DENTAL IMPLANTS AND BONE GRAFTING: INSTRUCTIONS FOR POST OPERATIVE CARE
Dental implants are the best way of replacing lost teeth. They form a firm foundation for placement of a prosthesis, provide excellent aesthetics, restore complete chewing and speech and best of all, they last a long time.
Dental implants require certain bone width and height to be placed successfully. In cases of severe bone loss, when there is not enough bone present, you might be recommended to undergo a bone grafting procedure. These procedures may become ridge augmentation, or sinus lift surgeries. These are done to enable the growth of new bone so that placement of dental implants become possible.
Proper post operative care will ensure that your surgical wound heals well and you get the results you desire.
It is normal to have some bleeding from the surgical site for the first few hours. Therefore, it is important that you keep in the mind the following instructions:
- Bite down gently but firmly and constantly on a folded piece of gauze over the surgical site for 1 hour after your procedure. The gauze pack should be big enough so that your teeth do not touch when biting down to make sure there is pressure over the area. Your oral surgeon will place such a pack on the surgical site.
- If bleeding persists after 1 hour, place a new piece of folded gauze over the site for another 30 to 45 minutes and repeat as needed. It is important that you do NOT change the gauze too frequently as this will pull off the clot and stimulate bleeding.
- It is common to have some mild oozing or spotting for up to 24 to 48 hours. If bleeding still persists, bite more firmly on the gauze moistened with water or soaked in strong, regular black tea (which contains tannic acid that helps with clotting) for an additional hour and make sure the gauze is positioned directly over the surgical area.
- However, if the bleeding is severe, please contact us immediately and we will take care of it.
- Please remember to remove the gauze gently when you sleep or eat.
- It is also recommended that you keep your head slightly elevated the first day while lying down (head above the heart). This will help decrease the swelling in the area and promote recovery.
- Do not disturb the surgical area for at least 48 hours. Any type of aggressive swishing, spitting, manipulation, or the use of straws within 48 hours can disturb the clot that is being formed in the wound area. This will delay wound healing, prolong bleeding and pain contribute to pain.
- Maintain good oral hygiene. Gently brush your teeth that are away from the site of your surgery. Make sure you are swishing and spitting gently to ensure you do not disturb the clot.
- You can go back to brushing as regular after 1 week of surgery.
- If bleeding is well controlled after 24 hours, begin rinsing gently with warm salt water (1/2 tsp of table salt in 8 ounces of warm water) and allow the water to fall out or drip into the sink. Rinse gently after all meals and after brushing for 2 weeks.
- If you have been given a prescription for (Peridex) mouthwash, start using the day after surgery, as directed. Do not use Peridex longer than advised because long term use may cause persistent brownish staining of the teeth.
- If your surgeon placed a silver healing cap or abutment over the dental implant, you may begin cleaning the abutment after 24 hours with a Q-tip moistened with tap water and with a small amount of toothpaste. It is important to keep the abutment clean to allow proper healing of the surrounding gum tissue.
- Avoid using a WaterPik®, electric toothbrush, peroxide, or other OTC mouthwashes for 2 weeks.
- Be careful of eating and drinking until your local anesthesia has worn off as you may spill or accidentally bite your lip or tongue.
- For the first week, your diet should be SOFT or SQUISHY. Avoid anything too hot or spicy. Anything hot may increase your swelling.
- Remember that you shouldn’t chew on the implant cap, bone graft, or surgical site!
Preventing Swelling & Bruising:
- Swelling and bruising are normal after oral surgery and usually peaks by day 2 or 3. The swelling will usually go down by 4th or 5th day.
- You can use a cold pack for compression. Take some ice and wrap it in soft cloth. Use it as an ice pack around the area of surgery from the outside. This will aid in reducing the swelling and will also provide you comfort. It is recommended that you do 15 minutes on and 15 minutes off for the first 48 hours.
- Please take adequate rest of the day of your surgery. Avoid heavy lifting, exercise, or other strenuous activity for at least 1 week.
- You may switch to moist heat after 48 hours. Heat is more effective than ice after 48 hours.
- Bruising may be more noticeable after 3 days and be more profound if you're taking aspirin or other blood thinners. Bruising slowly disappears and the use of warm compresses in the area will speed up resolution.
- Take any antibiotic tablets as directed until the prescription is finished to prevent infection.
- If you are taking birth control pills, antibiotics are known to block them from working. You should use back-up birth control methods for 1 month after surgery as a precaution.
- Some discomfort may be expected after surgery with the most discomfort happening within the first 48 hours. This should decrease after the first 2-3 days.
- BEFORE the local anesthetic injection wears off, you may take your non-narcotic pain medication, i.e. Motrin, Advil, or ibuprofen.
- If your discomfort is not controlled, you may take a stronger prescription pain medication, i.e. Norco.
- Medications like ibuprofen/ Advil/ Motrin are different from Tylenol or Norco (which contains Tylenol). So these can be taken at the same time or overlapped. You should NOT take Tylenol and Norco at the same time however since they both contain Tylenol (acetaminophen). You could overdose on this ingredient if you do so.
- You must NOT drive, operate heavy machinery, drink alcohol or take other sedative medications while taking the prescription pain medication.
For Socket Bone Grafts:
- Bone graft products feel like small, sand-like particles and some may leak out during the first week. This is to be expected and not a cause for concern.
- To prevent excessive amounts of bone graft particles from becoming dislodged:
- Do not rinse vigorously for the first week after surgery. Rinse and swirl only in a gentle fashion.
- Do not touch or scrape the graft area as the material is movable during the first week or two
- Do not eat sharp or crusty foods that may scrape or dig into the graft area.
- Do not pull on your lip to examine the surgical site or probe the area with your tongue, or any objects or your fingers. The stitches may loosen or the incision may open which can jeopardize and delay the healing of the graft or implant.
If You Have a Denture or Prostheses:
- If you wear a "flipper" or denture, keep it out until the bleeding has stopped and your local anesthesia has worn off.
- A denture / prosthesis should not touch the gum over the surgical site or put pressure on the dental implant. If so, it can cause the wound to open or put pressure on the implant which is trying to heal.
- If you have any problems with the fit, do NOT force it or try to wear the device until you are seen for follow up or until your dentist has adjusted it.
Remember These Important Points:
- Do NOT drive, operate heavy machinery, or make important decisions for 24 hours if you have had IV sedation or general anesthesia.
- Do NOT smoke as it increases the risk of infection, poor healing, and graft or implant failure.
- Do NOT use a straw or drink carbonated liquids for the first 3 days.
- Do NOT stretch your lip or cheek daily to examine the surgical site as this may lead to wound breakdown.
- Keep your lips and corners of your mouth moist with Vaseline® to prevent cracking.
- It may be difficult to chew and open your mouth due to tightness of the jaw muscles. This should disappear within 7 days. A continued soft diet, warm compresses, and OTC pain relievers may be helpful.
Remember These Important Points:
- We will see you in 1 to 2 weeks after your implant or bone graft procedure to check on your healing, your hygiene, and possibly to remove sutures.
If you have any more questions or wish to know more, then please reach out to us at (602) 956-9560