After Placement of Dental Implants
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will often be a metal healing abutment protruding through the gingival (gum) tissue.
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 gauze pad placed directly on the bleeding wound for 30 minutes. Bite down and maintain firm pressure on the gauze pack that was placed at the end of your surgery. Do this for at least 30 minutes. At that time, remove the pack and replace it with another gauze sponge as provided. Repeat this as necessary. There should not be excessive bleeding. Bright red blood rapidly pooling in the area is not normal. If this occurs and does not decrease with pressure please call the office immediately.
Apply ice immediately in the area where the surgery was done. If your surgery was in the anterior upper jaw you can expect swelling and discomfort up into the nose and even under the eyes. Bruising and discoloration is not unusual. Crushed ice or equivalent should be placed in a plastic bag then in a washcloth and placed on the face. Apply for 30 minutes, then off for 20-30 minutes. This should be done on a near continuous basis (or as much as possible) for the first 48 hours and longer if possible or if this helps reduce your pain.
Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed. Do not drink with a straw or drink carbonated liquids (minimum 3 days).
If you were asleep for the surgery be sure to eat a soft nutritious food prior to taking any medications. This will decrease the chances of post surgical nausea. You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, purchased over the counter, comes in 200 mg tablets: 2-4 tablets may be taken every 4-6 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it. Do not consume alcoholic beverages while taking your pain medication.
Be sure to take the prescribed antibiotics as directed to help prevent infection
Do not rinse or spit for a minimum of 72 hours and longer if possible. This tends to disturb the blood clot, open the wound and can prolong bleeding and slow healing. There should be no blood in your mouth. Saliva can be swallowed. Do not brush the teeth in the area of surgery for 48 hours. When brushing, be gentle. When expectorating, BE GENTLE. If you used a prescribed mouthwash, such as Peridex, prior to surgery, it should be continued starting after your surgery. Place the mouthwash in the area of the surgery and let it sit 30-60 seconds twice daily until your post-operative appointment.
Warm salt water rinses (half a teaspoon of salt in a cup of warm water) should 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. Remember that an ultrasonic toothbrush may not be used in the implant area for eight months after implant placement.
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 are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise. Avoid excess physical activity and exercise.
DO NOT SMOKE for at least two weeks following surgery. As discussed at your consultation, smoking dramatically increases the risk of implant failure. Dr. De Tolla can prescribe a Nicoderm patch if you feel you need it.
Wearing your Prosthesis or Nightguards
Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment, unless specifically instructed otherwise. Please contact the office if there is any question. If you have a temporary “flipper” to wear, do not place it until the numbness in the area is gone. When it is placed, it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. If you have questions about the fit of your flipper, denture or nightguard, do not wear it until your general dentist or this office can see you.
Other Post-operative Considerations
You will notice that you cannot see the actual implants in your mouth as the gums cover the area. This is good. Do not stretch your lip daily to inspect the area. This can cause wound breakdown. In many instances, a healing cap or abutment was placed over the implant. This will look silver and will be emerging through the gums. Again, do not stretch your lip daily to inspect the area. This can cause wound breakdown. Be very cautious not to eat or chew on these temporary caps or teeth, as it will place undue movement on the implants below and can cause implant failure.