Aftercare Instructions: Dental Implants The place of a dental implant can be very simple or may be complicated depending on the circumstances of your case. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully. 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 phase until the tooth is place on the implant. Bite on the gauze pad placed over the surgical site for 30 minutes. After this time, the gauze pad should be removed and discarded and replaced b 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 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 swelling for explanation. Take prescribed pain medication as soon as you can so it is digested before the local aesthetic 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, your heart will be beating harder and you can expect excessive bleeding and throbbing from the wound. NO SMOKING UNDER ANY CIRCUMSTANCES.
A certain amount of bleeding is to be expected following surgery. On the skin where the surface is dry, bleeding clots in 10 minutes. In the mouth where things are wet, it takes 6-8 hours for the clot to gel up and the bleeding to subside. Slight bleeding or ozzing causing redness in the saliva is very common. For this reason, the gauze will always appear red when it is removed. Saliva washes over the blood clots and dyes the gauze red evening after bleeding from the sockets has actually stopped. Excessive bleeding may be controlled by first gently rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for sixty minutes. Repeat necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a blood clot by contracting bleeding vessels. This can repeated several times. To minimize further bleeding, sit upright, do not become excited, and maintain constant pressure on the gauze (no talking or chewing) and avoiding exercise. If bleeding does not subside after 6-8 hours call the surgery for further instructions (01296 434848). The swelling that is normally expected is usually proportional to the surgery involved. There is usually a fair amount of the cheek retraction involved with the removal of impacted wisdom teeth. Therefore, you should expect swelling of the cheek after your surgery. The swelling will not become apparent until the following day and will not reach its maximum until 2-3 days post-operatively. The swelling may be minimized by the immediate use of ice packs. Sealed plastic bags filled with ice, ice packs or a frozen bag of peas wrapped in a wash cloth should be applied to the side of the face where surgery was performed. The ice packs should be applied within 20 minutes on/20 minutes off for the afternoon and evening immediately following your extraction. After 24 hours ice has no beneficial effect. Thirty-six hours (36) following surgery the application of moist heat to the side of the face may help some in reducing the size any swelling that has formed. If swelling of the jaw stiffness has persisted for several days, there is no cause for alarm. Soft, puffy swelling that you can indent with your finger after oral surgery is very normal. Bright red, rock hard, hot swelling that does not indent with finger pressure which is getting bigger by the hour would suggest infection. This usually would develop around 3-4 days after surgery, when you would expect swelling to be going down, not up. If this should occur, please call our surgery (01296 434 848). It is normal to run a low grade temperature (99 -100f) for 7-10 days following oral surgery. This reflects your immune response to the normal bacteria that are present in your mouth. A high temperature (>101f) might exist for 6-8 hours after surgery but no more than that. Two paracetamol tablets or 2-4 ibuprofen every 4-6 hours will help moderate a temperature. A temperature >101F several days after surgery especially if accompanied by the rock hard swelling and increased pain, is usually indicative of infection. You should call the surgery for instructions if this should occur. When the bone requires smoothing to allow for the fit of the denture, there is a good chance there will be some bruising on the surface skin over the area. The most common location is over the upper eye teeth (on the cheek below the eye). Bruising may not be obvious for a day or two. By the time it reaches the surface it may have already turned from purple to green to yellow in colour. Over several days the yellow colour will settle down the neck to about the nipple line of the chest before it disappears. Pain or discomfort following surgery is expected to last 4-5 days. For many patients, it seems the third and fourth day may require more pain medicine that the first and second day. Following the fourth day pain should subside more and more each day. Many medications for pain can cause nausea or vomiting. It is wise to have something of substance in the stomach (yogurt, ice cream, pudding ect) before taking prescription medicine/ over the counter medicines (aspirin/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 of paracetamol or extra strength parcetamol may be taken every 3-4to hours or ibuprofen two –four 200mg tablets to be taken 3-4 hours. DO NOT DRIVE AN AUTOMOBILE OR WORK AROUND OR OPERATE HEAVY

Alcohol and prescription medicines do NOT mix! If prescription pain medications are required beyond 4 days, further treatment may be indicated, please call the surgery and discuss your situation with us. (01296 434 848) Antibiotics are NOT given as a routine procedure after oral surgery. The overuse of antibiotics leading to the development of resistant bacteria is well documented so careful consideration is given to each circumstance when deciding whether antibiotics are necessary. In specific circumstances, antibiotics will be given to help prevent infection or treat and existing infection. If you have been placed on antibiotics take the tablets or liquid as directed. You should take them on schedule until they are completely gone. Discontinue antibiotic use in the event of a rash or other unfavourable reaction. You should call the surgery (01296 434848) to report any such finding or if you have any questions. Drink plenty of fluids. Try to drink 5-6 eight ounce glasses first day. Drink from a glass or cup and don’t use a straw. The sucking motion out the healing blood clot and 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. The act of chewing doesn’t damage anything, but you should avoid chewing sharp or hard objects at the surgical site for several days Returning to a normal diet as soon as possible unless otherwise directed. You will find eating multiple small meals is easier than 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. If you suddenly sit up or stand up from a lying position you may become dizzy. Therefore, immediately following surgery, if you are lying down make sure you sit for one minute before standing. good oral hygiene is essential to proper healing of any oral surgery site. you can brush your teeth and the healing abutments no problem. Do not avoid them but be very gentle. Vigorous rinsing should be avoided until the next day following surgery. The day after surgery you should begin rinsing at least 5-6 times a day especially after eating. Salt water (cup of warm water mixed with a teaspoon of salt) is ideal but plain water is also ok. In some cases you will be instructed to use prescribed corsodyl oral rinse before bed. The day after surgery, the corsodyl should be used three times daily, after breakfast, lunch and before bed. Be sure to rinse for atleast 30 seconds then spit out. Smoking retards healing dramatically. Nicotine constricts blood vessels which slows 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 the implant companies will not honour 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. You should keep physical activities to a minimum for 6-12 hours following surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs you should discontinue exercising. Keep in mind that you are probably not taking normal nourishment. This may weaken you and further limit your ability to exercise. Partial dentures, bridges or full dentures should not be used immediately after surgery. Biting directly on the gauze will stop bleeding faster and prevent bleeding underthe gums around the implant. Your doctor will give you specific instructions at the time of surgery as to when you may wear your denture or bridge. In all cases you should remember that the prosthesis is for esthetics 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.

Source: http://aylesburydental.co.uk/images/Aftercare%20PDFs/aftercare%20instructions%20dental%20implants.pdf

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