After Placement of Dental Implants
Do not disturb the wound. Avoid rinsing, spitting, or touching the wound with applicators on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue if the procedure was done as a single stage procedure. If the gingival tissue was closed over the implant then it is a two-stage procedure requiring an uncovering procedure after a specified length of time for healing depending on what procedure was done.
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 lightly biting on a moistened gauze pad placed directly on the bleeding wound for 30 -45 minutes. Most bleeding after the first day is intermittent and stops with no to little pressure with gauze pads needed. If the bleeding is significant, as noted by the front teeth turning noticeably red when the patient smiles, please call for further instructions on what to do to control the bleeding. Excessive changes of the gauze pads (more than 4 times) or frequent changes (less than 30 minutes), using straws, spitting, or rinsing the mouth on the first day of surgery often create more bleeding.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, bag of frozen peas, or a plastic zip lock bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice intermittently 20 minutes on and 20 minutes off, as much as possible, for the first 12-24 hours after surgery. Keep the head elevated when resting or while sleeping at a 30-degree angulation (three pillows or a recliner) for at least the first 2 days postoperatively.
Drink plenty of clear, non-acidic fluids. Avoid hot liquids or food high in particulates or acidity in the first 8-12 hours. Soft foods and hot liquids can be eaten on the day after surgery. Spicy foods should be avoided for 10 days or more after surgery. A return to a fairly normal routine diet in 7 -10 days is usually possible unless otherwise directed by Dr. Chun at the follow-up appointment
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. The local anesthesia most commonly used will wear off within 2-4 hours after leaving the office unless you are otherwise advised that other types of local anesthetic were used. For moderate pain on a rating scale of 3-4 out of 10, Ibuprofen (Advil or Motrin) may be taken instead of Tylenol. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets (400 to 600mg) may be taken every 6-8 hours as needed for pain. If you cannot take Ibuprofen due to a bleeding tendency, ulcers, kidney disease, drug interaction or allergy, you may try Tylenol as a second choice. 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 6 hours. For severe pain, the prescribed medication, usually a narcotic, should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your physician/medical doctor not to take it.
Be sure to take any prescribed antibiotics as directed by Dr. Chun to help prevent infections.
If you have a prior history of bacterial endocarditis (bacterial infection of the heart) or a prosthetic heart valve replacement you will need antibiotic prophylaxis prior to surgery that should be discussed at the consult prior to surgery. Patients with orthopedic joint replacements are another patient population that will need to have antibiotic prophylaxis prior to any dental surgery or cleanings being done.
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 30 seconds and then spit it out. Warm salt water rinses (a teaspoon of salt dissolved in ½ to 1 cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth around the healing abutments is no problem but stay about a tooth away from the healing abutment for about 2 weeks or until your follow-up exam. Be gentle initially with brushing the surgical areas not to hit the tissue directly around the implant.
Keep physical activities to a minimum immediately following surgery for 2-3 days. If you are considering exercise, throbbing or bleeding may occur. This is not serious unless the site has direct trauma to it. If this occurs, you should discontinue exercising and take Ibuprofen for the throbbing if needed. Bleeding usually stops on its own if it occurs. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise as you normally would prior to surgery.
Wearing your Prosthesis
Partial dentures, flippers, or full dentures may be placed immediately after the surgery and adjusted for you to use. If they have not been adjusted by Dr. Chun or the restorative doctor doing your case then you should not wear the dentures until they are adjusted by your doctors. Even after surgery, if the denture prosthesis is causing soreness or irritation then they should be immediately removed and your doctor called to adjust the denture so that the area is not traumatized by the prosthesis.