After Placement of Dental Implants
Every implant procedure has specific post-surgical care associated with it. The following are brief descriptions of post-surgical instructions following the placement of dental implants. These instructions will generally provide enough information for the majority of situations. Dr. Maranon and the surgical staff will provide specific instructions for each patient after their procedure. If additional information is necessary, that information can be found on the adjacent tabs or by contacting the office
It is best to think of pain on the scale of 1-10 (10 being worst). Patients should take the pain medications as soon as you begin to feel discomfort (3/10). This will usually coincide as the effects of the local anesthetic diminish. It is important not to wait until pain becomes worse. Pain medication should be taken on a schedule and not in response to pain. Dr. Maranon and the staff will clarify the schedule of pain medication for each patient. For more information see Pain and Discomfort and Pain medication.
If prescription strength pain medication was prescribed, take these medications directed. The prescribed pain medicine may make patients groggy and will slow down reflexes. It is important that patient not drive an automobile, work around machinery or participate in activities that can cause injury while under the effect of anesthesia or whole taking prescription pain medication. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office. Dr. Maranon and the staff will discuss strategies for alternating prescription pain medication and over the counter pain medication with each patient.
For mild to moderate pain, adult patients may take one or two tablets of Tylenol or Extra Strength Tylenol may be taken every four hours or Ibuprofen (two-three 200 mg tablets may be taken every 4-6 hours. These medications should not be used if they are contraindicated by a medical condition or interaction with other medication.
Though a small amount of bleeding after surgery in common, bleeding after most implant surgery is usually well controlled. If instructed to do so, patients should bite on the gauze placed over their surgical site with continuous firm pressure for the first two hours after surgery. This will help to control bleeding. Patients should not chew on the gauze or spit out, as this will prolong the bleeding. It is important that patients do not smoke after surgery as this can cause bleeding or delay wound healing. Some blood in the saliva for 1 or 2 days is normal. If heavy bleeding occurs, it may be controlled by placing a fresh moistened gauze pack, folded into a two inch square, or non-herbal tea bags over the wound under biting pressure for 30 minutes. Patients may want to cover their pillowcase or use an older pillow in case they have any oozing while sleeping. Remember that a lot of saliva and a little blood can look like a lot of bleeding. If the bleeding continues or if there are concerns about bleeding, contact Dr. Maranon immediately.
Swelling is the body’s normal response after surgery. Swelling normally increases until the second or third post-operative day and resolves in about a week. To minimize swelling apply ice or cold packs to your cheeks for the first 24-36 hours after surgery. These should be used alternating on and off every 20 minutes. Do not use heat unless specifically directed to do so. Light physical activity the day after surgery will help reduce swelling.
Patients may have liquids after 1 hour. Start with clear liquids such as clear juices, Jell-O, Gatorade, Coke, or 7-up. If the patient does not have nausea after 15 minutes, the diet should then be advanced to full liquids (ice-cream or yogurt) as tolerated. Unless instructed by Dr. Maranon, a soft diet may be resumed after a few hours. It is important not to chew on the side of surgery. Patients should drink plenty of fluids. They should not consume any alcoholic beverages for at least 24 hours or while on prescription pain medication or antibiotics. Dr. Maranon will advise each patient on when to advance their diet. Patients may be more comfortable if they avoid spicy foods. Lastly, patients should not eat hard or crunchy foods like French bread, popcorn, nuts, lettuce, raw vegetables, seeds, potato chips or foods that are difficult to chew like salad or chewing gum until instructed to do so by Dr. Maranon.
Use of Temporary Tooth Replacement Appliances or Dentures
If patients use removable appliances to replace missing teeth at the implant site, Dr. Maranon will instruct each patient on the use of these appliances. Patients may initially be instructed not to use them while eating. Depending on the extent of surgery, it may be necessary for patients not to wear these appliances for a few days or longer. Healing of dental implants requires that they not be subjected to functional loads. Excessive loading may result in implant failure requiring removal. If patients have immediate implant supported replacement teeth placed, the patient should remember that these teeth are primarily for cosmetic purposes. Dr. Maranon will instruct the patient as to when normal function on their removable appliances or implant supported replacement teeth can be resumed.
Use of Provisional Tooth Replacement Restorations(Teeth in a Day)
Dr. Maranon uses the term “Party Teeth” to describe these appliances. During the initial healing phase, these replacement teeth must not be used to eat with. Foods must be chewed away from these restorations. Hard, crunchy foods or foods that require grinding of teeth should be avoided completely until advised by Dr. Maranon that these items can be added to the diet.
The numbing effects of the local anesthetic may last for several hours. Special care should be taken not to burn, bite, or otherwise traumatize your lips and tongue. It is important to notify Dr. Maranon if the numbness persists the day after surgery.
Depending on the surgical procedures performed, sutures (stitches) may be placed. They generally “fall out’ on their own as early as three to five days or may last for two weeks or more. The lips or cheeks should not be pulled since this may separate wound margins. The wound should not be disturbed by the tongue or fingers. Sutures are typically white or straw colored and are sometimes thought to be bone, tooth fragments or food. If patients notice them or have any questions about their wound, call our office to have the site evaluated.
Nausea and Vomiting
Rarely, patients will experience nausea and/or vomiting as a side effect of pain medication. This typically resolves quickly. It is important that you discontinue the medication and contact the office. Supportive care is often all that is necessary. Dr. Maranon recommends 7 Up or Ginger ale. Patients should avoid dairy products or advancing to solid foods until symptoms improve. If the symptoms persist, or if patients have an questions or concerns, they should contact Dr. Maranon as soon as possible.
It is not always necessary or appropriate to take antibiotics after oral surgery. If patients are given a prescription, they should have the prescription filled and take the medication according to the directions on the label. Antibiotic medications are to be taken until completed to prevent infection. If patients were given antibiotic medications in the office prior to surgery, the first prescription dose should be taken 6 hours after that dose.
Dr. Maranon will discuss with each patient the use of prescription pain medication. Prescription pain medication is taken as needed, substituting as soon as possible with ibuprofen (Advil, Motrin, or Nuprin), if adequate relief is given. It is important that patients eat something prior to taking pain medication. It is important to remember that the prescription pain medications may make patients drowsy and slow reflexes. Patients must not drive automobiles, work around machinery or participate in activities that have the potential to cause injury while taking these medications or sooner than 24 hours after receiving general anesthetic or sedative medications. Alcoholic beverages must avoided while taking prescription pain medications.
Medications Reactions or Allergies
If a patient should develop a rash or itching, they should stop taking their medication. Nausea, vomiting, diarrhea, urinary problems or fungal infections may also be side effects of medications. Should patients have any reaction to the medications, patients should contact Dr. Maranon as soon as possible.
Patients are asked not to rinse for 24 hours after surgery to control bleeding. After 24 hours, if bleeding has stopped, rinse with warm salt water (1/2 teaspoonful salt to a glass of warm water) every 3-4 hours and after you eat for one week. After 24 hours, patients should brush their teeth carefully, but do not disturb the wounds. An antibacterial mouth rinse may be prescribed. Dr. Maranon will instruct those patients on the use of that rinse. Only use the toothbrush that we give you at the surgery appointment for the first week. Only manual tooth brushes must be used. “Electric type” toothbrushes should not be used until instructed to do so. The proper wound care following oral surgical procedures will hasten recovery and prevent complications. Patient should try not to disturb the surgical site with their tongue or fingers.
If patients should have any questions or concerns about their surgical site, they should contact the office to have the site evaluated.
Cracked or Chapped Lips
If the corners of the mouth are cracked or sore after surgery, the patient should keep them lubricated with Vaseline, Chapstick, or Vitamin A&D ointment.
Fever and Infection
It is normal to have a low-grade fever for the first couple of days after surgery. If a patient’s temperature reaches 101 degrees and they are not feeling well, they should contact Dr. Maranon immediately.
Patients must refrain from smoking after implant surgery. Smoking may cause bleeding and may also slow or impair wound healing or lead to implant failure.
The Post-Operative Appointment
Dr. Maranon needs to monitor the recovery of every implant patient. Patients will have a number of implant post-operative appointments in our office. It is important that patients keep every appointment, even if they feel they are healing well. Those appointments must be kept except for unforeseen circumstances. If a patient must change an appointment, it is important that they arrange another appointment as soon as possible. Dr. Maranon prides himself on his many implant successes. Patient participation and communication play a big role in the success of the implant treatment.
We hope that this information is helpful, and that your recovery is uneventful. Again, should you have any questions, do not hesitate to contact the office at any time.