Please read these instructions carefully, and ask the office if you have any questions.
PRIOR TO SURGERY:
- If you take routine oral medications, please check with the doctor prior to your surgical date for instructions.
- Provide our office with a list of doctors you see and medications you take.
- Inform us if you have had an adverse effect under sedation in the past or use/abuse narcotics of any kind.
- Do not eat or drink (including water) for at least eight hours prior to the appointment.
- Do not smoke for at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible prior to the day of surgery.
- If you acquire an illness such as a cold, sore throat, stomach or upset bowels prior to the surgery, please notify the office.
- Do not eat or drink (including water) for at least eight hours before the appointment.
- Do not smoke for at least 12 hours before surgery. Ideally, cut down or stop smoking as soon as possible before the day of surgery.
- Wear loose-fitting clothing with sleeves that can be rolled up past the elbow and low-heeled shoes.
- Remove contact lenses, jewelry, and dentures at the time of surgery.
- Do not wear lipstick, excessive makeup, or nail polish on the day of surgery.
- A responsible adult must accompany the patient to the office and remain in the office during the procedure. The adult must drive the patient home.
If you have any questions or concerns, please give our office a call.
- Immediately following surgery, maintain pressure on the surgical area by biting down on the provided gauze pad or roll until the bleeding stops. A certain amount of bleeding is to be expected following a surgical procedure. Placing the gauze pad over the area and biting firmly will help prevent excessive bleeding. Replace the gauze as necessary until the bleeding stops.
- For a few days following surgery, you may become dizzy when getting up. Sit up slowly, and give yourself a minute to adjust before getting up and walking.
- Avoid vigorous activities for three to four days after surgery. You may go back to your normal routine as tolerated.
- Please fill any prescriptions you have been given and take as directed. If you have been prescribed pain medication other than aspirin, Tylenol or ibuprofen (Advil or Motrin), do not drive, operate heavy equipment, work around machinery or tools, or engage in any other activity that may be unsafe when groggy, as your reflexes and judgment will be affected by the medication.
- Antibiotics may be prescribed to help prevent infection. If you have been placed on antibiotics, take the medicine as directed.
- Swelling and stiffness are to be expected the first 24 hours after surgery. Swelling around the face, eyes, and surgical site is not uncommon and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the extraction site will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off as needed. After 36 hours the cold compress will have no further impact on swelling. After this period, the application of moist heat to the sides of the face can help reduce swelling.
- For 24-48 hours following your surgery, do not suck on a straw, drink from a bottle, rinse, spit, or smoke. Avoid hot and spicy foods, carbonated and alcoholic beverages.
- During the first few days after surgery, restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
- Do not rinse, spit, or brush your teeth on the day of surgery. Resume brushing the day after surgery, avoiding surgical sites with the toothbrush.
- After brushing, rinse gently with warm salt water (1/2 teaspoon of salt mixed with eight ounces of warm water). Start the salt water rinse the day after surgery and repeat 3 times a day for 7-10 days. This will help keep the surgical areas clean and will also help dissolve the sutures.
- Please do not use the irrigating syringe for the first five days. After five days, fill the syringe with warm salt water and flush out the socket. This will flush out any food or debris.
- If you are experiencing numbness of the lip, chin, or tongue, be aware that this is usually temporary in nature and normal feeling should return after a few days. Until then, please be cautious while eating and chewing in order to avoid accidentally biting your tongue, cheek or lip.
- A dry socket can develop when blood clot gets dislodged prematurely from the walls of the tooth socket. Symptoms of a dry socket include throbbing pain at the surgical site, the ear, chin, adjacent teeth, and/or jaw. These symptoms indicate a dry socket when they occur three to four days following surgery and do not respond to pain medication.
- Please call our office if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.
- Some pain, bleeding, swelling, and seeping is normal following oral surgery. Please do not try to view the site by pulling on your lip and do not probe the area with your tongue or fingers. If you experience excessive bleeding or discomfort after 48-72 hours, please call our office immediately.
- You can take ibuprofen or acetaminophen according to the instructions on the label or those provided by our office as needed.
- Swelling around the face, eyes, and surgical site is not uncommon and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the implant site will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off as needed. After 36 hours the cold compress will have no further impact on swelling. After this period, the application of moist heat to the sides of the face can help reduce swelling.
- A warm salt water rinse, approximately ½ teaspoon in an eight-ounce glass of water, three times a day can be helpful.
- Avoid brushing your teeth near the surgery site but brush and floss the rest of your mouth as instructed by our office.
- For 24 hours following your surgery, do not suck on a straw, brush, rinse, spit, or smoke.
- For the first 24 hours, you may experience some cold and heat sensitivity. Avoid hot and spicy foods as well as carbonated and alcoholic beverages.
- Restrict your activities on the day of your surgery. Avoid excessive work or play, and resume normal activity the following day as tolerated.
- After the first day, gently rinse with a warm salt water rinse, approximately one-half teaspoon of salt in an eight-ounce glass of water, three times a day.
- During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
- Follow any other instructions provided by the office on your visit. Please take all medications as prescribed including your prescribed antibiotics to help prevent infection.
- If you have a denture that overlaps the implant site, please minimize the use of the denture following surgery to allow the site to heal. After the first week, you should be able to gradually increase the amount of time you can wear your denture.
- It is extremely important to keep your follow-up appointment(s) so that we can monitor the healing process.
- If pain and swelling are increasing after a few days, please call our office right away.
Immediate Post Op Period: (24 hours after surgery)
- Your lip, tongue and cheek may be numb for up to twenty-four (24) hours.
- Maintain pressure on the gauze, but be careful not to bite the numb areas.
- While you are still numb, avoid hot food and drink. It is common to have a nose-bleed during this period.
- You may also have oozing or intermittent bleeding from the surgery site.
- The medication given to you in the IV and the prescribed pain medication can make you feel dizzy and impair your judgment.
- It is advisable to have someone help you while walking, climbing stairs or using the restroom during this time. It is advisable to have someone at home with you to assist you for the first 24 hours.
- Apply ice to the treatment area, alternating 30 minutes on, and ten minutes off. Do this for the first 8 to 10 hours after surgery.
Over the next few days, you will experience soreness. Please continue using the prescribed pain medication or you may end up feeling pain unexpectedly. It is typical to experience the most swelling and bruising around the third day. Bruising and swelling all around the face and neck is normal. It is common to experience lower than normal energy levels while you heal due to loss of blood. Get as much rest as possible and drink lots of fluids. Tenderness, bruising, and swelling is normal.
BLEEDING: It is normal to experience some bleeding over the first few days. Over the period of 1 week, the bleeding should decrease and the color should change from red to brown until it disappears. PERSISTENT BLEEDING: If the bleeding has not stopped or the color remains bright red, please call us as we will need to see you to control the bleeding.
SWELLING: Swelling often accompanies surgery. To reduce swelling, wrap a cold pack, an ice bag or a bag of frozen peas in a towel and apply it to the cheek of the surgical area. It should be applied for 30 minutes of every hour during the first 3 days after surgery. Do not leave ice on the area for more than 30 at a time or in direct contact with the skin.
DO NOT DISTURB THE SURGICAL SITE(S): Do NOT forcefully rinse or attempt to clean the area under your new teeth with any instruments. You are encouraged to brush the white part of your teeth gently. DO NOT SMOKE for at least 72 hours since smoking will negatively affect your healing.
PAIN: The days following surgery will most likely be accompanied by some discomfort. You will be prescribed pain medication to ease the discomfort. For best results, take the first pill before the surgical anesthetic wears off. Do not abuse the pain medication; use it according to the prescription.
MEDICATIONS: Pain medication (i.e. Norco): Take pain medication every 4 hours as needed, and stay on top of it to effectively maintain a tolerable pain level. In addition to the pain medication, you may take 1 tablet (600mg) of Ibuprofen (i.e. Motrin or Advil) every 6 hours. Alternating the medications will help them function more effectively (ex. take 1 Norco, then 4 hours later take Ibuprofen...4 hours later take another Norco). DO NOT USE TYLENOL. Remember to take the medication with a small amount of food.
ANTIBIOTICS:
- If taking Amoxicillin: You will have taken 2 tablets 1 hour before surgery. Take 2 tablets the evening after surgery, then take 3 times a day at breakfast, lunch and dinner until antibiotics are gone.
- If taking Cleocin: Take 4 times a day at breakfast, lunch, dinner and bedtime.
MOUTH RINSES: Rinsing should not start until 48 hours after surgery. It is important to rinse your mouth often in order to keep the environment clean. Dissolve 1/4 teaspoon of salt in 8 ounces of warm water. Then, gradually rinse out your mouth, one sip at a time, over five minutes. Do this as often as you like; at least two or three times a day.
In addition, apply the prescribed Chlorhexidine rinse three times a day with a cotton tipped applicator (Q-tip), for the first two weeks.
NAUSEA: It is common to experience nausea after surgery, and it should pass within a short period of time. If the nausea does not get better in a few days, please call our office.
BRUSHING: Due to soreness and swelling, vigorous brushing may not be possible. It is still important that you make every effort to clean your teeth. Post-surgery, begin gently brushing with a manual toothbrush as you are able. Do not disturb the sutures or healing tissue around the surgical site(s). After about 10 days your sutures will dissolve, but until then only mild brushing is suggested. DO NOT USE A WATERPIK or ROTARY TOOTHBRUSH (i.e. Oral-B Braun).
DO NOT exercise or participate in any strenuous activity for the next 7 days
Instructions after the 3rd Day
HOT APPLICATIONS: Use warm compresses to the skin over the areas of swelling (hot water bottle, hot moist towels, heating pads) for 20 minutes on and 20 minutes off to help soothe tender areas.
HEALING: Normal healing after full arch immediate load implant therapy should be as follows: Days 1-2 will have the most swelling. Day 3 will have the greatest discoloration with bruising. If you feel up to it after the first 3 days, you may begin a more substantial diet but be mindful of the soft food diet suggestions provided. The remainder of the healing should be steady improvement. If you don’t see slow improvement, please contact our office so we can evaluate any issues with healing.
SHARP SPOTS: If you feel something sharp in the surgical areas, it is likely a bone spur from the walls that once supported the extracted teeth. Small slivers of bone due to the extraction procedure may work themselves out of the gum tissue over the healing phase. This is normal. Also, the teeth themselves may have rough or sharp areas. Please contact our offices to set up a visit for evaluation if you have these issues.
DIET: Avoid hot foods and liquid during the first week. Do not use a straw for 72 hours after surgery. Eat very soft or puréed foods as needed until it becomes comfortable enough to have more normal foods. Always refer to the soft food dietary restrictions to make sure you do not harm your implants or your temporary teeth. Do NOT eat foods like chips, crackers, popcorn, etc. which may get stuck in the surgical healing site(s). The soft tissues will heal within 4 weeks, however, the bone around the implants will require 12 weeks to heal. Please be cautious with the temporary teeth.
10-day Post Op Check
We will see you back in our office in 10 days.
This appointment is very important. If you have any questions or if an emergency situation arises, please contact our office at (703)263-8640.
PLEASE NOTE: Telephone calls for pain medication prescription refills are ONLY accepted during office hours.
- Immediately following surgery, maintain pressure on the surgical area by biting down on the provided gauze pad or roll until the bleeding stops. A certain amount of bleeding is to be expected following a surgical procedure. Placing the gauze pad over the area and biting firmly will help prevent excessive bleeding. Replace the gauze as necessary until the bleeding stops.
- Children should be supervised after having an extraction to make sure they do not bite or chew their tongue or lips as this can cause serious injury to the soft tissue.
- Please fill any prescriptions you have been given and take as directed. If you have been prescribed pain medication other than aspirin, Tylenol or ibuprofen (Advil or Motrin), do not drive, operate heavy equipment, work around machinery or tools, or engage in any other activity that may be unsafe when groggy, as your reflexes and judgment will be affected by the medication.
- Antibiotics may be prescribed to help prevent infection. If you have been placed on antibiotics, take the medicine as directed.
- Swelling around the face, eyes, and surgical site is not uncommon although it may not appear until the day following the surgery and may become more noticeable two to three days following surgery. Applying a cold compress to the face near the extraction site will help minimize swelling. If using an ice pack, please do not apply ice directly to your skin but place a cloth between the ice and your skin at all times. You may apply the cold compress for up to 20 minutes on and at least 20 minutes off as needed. After 36 hours the cold compress will have no further impact on swelling. After this period, the application of moist heat to the sides of the face can help reduce swelling.
- For 24 hours following your surgery, do not suck on a straw, brush, rinse, spit, or smoke. Avoid hot and spicy foods as well as carbonated and alcoholic beverages.
- Restrict your activities on the day of your surgery. Avoid excessive work or play, and resume normal activity the following day as tolerated.
- After the first day, gently rinse with a warm salt water rinse, approximately one-half teaspoon of salt in an eight ounce glass of water, three times a day.
- During the first few days after surgery restrict your diet to liquids and soft foods such as soups, yogurt, juice, and smoothies.
- Sutures may have been placed. Most sutures placed by our office will dissolve on their own in 7-10 days, and it may not be necessary to return to the office for sutures to be removed. If you have sutures that do need a follow-up visit for removal, we will let you know at the time they are placed.
- Please call our office if you experience severe pain, excessive bleeding or swelling, or if you have any questions or concerns. In the event of an emergency please call our office. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.