After Placement of Dental Implants
DAY OF SURGERY
FIRST HOUR: Bite down gently but firmly on the gauze packs that have been placed over the surgical area(s), making sure they remain in place. Do not change them for the first hour unless the bleeding is not controlled. The packs may be gently removed after one hour. If active bleeding persists, place enough new gauze to obtain pressure over the surgical site for another 30 minutes. The gauze may then be changed as necessary (typically every 30 to 45 minutes). It is best to moisten the gauze with tap water and loosely fluff for more comfortable positioning.
EXERCISE CARE: Do not disturb the surgical area today. Do NOT rinse for the first 24 hours.
PLEASE DO NOT SMOKE for at least 48 hours, since this is very detrimental to healing. Please refrain from any exercise or physical activity for the next 5 to 7 days.
OOZING: Intermittent bleeding or oozing overnight is normal. It is common for your saliva to be pink colored. Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.
PERSISTENT BLEEDING: Bleeding should never be severe. If so, it usually means that the packs are being clenched between teeth only and are not exerting pressure on the surgical area(s). Try repositioning the packs. If bleeding persists or becomes heavy you may substitute a tea bag (soaked in very hot water, squeezed damp-dry and wrapped in moist gauze) for 20 or 30 minutes. If bleeding remains uncontrolled, please call our office.
SWELLING: Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 24 hours after surgery.
ORAL HYGIENE: Do not disturb the surgical area today. Do not rinse for 24 hours or probe the area with any objects, your tongue or your fingers.
YOU MUST BRUSH THE SURGICAL AREA GENTLY!!!
The morning following your procedure, begin rinsing with the Peridex (Chlorhexadine) rinse twice a day AFTER you brush your teeth. Additionally you should rinse using salt water (1/4 teaspoon of salt dissolved in an 8 oz. glass of warm water) to help keep the area clean. Repeat as often as you like, but at least two to three times daily for the next week. Two days following your procedure, begin brushing the implant site using a child’s toothbrush (soft bristles). Brush the front, back, sides, and top areas of the implant site. DO NOT use an electric tooth brush. Do NOT floss the surgical area for 2 weeks. DO NOT SMOKE for at least 72 hours, since it will delay healing. Cleanliness after surgery is very important for a rapid and uncomplicated recovery. Food left in the wounds retards healing and invites infection.
DIET: IT IS EXTREMELY IMPORTANT NOT TO CHEW ON THE IMPLANT SITE. Please keep all food on the opposite side of the implant site. Eat any nourishing food that can be taken with comfort. Avoid extremely hot foods. Do not use a straw for the first few days after surgery. It is sometimes advisable, but not absolutely required, to confine the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milk shakes, etc.) It is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the socket areas. Over the next several days you may gradually progress to solid foods. It is important not to skip meals! If you take nourishment regularly you will feel better, gain strength, have less discomfort and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor.
MEDICATIONS: Unfortunately most oral surgery is accompanied by some degree of discomfort. You will usually be given 2 prescriptions for pain medication. Begin by taking one pill of each pain medicine (Motrin (Ibuprofen) and Vicodin (Hydrocodone)) together. Continue to take the 1 pill of Motrin every six hours and 1 pill of Vicodin every 4 hours. If you take the first doses before the local anesthetic has worn off, you should be able to manage any discomfort better. Some patients find that pain medicine causes nausea, but if you precede each pain pill with a small amount of food, chances for nausea will be reduced. The effects of pain medications vary widely among individuals. Remember that the most severe pain is usually within six hours after the local anesthetic wears off; after that your need for medicine should lessen. If you find you are taking large amounts of pain medicine at frequent intervals, please call our office. If you anticipate needing more prescription medication for the weekend, you must call for a refill during weekday business hours. You will also usually be given an antibiotic to take for one week after your procedure. For your initial dose begin by taking two pills then one pill 4 times a day (after breakfast, lunch, and dinner and before bed).
INSTRUCTIONS FOR THE SECOND AND THIRD DAYS
HOT APPLICATIONS: Apply warm compresses to the skin over the areas of swelling (Moist Heat/Moist Heating Pad) for 20 minutes on and 20 minutes off to help soothe tender areas. This will also help decrease swelling and stiffness.
HEALING: Normal healing implant placement should be as follows: The first two days after surgery are generally the most uncomfortable and there is usually some swelling. On the third day you should be more comfortable and, although still swollen, can usually begin a more substantial diet. The remainder of the post-operative course should be gradual, steady improvement. If you don’t see continued improvement, please call our office.
It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. Dr. Gold can be reached at any time after hours. Calling during office hours will afford a faster response to your question or concern. PLEASE NOTE: Telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours.