The placement of a dental implant is typically very simple, but it may be more complicated depending on the circumstances of your case. Either way, post-operative care is very important. That is why Dr. Swetha Reddy Pakanati has provided the below instructions for post-operative car in Hamilton Township, New Jersey. Unnecessary pain, infection and swelling can be minimized if you carefully follow these instructions.
There may be a metal healing abutment protruding through the gingival (gum) tissue at the implant site. It should be cleaned just like a tooth. You must be careful not to chew on the implant during the entire healing process until the tooth is placed on the implant.
Immediately Following Surgery
Bite down on the gauze pad placed over the surgical site for an hour. After this time, the gauze pad should be removed, discarded and replaced by another gauze pad. Refer to the section on bleeding for specific details.
Avoid vigorous mouth rinsing or touching the wound area following surgery. This may initiate bleeding by causing the blood clot that has formed to become dislodged. To minimize any swelling, place ice packs to the sides of your face where surgery was performed. Refer to the section on swelling for a more in-depth explanation.
Take the prescribed pain medications as soon as you can so it is digested before the local anesthetic has worn off. Having something of substance in the stomach to coat the stomach will help minimize nausea from the pain medications. Refer to the section on pain for specific details. Restrict your activities the day of surgery and resume normal activity when you feel comfortable. If you are active immediately after surgery, your heart will be beating harder, and you may expect excessive bleeding and throbbing from the wound.
NO SMOKING UNDER ANY CIRCUMSTANCES.
Bleeding
Generally, there is much less bleeding with implant surgery than there is with a tooth extraction because the implant fills the hole created in the bone. There is no open extraction site where a clot must form.
Biting on gauze is still important for six to 10 hours after surgery. The pressure keeps the adjacent gum pushed tightly against the bone, which minimizes bleeding under the gum around the implants. Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 60 minutes. Repeat as needed every hour for six to eight hours. If bleeding continues, bite on a moistened tea bag for 30 minutes. Tannic acid in tea bag can help form a blood clot by constricting blood vessels. To minimize further bleeding, sit upright, avoid getting excited, maintain constant pressure on the gauze (no talking or chewing), and minimize physical exercise.
If bleeding persists, call our team at 609-581-4322 for further instructions.
Swelling
Swelling can be expected and is usually proportional to the surgery involved. Placement of a dental implant generally does not produce much swelling, so it may not be necessary to use ice at all. If there was a fair amount of cheek retraction involved with your implant procedure, then it would be appropriate to apply ice on the outside of the face on the affected side. The swelling will not become apparent until the day after surgery and will not reach its maximum until two to three days post operation.
The swelling may be minimized by the immediate use of ice packs. Sealed plastic bags filled with ice, ice packs, or a bag of frozen peas or corn wrapped in a washcloth should be applied to the side of the face where surgery was performed. The ice packs should be applied 20 minutes on and 10 minutes off throughout the afternoon and evening immediately following your extraction.
If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. Soft, puffy swelling that you can indent with you finger after oral surgery is very normal. Bright red, rock hard, or warm swelling that does not indent with finger pressure and that is getting bigger by the hour would suggest infection. If infection were to develop, it would usually do so three to four days after surgery, when you would expect swelling to be going down, not up. If this should occur, please call our dentist at 609-581-4322.
Temperature
It is normal to run a low-grade temperature (99-100° F) for seven to 10 days following oral surgery. This reflects your immune response to the normal bacteria present in your mouth. A high temperature (>101° F) might exist for six to eight hours after surgery, but one to two Tylenol or two to four ibuprofen every four to six hours will help to moderate your temperature.
A high temperature (>101° F) several days after surgery, especially if accompanied by rock hard swelling and increased pain, is usually indicative of infection. Call our office at 609-581-4322 for instructions if this should occur.
Pain
Pain or discomfort following surgery may last up to four to five days. By the second day, most patients rely mainly on Tylenol or ibuprofen. If prescription pain medications are required beyond four days, further treatment may be needed to address your pain. Please call our office and discuss your situation with us.
Many medications for pain can cause nausea or vomiting. It is wise to have something of substance in the stomach (yogurt, ice cream, pudding or apple sauce) before taking prescription or over-the-counter pain medicines (especially aspirin or ibuprofen). Even coating the stomach with Pepto Bismol or Milk of Magnesia can help prevent or moderate nausea.
For moderate pain, one or two tablets or Tylenol or Extra Strength Tylenol may be taken every three to four hours. For ibuprofen (Motrin or Advil), two to four 200 mg tablets may be taken every three to four hours. For severe pain, take the narcotic-type tablets (either Tylenol #3 or Percocet) prescribed for pain as directed, every four hours in addition to ibuprofen. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around or operate heavy machinery if you are taking prescription pain medicine. Alcohol and prescription pain medicines do not mix!
Antibiotics
Be sure to take the prescribed antibiotics as directed until they are completely gone, regardless of how good you may feel, to help prevent infection.
Diet
While eating during the healing process, chew where your natural teeth are and not on the dental implant.
Drink plenty of fluids. On the first day post-operation, try to drink 40-48 ounces. Drink from a glass or cup and do not use a straw. The sucking motion of a straw will suck out the healing blood clot and open the wound to start bleeding again.
Avoid hot liquids or food while you are numb so you don’t burn yourself. Soft foods and liquids can be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed. You will find eating multiple small meals is easier that three regular meals for the first few days. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
Oral Hygiene
Good oral hygiene is essential to good healing. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas but do not avoid them. Plain or warm salt-water rinses (teaspoon of salt in a cup of warm water) should be used at least four to five times a day, especially after meals starting the day after surgery. In some cases, you will be instructed to use a prescribed Peridex Chlorhexidine 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, then spit it out.
Smoking
Smoking retards healing dramatically. Nicotine constricts blood vessels, which slows the healing of surgery sites and affects the long-term health of the gum and bone. Smoking and dental implants do not mix.
There is a documented increased failure rate of implants in patients who smoke. Therefore, implant companies will not honor any of the replacement warranties on implants in patients who smoke. If you choose to smoke, you do so at the risk of losing your dental implants due to poor healing and increased gum disease in smokers.
Activity
You should keep physical activities to a minimum for six to 12 hours after surgery. If you are considering exercise, be aware that throbbing or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking your typical calorie intake. This may weaken you and further limit your ability to exercise.
Wearing Your Prosthesis
Partial dentures, flippers or full dentures should not be used immediately after surgery. Biting directly on the gauze will stop bleeding faster and prevent bleeding under the gum around the implant. Do not wear your flipper until we have instructed you to wear it. In all cases, you should remember that the prosthesis is for aesthetics only and not for vigorous chewing. You want to minimize vigorous chewing of any kind on the healing cap or over the submerged implants during the entire healing phase.
If you have any remaining questions or concerns following your dental implant surgery, please reach out to our dentist, Dr. Swetha Reddy Pakanati, and our team at Hamilton Dental Care. We will be happy to answer any questions you may have and walk you through the healing process. Call our office for more information.