After Placement of Dental Implants

Hygiene

Do not disturb the wound. Avoid rinsing or touching the wound on the day of surgery. There may be a metal abutment protruding through the gingival (gum) tissue, the wound may be closed up, or there may be a tooth on the implant. Brush and floss teeth and be very gentle in the area of surgery. When flossing pull floss through instead of popping back up between the teeth again as this may dislodge your temporary if placed on the implant. Rinse with mouth rinse as prescribed (usually this is peridex). This can be started the night of surgery or the day after.

Peridex is 15-30 ml swish and spit twice a day for 7-10 days.

Cleocin rinse (if given) is 15-30 ml swish and spit three times a day for 2 weeks or until follow up.

Salt water rinses as needed to keep food out of the site. ( ½ teaspoon of salt with 8 oz of clean warm water.) Do not rinse any bone graft or products out of the wound. Avoid water picks or vigorous rinsing until directed by your doctor.

 

Diet

Soft non-chew diet until directed by your doctor (ie. mashed potatoes, soups, over cooked pasta, flaky fish, soft vegatables, protein shakes, or anything pureed.)

Maintain hydration and high protein intake. Avoid chewing gum or candy.

 

Removable temporaries or prostheses

If you wear a night guard, retainer, or tmj appliance, consult your doctor prior to putting it back in, on the next business day. However, if it contacts the temporary or the abutment placed on the implant, please do not wear it until it can be relieved in that area.

          

Please do not eat with any of the removable temporaries such as a flipper or essix.

If you are out in public and cannot take it out, please order very soft or liquid foods such as soup, creamed vegatables, flaky fish, soft pasta or rice.

Do not sleep with the temporaries in and remove them daily to clean them and your mouth.

If you feel that the temporary flipper or essix is contacting the implant please let your doctor know on the next business day and leave it out until then if possible.

If you wear a partial denture or denture and you feel it is hitting the implant site, please let your doctor know at your nearest convenience.

Sometimes the denture will engage the implants the day of surgery if there are 4 or more implants placed. Your surgeon has discussed this in the original consult and explained about cross arch stabilization and why this type of scenario is okay.

 

Medications

Take all medicines including any antibiotics given to you by your doctor. Antibiotics are usually prescribed with dental implants for 5-7 days. Resume your next dose when it is time.

 

Pain

If able to take ibuprofen, take 2-3 over the counter tablets prior to the local anesthetic wearing off. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 4-6 hours as needed for mild to moderate pain. For moderate to severe pain, the prescribed medication should be taken as directed. You can alternate with the prescribed medication with ibuprofen taking one or the other every 2 hours. This may allow the prescribed pain medicine to work the full 4 hours. Do not take any of the above medication if you are allergic, or have been instructed by a doctor not to take it. Avoid ibuprofen if you have an internal ulcer, severe chronic asthma, or taking blood thinners. Also, the pain medication we prescribed may have Tylenol or ibuprofen already in it. If so, do not add any additional Tylenol or ibuprofen to your regimen as this could lead to kidney or liver damage. The maximum daily allowable dose of Tylenol is 3000 mg and 3200 for ibuprofen.

 

Nausea/Vomiting

The most likely reason is the pain medication you are taking or the anesthesia you were given if sedated.   Try using the nausea medication given to you by our office. If you don’t have any or have questions regarding this call our office. Try taking less of the pain medication and take the Ibuprofen regimen above if directed by your doctor. If this persists please call the office or answering service (same number) to speak to a nurse or doctor.

 

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 48 hours. Upper implants may have required a flap to place or a bone graft may have also been done. This reflection of the tissue can cause severe swelling for the first 72 hours sometimes involving the eyes. This edema will be greatest at 72 hours and should start to subside after this time.

 

Bruising

This is common with surgery and may cause discoloration under the skin.

 

Follow up

You should have a follow up appointment within 2-3 weeks after your surgery. Please call to schedule one if one has not been given to you on the day of your surgery.

 

Sutures

If any were placed, they may get loose and fall out within 5-10 days unless your doctor placed non-dissolvable ones, which he will likely need to remove in the next 1-3 weeks. They may be blue or black and left long intentionally. This is to prevent them from cutting into you gums or tongue.

 

Other complications:

Numbness

If you have numbness that persists until the next day, let Dr. Chandler know. Most of the time this is from holding the tissue back during surgery and the nerve may be bruised. Other times it may be from injury to the nerve by another mechanism. In either case, let Dr. Chandler know.

Temporary fell off

Call our office and let us know. If it is on the weekend, call us and let us know anyway. We may need to see you over the weekend for this.