Care After Implant Placement
Swelling is expected after implant surgery. Swelling is a part of the natural healing process and may last several weeks. This is dependent on the nature and the extent of your surgery. Individuals with fair skin or who bruise easily may anticipate some discoloration of the skin in the area surrounding the surgical procedure(s).
1. ANESTHETICS- The length of time you experience numbness varies, depending on your metabolism, the type and amount of anesthetic you received and the area of the mouth you were anesthetized. While it is numb, you’ll want to be careful not to bite your cheek, lip or tongue. Stay away from any foods that require chewing until the numbness is gone. When drinking, do not use a straw. The sucking action that occurs when using a straw may loosen the blood clots and prevent proper healing.
2. BLEEDING- Slight bleeding after surgery is not unusual. Your saliva may be tinged with blood for up to twenty-four (24) hours. Gauze should be left in place over the surgery site for at least two (2) hours maintaining firm biting pressure. Note: Sinus bone graft patients may experience bleeding through the nose for up to 24 hours after surgery. A gauze pack will be placed over the site after surgery. Do not forcefully spit or irritate the surgery site. This may cause further bleeding. If bleeding persists, it may be controlled with pressure. Moisten a clean gauze and place directly over the surgery site. Apply moderate biting pressure for approximately ½ hour. Repeat if necessary.
3. DISCOMFORT- It is not uncommon to have discomfort and pain for the first few days after surgery. Take pain medications as needed. The first day it is recommended to take medication even with minimal pain as it is easier to prevent pain than decrease it. Pain medications are most effective when taken before the local anesthesia diminishes and normal sensation returns. Do not take pain pills on an empty stomach. Narcotic pain medication such as codeine, oxycodone, or hydrocodone may cause nausea, vomiting, drowsiness, dizziness, itching or constipation. If these side effects occur, discontinue the medication. You may take an alternative over the counter pain medication as necessary or call our office for assistance. Note: Narcotics (Vicodin) can be supplemented with Ibuprofen (~ 600 mg) or extra strength Tylenol (500 mg) if added pain relief is needed.
4. SWELLING- After surgery, swelling around the mouth, cheeks, eyes, and side of face is very common. This is the body’s normal reaction to surgery and eventual repair. Swelling usually will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Apply an ice pack to the outside of your face over the surgery site for twenty (20) minutes on, twenty (20) minutes off for the first twenty-four (24) hours. Prepare several cold packs by putting damp washcloths in small zip lock freezer bags. These should be placed in your freezer for use following surgery. Poly-vinyl bags of frozen peas also work well.
After twenty-four (24) hours, moist heat can be applied to the area as ice will increase swelling. Sleeping with your head elevated above the level of the heart for the first two post-operative nights tends to lessen swelling.
5. BRUISING- Bruising is also very common after surgery. Bruising can be present over the surgery site and to the lower chin area (possibly the neck area). The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively and last up to 14 days. Moist heat applied to the area may speed up the removal of the discoloration.
6. NAUSEA- Nausea may result from anesthesia medications or the drugs prescribed for pain. To minimize this possibility, avoid taking any medications on an empty stomach. Take all medications with a small amount of food. If you feel nauseated or sick to your stomach drink clear liquids such as Ginger Ale, 7UP, apple juice, broth or try eating toast and crackers.
7. BONE GRAFT SITE- It is imperative that the graft material and sutures remain intact.
- DO NOT rinse or spit aggressively for 7 days.
- DO NOT apply pressure with your tongue or fingers over the surgery site. The graft material is movable during the initial healing phase.
- DO NOT lift or pull on your lip to look at the sutures. This will cause undue pressure and tear the sutures.
- DO NOT drink carbonated beverages for the first 10-14 days after surgery.
- DO rinse gently with the provided mouthwash as indicated.
- You may expect to find small granules in your mouth for the first several days.
- The sutures may take 2-3 weeks to completely dissolve. If they last longer than this, we may need to remove them.
8. DIET- After surgery, drink lots of clear liquids and eat soft nutritious foods. This includes foods that are high in vitamins and protein (high protein drinks, mashed vegetables, yogurt, etc). Do not drink alcohol, carbonated beverages or hot liquids. Be cautious until the anesthesia wears off as you have no feeling in the surrounding area and may unknowingly injure yourself. Avoid acidic foods such as tomatoes, orange juice, and citrus fruits until the surgery site has healed (2 weeks). Do not drink through a straw for at least 48 hours. If you had surgery on only one side of your mouth, favor the other side while chewing for the first few days.
9. ORAL HYGIENE- Hygiene should not be neglected as an accumulation of food and debris may promote inflammation and/or infection. You may rinse and brush your teeth after the numbness wears off. Use an extra-soft toothbrush at least twice daily, avoiding the surgical area. Do not brush the surgical area for at least 4 - 5 days. No electric toothbrushes for at least one week. Rinse with warm salt water (1/2 teaspoon of salt in 12oz of water) after each meal beginning gently the night of surgery. If you are given a mouth rinse by the office, continue it as prescribed. DO NOT apply pressure on the implant with your tongue or fingers.
10. ACTIVITY- Limit strenuous activity for the first 2 -3 days. This will reduce bleeding and minimize swelling. Strenuous work or exercise may promote bleeding.
11. FEVER- After surgery it is normal for the body temperature to be slightly elevated for 24 hours. Please remember to drink sufficient amounts of clear liquids to keep your body hydrated. Please contact the office if there exists a high temperature or if a low-grade temperature persists after the first 24 hours.
12. SMOKING/ALCOHOL- Smoking and alcohol delays healing and predisposes you to infection which can result in the failure of the implant or bone graft. Do not smoke or use alcohol until the incision line is completely healed (> 2 weeks).
13. SUTURES- Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures should dissolve on their own in approximately 3-14 days. If they are still present, we will remove them on your post-op appointment.
14. MEDICATIONS- It is very important that you take all your medications from our office as prescribed. Each medication has a specific role in the post-operative period of your surgery. Discontinue the antibiotic medication if a rash develops or if an upset stomach persists. Report this immediately to our office. Women please note: If you are currently taking Birth Control Pills, be aware that taking antibiotics will decrease the effectiveness of the Birth Control Pills and alternative methods should be utilized. NEVER DISCONTINUE OR MODIFY ANY MEDICATION YOUR PHYSICIAN HAS PRESCRIBED FOR YOU UNLESS INSTRUCTED BY YOUR PHYSICIAN.
15. WEARING YOUR PROSTHESIS- Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment, unless specifically instructed otherwise. If you have a temporary “flipper” to wear, do not insert it until the numbness in the area is gone. When it is inserted, it should not touch the gums in the area of the surgery. If it does, this may cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the implant or bone graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until we can see you.
16. HOMECARE FOLLOWING IMPLANT HEALING-
- Brush at least twice daily with a low abrasive toothpaste.
- Use a soft toothbrush or an electric toothbrush being gentle around the implant site.
- Keep using a non-alcohol, antimicrobial mouth rinse at least twice daily. Dr. Andow recommends Closys rinse but there are other non-alcohol, antimicrobial rinses that work well.
- Use a Waterpik® that has a tank and a Plaque Seeker® Tip. The Plaque Seeker® Tip is made to use specifically around implants. Fill the tank with just water or add one capful of non-alcohol, antimicrobial mouth rinse to the water.
- Other options to clean around the implant include GUM® Soft-Picks®, RotaPoints, GUM® rubber tip stimulators, GUM® end tuft toothbrushes or crisscross flossing with only woven floss or dentotape. Waxed floss is NOT recommended to use around implants.
- Do not use fluoride toothpaste or Sensodyne® ProNamel® toothpaste around the implant.
17. UNUSUAL SYMPTOMS- If any unusual symptoms arise or if you have any questions, please feel free to call Dr. Andow anytime at 303-799-1525 (office), 720-482-9530 (home) or 303-908-4442 (mobile).