POST-OPERATIVE INSTRUCTIONS FOR DENTAL IMPLANTS AND BONE GRAFTS

YOUR SURGICAL PROCEDURE

Most implant and bone grafting procedures are completed in the surgical office. Intravenous (IV) sedation is generally recommended, but not required. If you are scheduled to have IV sedation, you should not have anything to eat or drink after midnight the night before surgery with the EXCEPTION OF ANY MEDICATIONS, which may be taken with a sip of water. You should also brush your teeth before surgery. Wear loose, comfortable clothing with sleeves that may be rolled up easily.

Following your surgical procedure, you will be transferred to the recovery area where you will be closely monitored by our team of surgical assistants. Once you are awake, you will be discharged and permitted to go home to recuperate for the rest of the day and evening of surgery. You should relax in a semi-reclining position.

CARE GIVER INSTRUCTIONS

Because you will be groggy following your surgery, it is necessary for you to select a person to be your caregiver. This person will be responsible for bringing you to the office for surgery, picking up prescriptions, and taking you home once you are discharged. This person should plan on staying with you the first twelve (12) hours after receiving general anesthesia.

At the time of your arrival, both you and your caregiver will register with the receptionist. The caregiver will be given the option of waiting for you in the office or returning to pick you up after the surgery. The receptionist will be able to give your caregiver an estimated waiting time, which will vary depending on the procedure performed.

THE RECOVERY ROOM

After surgery, you will be taken to the recovery room in our office. Each patient is affected differently by general anesthesia. Patients may be very sleepy, restless, or quite aware of their surroundings. Whatever your reaction is to the general anesthesia, our assistants are prepared to make your stay as relaxing and as comfortable as possible.

In the recovery room, you will be instructed to bite gently on the gauze bandage to stop the oozing in the surgical area. These bandages will require changing periodically. During surgery, you will have received a local anesthetic (numbing medicine) in your mouth. Because of the local anesthetic, you may have difficulty in speaking, swallowing, dryness of mouth, or numbness of the lips and face. This feeling will last approximately three hours; which will allow time for you to be taken home and made comfortable.

FOLLOWING YOUR SURGERY

An ice pack may be used during the first 48-hours to help reduce swelling. You can expect some swelling in the area of the implant/bone graft surgery following the procedure, as well as some discoloration of the skin and gums for a few days.

Pain medication prescribed by Dr. Wade, Dr. Vollmer, or Dr. Gatto will help alleviate any discomfort, and you should be able to resume normal activities within a day or two. Antibiotics will be prescribed by your surgeon, and possibly an antimicrobial rinse, which should be used according to the directions on the bottle.

You can expect some minor bleeding on the day of surgery, but report excessive bleeding to your surgeon immediately.

If you have been wearing a denture, the surgeon or restorative dentist may place a soft lining in it so you can wear it comfortably during the healing period or it may be necessary to leave it out for a short period of time.

You will return to see Dr. Wade, Dr. Vollmer, or Dr. Gatto the following week for a post-operative visit. At that time, healing will be assessed, and sutures removed. You will need to be seen for periodic post-operative visits following your surgery so we can monitor your healing progress.

POST-OPERATIVE GUIDELINES FOR IMPLANTS/BONE GRAFTS

For rapid healing, it is essential that the following directions be adhered to during the first two weeks post-operatively.

1. Nutrition. It is important to follow a regimen of good nutrition post-operatively to enhance the body’s capabilities of healing. Additionally, it is recommended that adults take Vitamin C supplement 500 mg daily as well as Vitamin E supplement 400 I.U. daily. A stress-formula multi-vitamin may have these present but if not, they may be purchased individually at the pharmacy. These should be taken for the entire treatment time.

2. For denture patients, only liquids are advised during the first two (2) days in order to avoid food particles from lodging in the wound. Semi-liquid food (mashed) may be added to the diet during the second week. For those patients with teeth remaining, a soft diet may be followed. There should be no chewing over the surgical area.

3. One should refrain from alcohol intake for the first week while the oral incisions are healing.

4. Avoid soda pop with phosphoric acid. Biochemically, this pulls calcium out of the bloodstream, compromising good bone formation and healing.

5. Any smoking is strictly prohibited and will compromise the success of the surgery.

6. Ice packs should be applied every 20 minutes to the face in the surgical area for the first 48 hours. An elevated head rest (extra pillow) should be used during the first two nights to reduce swelling in the area.

7. Should oozing or bleeding occur after surgery, it may be stopped by gently biting on a roll of moist gauze for fifteen minutes. If the bleeding doesn’t stop after doing this, the surgeon should be contacted.

8. The mouth should be rinsed with a salt-water solution (one level teaspoon in 8 ounces of warm water) after each meal for the first week post-operatively.

9. If your surgeon has prescribed a specific mouthwash, begin to use it on the first day after surgery, rinse twice a day, once in the morning and once at night. Commercial mouth washes or sprays should not be used until authorized by your surgeon.

10. Sinus graft patients should not blow their noses forcibly. Puffing lightly into a Kleenex is permissible.

11. Contact the surgeon if there are any questions or if there are any unusual occurrences related to the healing of the implant area.

Dental implant and bone graft surgeries have a high rate of success, but as with any surgical procedure, certain side effects or complications are possible. You should understand these before you consent to implant surgery. Your surgeon will answer any questions you have about these risks and complications.

1. Bruising occasionally develops in areas close to the surgical site. Any discoloration from bruising should disappear within a few days following surgery.

2. Moderate pain is common for 24-48 hours following surgery, and pain medication may be required. If intense pain persists that cannot be relieved by prescribed pain medication, contact your surgeon.

3. Trismus, or stiffness of the jaw muscles, may be caused by swelling following surgery.

4. As the swelling decreases, trismus should disappear. Infection is very rare following implant/bone graft surgery, but occasionally an infection can occur. If fever, persistent swelling/pain, or pus develops following surgery, contact your surgeon immediately.

5. Injuries can potentially occur to adjacent teeth and roots, fillings or bridgework.

6. Loss or alteration of nerve sensation, resulting in numbness or tingling sensation in the lower lip, tongue, cheek, chin, gums, or teeth is rare, but can occur. Usually this is temporary. In very rare cases, it can be permanent.

7. Sinus complications, such as drainage or pain (sinusitis), occasionally occur if implants are placed in the upper jaw and the sinuses become involved. This may or may not require further treatment. Any sinus symptoms should be reported to your surgeon.

8. Swelling is a normal reaction to any surgical procedure and the amount of swelling depends on how extensive the surgery was. Normal swelling should peak within about 48 hours, and then gradually subside. If swelling worsens after 48 hours, contact your surgeon.

9. Bleeding can be expected following any type of surgery. During the first 24 to 48 hours some oozing may occur but it should be easily controlled. In the rare instance that bleeding is excessive or prolonged, contact your surgeon immediately.

10. TMJ (Jaw joint) pain or abnormal function is rare following implant/bone graft surgery, but can occur. If it does occur, contact your surgeon.

11. Bone loss is rare, but may occur around the implant if proper hygiene is not maintained or if excessive stress is placed on the implant.

PAYMENT FOR SERVICES

It has been our experience that implants are rarely covered by insurance, therefore, the patient is responsible for paying the entire cost of the implants. We require full payment on the day services are rendered. You will meet with one of our business office professionals to discuss these fees.

Because dental implants often involve a team approach between the surgeon and the restorative dentist, obtain cost estimates from each one prior to treatment. Their fees are your responsibility regardless of how much your insurance may cover.

It takes time and commitment to make dental implants successful. Your surgical specialist and restorative dentist provide their expertise and careful attention to detail. Add to this your dedication to good oral hygiene and regularly scheduled follow-up care and together, you have the makings of a winning smile.