  Gently, repeated opening of the mouth wide enough to accommodate at least two fingers placed vertically between your front teeth will help this, as will warm compresses.  Headaches may also occur.

More questions about Dental Implant Surgery or Home Care? Call our office at Coyle and Lance Oral & Maxillofacial Surgery Phone Number 573 449-4900.

Finally

Sutures are often placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged soon after surgery and this is no cause for alarm. Just remove the suture form your mouth and discard it. Sutures may be used that will dissolve and come out on their own in 4-8 days, however for implant surgery, longer lasting sutures are frequently used and may require removal at a follow-up appointment in about two weeks.

The pain and swelling may maximize 2-3 days following surgery should subside each day following that. If your post-operative pain or swelling worsens or unusual symptoms occur call our office for instructions.

Your case is individual since no two mouths are alike. Well intended advice from family or friends may be inappropriate. Please call our office if you have questions.

Brushing your teeth is okay – just be gentle at the surgical sites.

If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.  Strenuous activity, exercise, or work is discouraged for one week following oral surgery, as this may precipitate pain.