surgical instructions: before iv anesthesia | after dental implant surgery | after wisdom tooth removal
after multiple extractions | after exposure of an impacted tooth | after endodontic surgery

After Dental Implant Surgery

Immediately Following Dental Implant Surgery:

The gauze pack placed over the surgical site should be kept in place and replaced as needed for bleeding.
Take the prescribed pain medications as directed and start taking in fluids.
If liquids are well tolerated, the diet can be advanced to soft cool to room temperature foods.
Avoid chewing foods until after tongue sensation has returned.
Place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for explanation.


		Swelling
		Swelling is a normal occurrence after surgery and will not reach its maximum until 2-3 days after surgery. However, the swelling may be minimized by the immediate use of ice packs. A zipper lock bag filled with ice, or ice pack should be applied to the sides of the face where surgery was performed. If continuous use is uncomfortable, then use it for 20 minutes on and 20 minutes off. Apply the ice continuously as much as possible for the first 36 hours. Suggested way to apply ice: Fill two zipper lock bags with crushed ice. Cut a pair of pantyhose at thigh, and slide both bags halfway down the leg (to about the knee). Tie ends of pantyhose on top of the patient’s head and adjust ice to side of face. Please call the office if the swelling does not subside four to five days after surgery as this may indicate infection.

Bleeding

Bleeding will occur after surgery, and it is not uncommon to ooze blood for 24-48 hours after surgery. Keep in mind that oral bleeding represents a little blood and a lot of saliva. Placing a gauze pack over the area and biting firmly will control bleeding. If oozing is still active, replace gauze as needed. If bleeding continues or begins again, sit upright or in a recliner, avoid physical activity, use ice packs on the sides of the face where surgery was performed and bite gauze for 1 hour or on a moistened tea bag for 30 minutes. The tannic acid in the tea bag helps to form a clot by constricting bleeding vessels.

DO NOT RINSE, SPIT, OR DRINK THROUGH A STRAW - This will cause suction and could result in bleeding. If you wish to clear blood from your mouth, let it drip into the sink, but do not rinse or spit.

Pain

Discomfort is common after any surgical procedure. Take the pain medication as prescribed by your surgeon. For mild to moderate pain you may switch to your choice of over the counter pain medication. If your post-operative pain or swelling worsens beyond the third day after surgery or unusual symptoms occur, please call our office.

NOTE: Tylenol should not be taken concurrently with the prescription pain medication as this typically already has Tylenol as an ingredient and could result in overdosage.

Diet

On the day of surgery, we recommend cool liquids and soft cool foods. You may eat anything soft by chewing away from the surgical sites. You should prevent dehydration by taking fluids regularly. Try not to miss a meal.

Please avoid popcorn, rice, nuts, and seeds for 6 weeks after the placement of dental implants.

Discoloration or bruising

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to bruising beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively. Beginning 36-hours after surgery, moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

Antibiotics may be prescribed to help prevent infection. If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash or other unfavorable reaction, and call the office.

Female Patients: Antibiotics and other medications may interfere with the effectiveness of oral contraceptives. An additional form of birth control should be utilized for one complete cycle of birth control pills after the course of antibiotics or other medication is complete.

Nausea and Vomiting

Nausea and vomiting can occur as a result of swallowed blood, discomfort or anesthesia. Post-operative nausea is usually self-limiting and sipping on FLAT cola (Pepsi or Coke) often helps. Soda crackers may also be used with the cola. If nausea persists, stop taking the pain medication and substitute an over the counter pain medication for the next dose. If nausea is persistent, call our office.

		Activity
		Activities after surgery should be couch or bed rest for the first day. Bending, lifting, or strenuous activity will cause increased bleeding, swelling, or other problems. You should be careful going from the lying down position to standing. You could get light-headed when you stand up suddenly. If you are involved in regular exercise, be aware that your normal fluid and caloric intake is reduced. Exercise in the post-operative period may also result in increased bleeding, swelling, and discomfort. Exercise should be avoided for 3-4 days following surgery.

Tobacco

Smoking, chewing or dipping will retard healing and cause increased discomfort. We strongly advise you to discontinue these habits during your healing phase. As we discussed at the evaluation, smoking creates a great risk over the surgical areas by delaying wound healing, increasing the risk of infection and negatively affecting blood flow to the surgical sites. While we recognize the difficulty in smoking cessation, we expect a significant reduction in your smoking to at least one half of the amount smoked before your surgical procedure. (Example: Pre-surgery: 10 cigarettes per day, Post-surgery Maximum: 5 cigarettes per day.) While not being ideal, it will still improve our results. Your surgeon may also prescribe a nicotine replacement patch if you are not able to quit or reduce the amount you smoke.

Oral Hygiene

Mouth cleanliness is essential to good healing. Clean your mouth thoroughly after each meal beginning the day after surgery. If there is no bleeding, you should begin warm salt-water or baking soda rinses at least three (3) times per day beginning 24 hours after surgery. (Mix 1 tablespoon of salt or baking soda with 8 ounces of warm water.) In addition, an anti-microbial rinse may be prescribed.

Other Complications

Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
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. The muscles get swollen. The normal act of swallowing can then become painful. This should subside in 2-3 days.
Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event, which will resolve in time.

Finally

Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 10 days.
It is absolutely essential that all follow-up appointments be kept. Routine follow-up appointments can identify potential problems that could delay the restoration of your implant.