Post-Op Dental Implant Surgery
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. Your dental implants most often have a “healing abutment” protruding through the gingiva. This eventually gets thrown away once the tooth or prosthesis is made, and provides an opening through your gums to access the implant. If it is not present, your implant will likely be “uncovered” via a local anesthesia procedure in 3-4 months.
Drink plenty of fluids, and avoid very hot liquids the day of surgery. Soft foods and should be eaten on the day of surgery, especially while still numb from the local anesthesia. Avoid abrasive foods, such as crusty breads, bagels, sharp chips, etc in this area for about 5 days. These can break down the incision lines. At about 2 weeks the tissue around the implant’s healing abutment has matured enough you typically cannot hurt the implant or tissue with foods.
Swelling is a normal occurrence after surgery. To minimize swelling, wear the supplied ice packs, or 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 36 hours. Swelling often peaks 48 hours later, and a red flushness to the face often occurs on the third or fourth day after surgery.
When BMP has been used, you may notice profound second round of swelling on the sixth day. This may be alarming, but is common and usually normal.
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 10 minutes. It is important not to move or disturb the gauze pad for these 10 minutes. If bleeding continues, please call for further assistance.
The sutures usually dissolve in 6 days (plain gut), or 10-14 days (chromic gut).
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 and typically is much more effective. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets (400-600 mg) may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed narcotic 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. Also, aspirin should not be taken at the same time as Ibuprofen or Alieve (Naprosyn).
Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex Oral Rinse before bed. The day after surgery, the Peridex should be used twice daily, after breakfast and before bed. Be sure to rinse for at least 60 seconds then spit it out. Warm salt water rinses (teaspoon of salt in a cup of warm water) can 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. Always use the softest toothbrush you can buy.
Loosening of the Healing Abutment
The healing abutment is hand-tightened onto your implant. There is no lock washer to keep it from unscrewing. On occasion therefore the healing abutment can become loose or come out. If it is loose for more than 1 day, typically your gums will grow underneath it, and will require local anesthesia to trim them and replace it. If it becomes loos during the first 3-6 weeks, depending on the situation, we often wait for more bone maturation until we go back and uncover the implant, replacing the healing abutment. Your implant will be just fine without the healing abutment on it.
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. If your implant was placed without a bone graft – there are minimal limitations on exercising starting the next day, as long as you can tolerate it.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures can be be used after surgery, once Dr. Loetscher has adjusted them to fit, without pressure on the wound. It is very important to bring all prosthesis you wear to your consult and surgery appointments, so instruction and/or adjustments can be done for their use.
In many surgical procedures, intra-venous and post-op steroids (usually decadron) are administered to help control and minimize swelling. These typically give you a boost in energy and mood the first 2 days or so. Unfortunately, they often cause a mild rebound depression on the fourth or fifth day. This may be manifest as feeling slightly lethargic, having a poor pain tolerance, and sometimes grumpiness. By day six or seven, this usually resolves.