AFTER PLACEMENT OF DENTAL IMPLANTS

Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There will be a metal healing abutment protruding through the gingival (gum) tissue.

Bleeding

Some bleeding or redness in the saliva is normal for 24 hours. Excessive bleeding (your mouth fills up rapidly with blood) can be controlled by biting on a gauze pad placed directly on the bleeding wound for 30 minutes. If bleeding continues please call for further instructions.

Swelling

Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag, or a plastic bag, or towel filled with ice on the cheek in the area of surgery. Apply the ice continuously, as much as possible, for the first 36 hours

Diet

Drink plenty of fluids. Avoid hot liquids or food. Soft food and liquids should be eaten on the day of surgery. Return to a normal diet as soon as possible unless otherwise directed.

Pain

You should begin taking pain medication as soon as you feel the local anesthetic wearing off. For mild to moderate pain, Ibuprofen (Advil or Motrin) may be taken. Ibuprofen, bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.

Antibiotics

Be sure to take the prescribed antibiotics as directed to help prevent infection

Oral Hygiene

Good oral hygiene is essential to good healing. The night of surgery, use the prescribed Peridex 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. Warm salt water rinses (teaspoon of salt in a cup of warm water) should be used at least 4-5 times a day, as well, especially after meals. Brushing your teeth and the healing abutments is no problem. Be gentle initially with brushing the surgical areas.

Activity

Keep physical activities to a minimum immediately 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.

Wearing your Prosthesis

Partial dentures, flippers, or full dentures should not be used immediately after surgery and for at least 10 days. This was discussed in the pre-operative consultation.

Bleeding from the Nose

If you had implants placed in the upper jaw and/or had sinus grafting, it is not unusual to have some bleeding and/or clot present in the nose for a few days following surgery. However if the bleeding is heavy please call the office. If the bleeding persists more than 3-4 days, please call the office.

Numbness

Numbess of the lip, chin, tongue, or areas around the face is expected after surgery as local anesthesia was used. It is not unusual to have numbness for up to 24 hours following surgery as more potent and longer acting numbing medications are used during your procedure than you are used to receiving from your dentist. However, numbness persisting more than 48 hours should be report to your surgeon.

Headache and Dizziness

It is not unusual to have a headache after having implants placed. However if the headache is severe, please report the findings to the office. Normally the pain medicine helps the headache and after a 2-3 days the headache normally resolves. If the headache worsens or is persistent, please notify the office. If you have any numbness, weakness, visual or hearing changes associated with your headache, please seek emergent care as this is likely some other problem not associated with the implant placement.

Dizziness following implant surgery is rare but not dangerous. Occasionally, to place implants, instead of a drill, the surgeon may elect to use a blunt shaping device (osteotome) to make the space for the implant. To create the space, the gentle tapping of the osteotome is used. Occasionally this tapping can create a clinical situation called Benign Paroxysmal Positional Vertigo (BPPV).

Inside your ear is a tiny organ called the vestibular labyrinth. It includes loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head. Other structures (otolith organs) in your ear monitor movements of your head and your head's position. These otolith organs contain crystals that make you sensitive to movement. For a variety of reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you're lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to. As a result, you feel dizzy.

Benign paroxysmal positional vertigo occurs most often in people age 60 and older. It can occur after a severe blow to your head. However, some patients are sensitive to this and even small amounts of trauma can elicit BPPV. As such, the tapping used to place implants can cause BPPV in rare cases. However, most dizziness following surgery is most likely from the pain medicine being used.

Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or during prolonged positioning on your back (supine).

Doctors can sometimes determine the cause of BPPV. It may require a consultation with an ear, nose and throat (ENT) specialist or a doctor who specializes in the brain and nervous system (neurologist). However, it is almost as common that no specific cause for BPPV can be determined and the patient improves on their own after a few days or a couple of weeks.