After Implant Surgery

POST-OPERATIVE INSTRUCTIONS FOR IMPLANT(S) SURGERY

The following information has been prepared to help answer some of your questions about postoperative care. Please read them thoroughly. If you still have concerns and you don’t see the answer to those, please call the office directly during business hours (954-723-7771) or Dr. Montamarta’s personal cell phone (954-682-4323). You may also want to text in case he is unavailable to take your call right away.

POST-OPERATIVE CARE AND MAINTENANCE

Some discomfort is expected. Please refer to the instructions regarding pain below. If you follow those recommendations, you should manage it well. We might give you a post-operation toothbrush, to be used on the treated area only. This brush is more like a mop and helps while not hurting the surgical site. It is not a good regular toothbrush and should be avoided on the rest of your teeth. Do not use a powered or electric toothbrush near the implant either immediately after surgery or for the following two months. The ultrasonic vibration of these toothbrushes may affect the healing process and you may lose the implant(s). The rest of your teeth may be brushed the way you normally do, with your regular manual or electric toothbrush. If you see a round post above the gum line where the surgery was done, it might be what we call a healing abutment. This is not your implant, but it is connected to it (screwed in). Implants only fail during the healing process if they are not cleaned properly or if you chew something hard and the traumatic pressure breaks the seal between implant and bone. Therefore, avoid chewing anything moderately hard where the implant(s) is for two months. This is extremely important. If the implant fails due to any of these conditions, please refer to the section regarding loss of implants on your consent.

If you are using a temporary replacement over the implant site, make sure you do not sleep with it and you keep it extremely clean daily. Examples of these replacements include a flipper, full dentures, partial removable dentures and retainers covering your teeth including the space where the implant is. If you feel the temporary tooth or denture is applying pressure on the implant, let us know immediately. It will need to be adjusted.

You will likely have a prescription for chlorhexidine (Peridex). Apply this to the areas treated by soaking a gauze or cotton pad in it and holding it for 20 seconds. By doing this, and not rinsing, you will avoid unnecessary staining of your teeth. Rinsing your mouth out (not swishing) with warm saltwater is acceptable (1 teaspoon/8 oz. glass).

Rest is important. Avoid excessive physical activity for 48 hours. Lifting objects, walking stairs, etc. are examples. You may resume normal activities after 48 hours, except intense exercise (running, lifting weights, etc.)

You may experience a slight feeling of weakness and elevation of temperature (one degree is normal). Do not be concerned, as this is to be expected.

MEDICATIONS

Use all medications as directed. Usually antibiotics are started the day before the procedure. Certain anti-inflammatories (steroids) are usually started the day before the procedure. Make sure all medications you take are listed on your file, in case they interact with the ones prescribed by us. It is always a good idea to eat before taking medications. This applies to those started before the procedure, as well as to the ones to be taken after. Due to the soft diet, we don’t recommend taking medications together. Patients have reported significant nausea for hours when both antibiotics and painkillers are taken at the same time. Give priority to pain medications first and allow two hours to take an antibiotic if it’s due. For female: please take into account antibiotics decrease the efficacy of contraceptive medications.

SWELLING

it is unlikely, but it may occur. Apply cold packs (ice or similar) on the side of the face where the procedure was done. Keeping ice for an extended time might be uncomfortable. The trick is to keep the area constantly cold (less swelling= less pain). This may be accomplished by placing those packs on and off the first day, taking short breaks in between. If swelling occurs, you might see a discoloration or bruising of the skin, face and neck. Not to worry, this will disappear, but it may take longer than expected. If swelling is present after 48 hours, replace the cold packs for warm compresses. Applying cold after two days may actually be detrimental. Swelling may be aggravated by excessive physical exercise or constant chewing. Therefore, a soft diet is highly recommended until it subsides. Sleeping the first two nights propped up (inclined) will also help reduce swelling.

BLEEDING

Occasional bleeding is expected the first 24 hours. It will be mixed with your saliva and might appear worse than it is. Avoid rinsing excessively, spitting, drinking from a straw and hot (temperature) foods and drinks. If constant bleeding occurs, soak a gauze pad (2 x 2) in iced water and place it firmly over the bleeding site until it stops. It may take over 10 minutes for this to happen. If this does not stop the bleeding, please call Dr. Montamarta. As mentioned before, sleeping the first two nights with your head propped up will reduce the chances for bleeding.

PAIN

Unless you have had an allergy or reaction to either medication, it is best to take one ibuprofen 800 mg together with two Tylenol 500 mg (always after food, remember). This is by far the most effective way to control discomfort and pain. If you are proactive and follow this routine every four hours the first day, you will likely have no pain at all. In most cases, it works better than narcotics (Vicodin, Percocet, etc.). Pain is usually gone by the second day. If you need to take a narcotic, we recommend breaking the pill in half and taking it with food. If pain persists after one hour, eat some food again and take the other half. NEVER TAKE A NARCOTIC IF YOU HAVE TAKEN THE IBUPROFEN/TYLENOL COMBINATION ALREADY. In case of doubt, text or call Dr. Montamarta. In most cases, and unless you have had a reaction to it, you may take Benadryl prior to bedtime to help you rest. Do consult with Dr. Montamarta prior to doing this.

DIET

Eat only liquid and soft foods the day of the procedure. If discomfort is still present the second day, stay on this diet as it will help you heal faster. Regular foods are acceptable after 48 hours unless instructed otherwise. Always make an effort to chew away from the area treated. Remember: chewing a lot will give you more pain, swelling and possibly bleeding. Citric juices, carbonated beverages or acidic foods like tomatoes, may affect the healing. Avoid spicy foods as well.

RISK FACTORS

If you have been provided or you have a nightguard, you should wear it during healing time. Dr. Montamarta will inform you about the length of this period. It is critical to allow your teeth to rest protected for a few hours (while sleeping) to maximize the results of the procedure. If you smoke, complications may arise including higher pain rates, slow healing and infections. Though we don’t expect anyone to quit (ideal), it is best to minimize smoking as much as possible.