POST-OP INSTRUCTIONS Implant Surgery

BLEEDING:

  • Significant bleeding after dental implant placement is uncommon. There may be minor oozing that can last for 30-45 minutes after surgery. That’s okay!
  • Most implants sites do not bleed significantly due to the presence of sutures (stitches) and/or abutment(s)/crown(s)
  • Accordingly, gauze is typically NOT needed.
  • If gauze has been placed at your surgery site:
    • Bite down with CONSTANT, firm pressure and try to “keep your teeth together” while you speak.
    • Remove the gauze 30 minutes from the time you leave the office.
    • DO NOT REPLACE the gauze unless specifically instructed to do so. Repeatedly changing the gauze only makes the bleeding go LONGER.
    • To help the oozing stop: rest to maintain a low heart rate, keep the ice packs on, and drink small amounts of cold liquid.
  • If you have had IV anesthesia:
    • ALL GAUZE MUST BE REMOVED FROM THE MOUTH BEFORE THE PATIENT LIES DOWN TO REST/SLEEP!! Sleeping with gauze in the mouth is extremely dangerous and can lead to aspiration of gauze and death
  • Please contact our office if oozing persists for more than 2 hours after surgery

PAIN:

  • Soreness and mild discomfort are normal following dental implant placement.
  • Begin taking pain medication when you feel the numbness begin to wear off.
  • Over-the-counter pain medications (e.g. ibuprofen, Tylenol, or naproxen) are usually all that is needed for post-operative pain control
  • If your pain is still poorly controlled 30-45 minutes after taking over-the-counter pain medication:
    • Take your prescription strength pain medication (if you’ve been given a prescription)
  • When taking narcotic strength pain medication:
    • Make sure you have food in your stomach before taking the narcotic pain medication!
    • Do not drink alcohol or consume any cannabis products
    • DO NOT DRIVE!
    • Do not operate heavy machinery
    • Do not attempt tasks that require close concentration.
  • Do not take any additional pain medication unless our office or pharmacist specifically directs you to do so.
  • DO NOT take any extra Tylenol (acetaminophen) when taking the narcotic pain medication as this may lead to a Tylenol overdose.

SWELLING:

  • Swelling after dental implant surgery is typically mild and limited to the area in the mouth around the implant site.
  • Minor facial bruising may accompany swelling. This is normal and should go away in 4-5 days.
  • To minimize swelling:
    • Use ice packs on your face near the implant site(s) for 20 min every hours for the first 4-6 hours.
    • “Sleep with your head elevated above heart-level” for the first 48 hours following surgery.
  • Swelling typically INCREASES gradually for the first 48 hours following surgery, then begins to subside. This is normal!
  • Rapid swelling is NOT normal! Call our office immediately if this occurs.

DRY SOCKET:

  • Dry socket does not occur from implant surgery, even if you have had a tooth/teeth extracted in conjunction with your procedure.
  • Therefore, any substantial pain that persists more than 48 hours after surgery is NOT normal. If you are experiencing this, and it’s been 48 hours since your surgery, please call our office.

SUTURES:

  • You may have sutures (stiches) at the surgical site.
  • Most sutures used with implant sites are NOT dissolvable
    • Non-dissolvable sutures are used because they provide consistent support to the healing tissues, which is important to help the gum tissue form correctly to eventually keep the future crown healthy.
    • Non-dissolvable sutures appear white but may yellow somewhat due to staining from foods.
    • Non-dissolvable sutures generally need to be removed 1-2 weeks following surgery.
  • If you notice “looping” or substantial laxity in your sutures, please contact our office.

ANTIBIOTICS:

  • Continue taking your antibiotics until gone.
  • If you have not been prescribed antibiotics, please call our office so a prescription can be called in.
  • If you break out in a rash, stop taking the medication immediately and call our office.

MOUTHRINSES:

  • DO NOT USE ANY MOUTHRINSES FOR THE FIRST 48 HOURS AFTER SURGERY! There is a 2 day “break” from using your prescription strength rinses (both of them).
  • Please use salt water rinses only during the first 48 hours after surgery.
    • Gently swirl the salt water and carefully spit it out.
    • DO NOT aggressively or vigorously swish and spit.
  • RESUME using BOTH of your prescription strength mouth rinses beginning 48 hours AFTER your surgery.
    • Always use the blue rinse before the yellow/orange rinse (when their dosing times coincide).

SMOKING:

  • Do not smoke for at least 5 days after surgery.
  • Smoking has been shown to cause significantly higher rates of implant failure
    • This is true for both immediately after surgery AND in the years to come!
  • Smoking delays healing, increases discomfort, and may cause bleeding to restart.
  • This includes cannabis AND VAPING/DABBING! No high- temperature vapors in the mouth!

DIET:

  • After surgery, you can eat as soon as you’re ready!
  • Things to eat: Soft foods…”anything that can squish through the tines of a fork.”
    • Mashed potatoes, pasta, fish, applesauce, Jell-O, pudding, eggs, soups (luke warm and no small pieces or bits).
  • Things to NOT eat:
    • Bulky/thick/chewy foods (i.e. bagels, jerky, steaks or anything you have to bite and tear to eat)
    • Anything spicy
    • Anything acidic (i.e. lemonade, orange juice, marinara sauce, soda/pop)
    • Anything with small pieces/bits/seeds (i.e. sesame seeds, strawberry seeds, raspberries, etc.)
    • ANYTHING WITH CAFFIENE! Yes, this includes coffee! Coffee contains caffeine and shrinks capillaries and diminishes both nutrient supply to (and waste removal from) your healing sites. PLUS, hot liquids damage the delicate healing tissue. If “iced decaf” coffee counts as “coffee” in your world, then go for it!
  • You may slowly “advance” your diet back to normal as you feel ready. If something is too much or uncomfortable, stop, and try again tomorrow. Most people are back to their “normal” diet 7-10 days after surgery.
  • If you have a temporary crown on your implant:
    • It is critically important that you DO NOT BITE INTO ANYTHING WITH YOUR IMPLANT TOOTH.
    • Using the implant crown before initial healing has occurred can cause the entire implant to fail or become permanently malpositioned.
    • You will be cleared to use your implant crown at one of your follow-up appointments (usually >6 weeks from the day of surgery).
    • Please be very careful with your implant crown in the early healing period!

ORAL HYGIENE:

  • Wait 24 hours after surgery to start brushing.
  • DO NOT BRUSH NEAR THE SURGERY SITES until 48 hours after surgery.
  • For the first 48 hours, gently rinse with salt water ONLY.
    • 1⁄2 tsp table salt in 1 cup warm water.
  • Begin prescription strength rinses again after 48 hours. Use these mouthwashes for 2 weeks then stop.
  • DO NOT USE A WATERPIK (or similar water flosser).
    • The new implant site is simply not strong enough to endure the forces that a Waterpik puts on tissues.
    • Do not use a Waterpik (anywhere in your mouth) until specifically cleared by our office to do so.
    • Failure to follow this instruction could cause serious and permanent injury to the implant site resulting in infection and/or implant loss.

”I FEEL SOMETHING WITH MY TONGUE…”:

  • “What’s that hard thing I feel there?”
    • Your healing abutment! It may be white, clear, or metallic (blue, yellow, or pink)
    • That’s there to help your gums heal correctly in preparation for your new crown.
    • If it ever feels “loose”, wiggly, or “pinchy”…call Dr. Auble immediately so that it can be tightened
  • “I feel this flappy, rubbery thing…”
    • That’s the rubbery filling material used to fill the hole in the white (or clear) healing abutment.
    • It’s there to exclude food from becoming impacted and gross in the screw access hole.
    • If it bothers you, we can trim it at your next appointment.
  • “I feel this flexible, plastic, rough thing…”
    • That is tissue glue.
    • It’s used on occasion to support the healing tissues.
    • It may fall off spontaneously on its own. If you swallow it, that’s okay! Don’t worry.
    • It is usually removed at the time of suture removal.
  • “I think I feel the stitches.”
    • Yes! You may feel this suture knot or the suture tails. This is normal. Try not to pull, tug or repeatedly bite the stiches if possible!

WHEN TO CALL:

  • Call us anytime if you have questions or concerns!
    • Call the office during normal business hours at (970) 669-4802
    • If it’s outside of normal business hours, please call Dr. Auble directly.
  • Rapid swelling
  • Difficulty breathing
  • Sudden onset of hives/rash
  • Streaky redness on skin
  • Temperature greater than 100.7 F over 4 consecutive hours that does not respond to 500mg of Tylenol
  • Any perceived looseness or “weirdness” of your healing abutment or your implant crown.

Post-Op Implant Surgery Instructions