Dental Implants

After Your Surgery

Post-Operative Instructions

Home Care After Implant Surgery

Please follow the guidelines below. Call your doctor if you notice any unusual symptoms. Please remember that you are under the influence of medication post-surgery if your procedure was completed with IV sedation; therefore, do not drive, drink alcoholic beverages, sign legal documents, or make any major decisions during the next 24 hours.

Protection of the blood clot and surgical site(s)

• Bleeding after implant placement is normal and may last for several hours.
• Put gentle pressure on your cheeks, jaws, and chin with cool packs.
• If you have a removable denture, then place gauze in the molar region and bite down.
• If there is no active bleeding, then leave the gauze out.
• Lay in a semi-reclined position. Keep your head above your heart unless you feel faint.
• Avoid spitting, bending over, sucking through a straw, and rinsing for 24 hours.
• No strenuous physical activity or smoking for 10 days.
• Oral mouth rinse should be continued for 2 weeks if prescribed.

Rinsing

Rinsing may dislodge the blood clot and interrupt the normal process of healing. Carefully follow these steps in order.

Day 1 (Day of surgery/first 24 hours after surgery):

• Do not rinse or brush your teeth.
• Do not spit.

Days 2 and 3:

• Brush your teeth 2 times a day. Be gentle around the surgical sites.
• If you have a non-fixed denture, remove it to rinse and clean the inside of the denture.
• Begin gentle rinsing using a glass of warm salt water solution (½ teaspoon of salt per 1 cup of water). Repeat rinsing after meals.
• If you were prescribed a solution, rinse as directed.
• Do not brush the gums. Avoid brushing the surgical site.

Day 4 until day 42 (6 weeks):

• Same regimen as days 2 and 3, however, rinse with a little more force.
• Continue rinsing and cleaning in this manner for 6 weeks.
• Care of teeth
• Starting day 2, brush your teeth 2 to 3 times a day. Be careful of the incisions.
• No temporary prosthesis may be placed on the implant site for at least 3 weeks unless advised otherwise.
• Do not start a Waterpik^® until 12 weeks after the surgery.

Swelling / Fever / Bruising

A cool pack placed on your face will be beneficial to help control swelling and bruising. This should be used for at least 48 hours. If extreme swelling or a fever temperature above 101.5 occurs, contact the office. It can be common for your face to be bruised or swollen for 2 to 3 weeks after surgery.

Pain

Some discomfort is normal following oral surgery. Specific medication instructions will be provided during discharge teaching. PLEASE TAKE THE MEDICATION AS PRESCRIBED. It is often beneficial to take the medication after eating to help prevent nausea. Do not drive while using narcotic pain medications.

No Smoking or Alcohol

Do not smoke for 10 days or drink alcohol for 48 hours following oral surgery. This may cause a disruption of healthy blood clot formation and increase the chances of complications, such as prolonged healing, wound breakdown, and post-operative infections.

Diet

No hot liquids for the first 24 hours. Cool liquids are best to start, but avoid sucking through straws. When the numbness starts to wear off, advance to a soft food diet but avoid chewing in the area of surgery. Eat something after your surgery. A soft food diet is recommended for 4 weeks.

A cool pureed diet (like smoothies) are best for the first day.

Sharp bony edges

You may feel hard, sharp areas on the surgical site. Leave them alone: never pick or scratch at them. Notify the office staff at your post-operative check-up.

Nausea

Nausea is a normal side effect of narcotic pain medications. If you have severe nausea or vomiting, you may need to stop the pain medications or take an additional anti-nausea medication.

Activity

Rest and relax. Limit vigorous physical activity for the first 3 to 4 days after surgery. After 4 days, you may resume activity as tolerated unless otherwise directed.

NOTE: If a healing abutment was placed on your implant, it may loosen as it is not a precision fit by design. It is meant to come off for restoration. Please do not panic, it is likely NOT your implant loosening. Simply call APEX the next business day and your surgeon will re-tighten it if necessary.

CONTINUING CARE AFTER IMPLANT STAGE 1 or 2

Please follow the guidelines below. Call your doctor if you notice any unusual symptoms.

CRITICAL CARE AND MAINTENANCE OF YOUR IMPLANTS AND RESTORATIONS

An implant is a FOREIGN BODY and NOT A REAL TOOTH. IT IS A MEDICAL DEVICE. Implants and their restoration are tooth replacement systems that require continuous and stringent maintenance and care to ensure long-term success and survivability.

The soft tissue around the implant/crown/prosthetics must be exceptionally maintained. The soft tissue is the “gatekeeper” which prevents food and bacteria from penetrating and/or compromising the implant in the bone. Good quality soft tissue helps to prevent chronic infections and problems with your implant prosthetics. Dental implants are an investment in yourself, your health, and your future.

DAILY MAINTENANCE

Poor oral hygiene and bad oral habits (e.g., tobacco products, grinding teeth) can lead to implant and prosthetic failure. Good oral hygiene is a must. A good rotary toothbrush, such as an Oral B^® Professional Care battery-operated toothbrush, is required to maintain ideal soft tissue and excellent oral dental hygiene. Flossing around the implant restoration with the TePe^® Bridge & Implant Floss must be completed daily. After brushing and flossing use Waterpik^® Water Flosser with Interdental Brush Heads (use 50% Listerine^® mixed with 50% water in the storage tank) to flush out the areas around and between all teeth and restorations. This complete process of brushing, flossing, and flushing should be completed at least twice a day, every morning and night, to ensure no plaque accumulation, bacteria, or calculus build-up occurs around the implant or restoration. Don’t use a setting higher than #6 on the Waterpik Water flosser. For Waterpik settings, start at setting 1 pulsating. Increase by 1 level per week until level 6.

In addition, it would be beneficial to complete a thorough swishing with a non-alcohol rinse (e.g., Listerine Zero) every night before bed. This will reduce bacteria and keep the area clean. A Monoject^™ syringe given to you can also be used to flush the area around the implant on a daily basis if you don’t have a Waterpik Water Flosser available. In areas where you have good access and larger spaces, one could use the WaterPik Power Flosser to assist with the removal of gross plaque accumulation.

WEEKLY MAINTENANCE

It is critical to continue to change the bacteria content and environment around the implant prosthetic system or tooth, as the anatomy is not similar to a real tooth. The mucosa (soft tissue) around the implant on both the tongue and cheek sides must be massaged once a week with your two fingers. This will create a pressure flushing movement and will assist in changing bacteria content around the implant and reducing chronic bacteria accumulation in the area of implant and soft tissue.

YEARLY MAINTENANCE

Implant systems need regular dental care and maintenance by your restorative dentist. This includes cleaning of the area, radiographic evaluation, and sometimes tightening or changing parts of the implant system.

The implant restoration is a screw-in-screw system which requires yearly maintenance. It is extremely important that you return to your restorative dentist as soon as possible if the crown/prosthesis becomes loose. In addition, implants do not move, but teeth do. Your bite must be assessed at every recall appointment with your restorative dentist, as overloading the implant (biting too hard on the implant) can lead to implant or restorative failure.

Please follow the guidelines as instructed. Call your doctor if you notice any unusual symptoms. Please remember that you are under the influence of medication post-surgery; therefore, do not drive, drink alcoholic beverages, sign legal documents, or make any major decisions during the next 24 hours.