POST-OP INSTRUCTIONS - IMPLANTS
Sometimes, the after-effects of oral surgery are minimal, so not all instructions may apply. Common sense will often dictate what you should do. However, when in doubt, follow these guidelines or call our office for Clarification. Our number is 301-468-9760.
DAY OF SURGERY
FIRST HOUR: Once the implant(s) is placed, the area will either be sutured to cover the implant, or a “stainless-steel” screw will protrude through the surgical site. This will depend on the “torque value” of the implant body and the density of the bone in which it has been placed. A special " Osstell " machine might also be used to determine that. Either way, the instructions are essentially the same.
PAIN:
Unfortunately, most oral surgery is accompanied by some degree of discomfort. You will usually have a prescription for antibiotics and pain medication. Before taking the medications, if you have not had anything to drink before your surgery, drink a “Protein Shake,” a Milkshake/Ice cream, or Yogurt with a spoon, and then take your pain medications as outlined by your doctor. If you take the pills before the anesthetic has worn off, you should be able to manage any discomfort better.
We have found that the best combination is taking 600-800 mg of Motrin (Ibuprofen) – which can be ONE-PILL by prescription, OR 3-4 over-the-counter tablets - 200 mg each, every SIX hours. You may additionally take TWO Extra Strength Tylenol (Acetaminophen) caplets (over the counter) THREE hours after your initial IBUPROFEN dose. This “staggering of medications” will continuously keep some analgesic in your system and keep you comfortable. You can repeat this cycle for the first 48 hours, as needed. Very seldom does one need anything stronger. CAUTION: DO NOT EXCEED 3200 mg OF IBUPROFEN/24 HOURS. ADDITIONALLY, DO NOT EXCEED 4000 mg OF TYLENOL (ACETOMINOPHEN) /24 HOURS.
SWELLING: An ice pack will be given to you upon completion of the surgery. Swelling is often associated with oral surgery. It can be minimized by using a cold pack, ice bag, or a bag of frozen peas placed inside tube socks or stockings and applied firmly to the cheek adjacent to the surgical area. This should be applied twenty minutes on and 5 minutes off during the first 24 hours after surgery. If needed, a prescription for a steroid dose pack will also be given to you.
FIRST 24 HOURS: Do not aggressively disturb the surgical area. You can gently brush the area where the implant was placed IF A HEALING CAP WAS DIRECTLY PLACED, AND THERE ARE NO SUTURES IN THE AREA. IF THERE ARE SUTURES PRESENT IN THE AREA, THEN PLEASE REFRIAN FROM BRUSHING THAT AREA. YOU MAY TAKE A COTTON TIP APPLICATOR AND DIP IT IN THE MOUTHRINSE THAT WILL BE DISPENSED TO YOU, AND GENTLY SWAB THE AREA. PLEASE DO NOT SMOKE OR DRINK ALCOHOL FOR AT LEAST 48 TO 72 HOURS, since this is very detrimental to the healing process and may CAUSE YOUR IMPLANT TO FAIL.
BLEEDING: There should be little to no bleeding after the procedure. A gauze pack may or may not be utilized. If bleeding should occur, please contact the office immediately. After work hours, contact your doctor at the Emergency number provided. Do not physically exert yourself for 5 days following surgery, as this may affect the integration of the implant.
DIET: Eat soft, nourishing food that can be tolerated without discomfort. Avoid hot foods on the day of surgery. Do not use a straw for the first day after surgery. It is advisable to confine the first day’s intake to liquids or pureed foods (soups (room temperature), puddings, yogurt, milkshakes, etc.) It is best to avoid foods like chips, nuts, sunflower seeds, popcorn, etc., for FOUR TO SIX weeks if the “screw” is sticking out of the gum area. If the implant site was sutured, avoid the above-listed foods for TWO-THREE WEEKS, as they may get lodged in the sutures or the socket areas. It is important, however, not to skip meals and stay nourished. If you stay nourished, you will feel better, gain strength, have less discomfort, and heal faster. If you are diabetic, maintain your normal eating habits or follow the instructions given by your physician.
MOUTH RINSES: Keeping your mouth clean after surgery is essential. Rinse at night with the mouth rinse dispensed on the day of surgery and then am and pm starting the second day. After meals, please use 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with the saline solution. Repeat the warm saline water rinse as often as you like, but certainly after every meal.
BRUSHING: Begin your normal oral hygiene routine 24 hours after surgery. Exercise caution in the area of the surgery, especially if sutures have been placed. If you are brushing with an electric toothbrush, turn the unit off before you reach the sutured area so that you do not inadvertently disturb the surgical site. Soreness and swelling may make the area tender, but please try to clean your teeth within the bounds of comfort.
HEALING: Normal healing after tooth extraction should be as follows: The first day or two following surgery are generally the most uncomfortable, as there is usually some swelling. Making sure to use the icepack diligently will decrease the pain immensely and help prevent facial 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, with noticeable improvement on a steady daily basis.
We will try to call you on the evening of the surgery (between 5:30 and 8:30 p.m.) to ensure you are doing well. Please try to have your phone with you. Following these instructions will assist you, but please call our office if you have questions about your progress. You can contact the doctor by phone after hours, but calling during office hours will afford a faster response to your question or concern.
We would like to see you again for your post-op check in 2 – 3 weeks to remove the sutures or check the tissues around the healing cap.