**These are GENERALIZED instructions for your information only; they are not to be used for self-diagnosis or self-treatment. Please see your personal dentist for your own care.**
Post Treatment Instructions
First 24 Hours
Completely avoid eating and
brushing and touching area
Use cold pack gently outside skin for first 1 – 2
hours on and off 10 minutes
Usually all bleeding has
subsided by time you are dismissed. There is some possibility of the return of
bleeding later as the local anesthetic wears off and the Adrenaline effect on
the blood vessels ends. It is normal for your mouth to have the taste of blood
and for a very small amount of clotted blood to mix with your saliva. However,
if you actually develop bleeding do the following:
Place a cold pack back on the
outside of your face in the area and place a wet tea bag insiden the mouth directly over
the site and gently bite to allow the tea to coagulate the blood
Unlike usual extractions – DO NOT BITE ON GAUZE – pressure may
disturb implant, bone graft healing process
Days 2 – 14 Continue to avoid eating and brushing in surgical area
completely
Restrict all eating to the opposite side of the mouth.
Chew carefully
The most important
requirement is to avoid disturbing the area while healing is proceeding.
If a tooth was extracted,
bone grafting, implant placed either separate or in combination; any force will
cause shifting and will disrupt closure of the surgical site, movement of bone
graft materials or membranes. Implants must be integrated within the bone for a
minimum of 90 days for routine conditions before being subjected to force from
chewing.
In lieu of contact even with
a soft tooth brush applied gently, we recommend:
Rinse 3 – 7 times daily with baking soda (one teaspoon dissolved in 8oz
water)
There is also available a
mouthwash with baking soda as the main ingredient. ( Tom's )
Use of temporary bridges,
retainers, dentures - It is extremely
important to prevent any direct forces on healing tooth sockets,
bone grafts and healing implants.
Special
Instructions
Day 15 – 1 Month
sutures have been removed and the doctor has
verified initial healing:
For two additional weeks
after suture removal do brush the teeth adjacent to the extraction, bone graft,
implant still being very gentle - only clean the teeth - do not massage the gum
tissue that was involved in the surgery. Floss gently any adjacent teeth but do
not force floss into crevice of gums immediately in the area of any implant or
bone graft
Continue eating carefully
still avoiding even soft foods on the surgical area.
Any
temporary restoration worn during the healing period should exert zero force on
the area surrounding the implant and any bone grafted area.
Month 1 through
[ ] 4
[ ] 6
[ ] 8
dependant on how many phases
from toothy extraction through the time implant is determined to be fully
integrated (secure in the bone)
During this time there are
two very important requirements to adhere to
1) Forces upon the healing graft or implant must be avoided entirely
2) Cleanliness is imperative
throughout the remaining period for healing - and forever thereafter!
Since there is a wide range
of situations, I will describe all of them and note which ones pertain to your
individual circumstances
Stage one - No exposed Implant structure and no
temporary appliance
Avoid eating moderate to
crunchy and sharp foods in the area
Brush and floss adjacent
teeth like normal
Healing Abutment exposed to the surface
Avoid anything but extremely
soft from contacting the exposed Titanium part
In addition to normal care
for the neighboring teeth keep the abutment and surrounding gum tissue clean
by gentle brushing in a circular motion
Healing Abutment with a Removable temporary
appliance
Use the same above
precautions to avoid forces upon the exposed metal part and to keep it clean.
Eat with the temporary
appliance in place according to your previous instructions based on the
durability and stability of your particular temporary. Clean the removable
appliance at least three times daily - as soon as possible after each meal. If
you detect any movement where the appliance transmits force to the abutment or
the gum tissue around it call the office and avoid further use until adjusted
Multiple Implants with a Temporary Full or Partial
Denture
Avoid use of denture adhesive
while stitches are in place and until gum tissue has healed closed - usually 2 - 4 weeks after extraction or implant
placement.
Keep denture clean outside
and under brushing soon after every meal
There should be no force upon
the healing sites - any force from chewing must be on the palate and remaining
teeth and ridge areas that are well healed where teeth have been missing for
more than a year.
Eat only soft foods the first
30 days and only gradually to moderate chewing until your implants are
integrated and a permanent denture or bridge is placed
crown or bridge attached to implant(s)
You were supplied with a
temporary attached to the implant for the purpose of shaping the surrounding
gum tissue in the final stages of healing.
In some cases (this is to be avoided since it
is a compromised situation with much higher risk) a temporary may be attached
to the implant immediately or much sooner than the time of full integration due
to the impossibility of fitting a suitable removable temporary and a strong
need for cosmetic appearance during healing.
[ ] Phase one - completely avoid all eating
that would contact the temporary tooth and transmit forces - Extremely Important - not even
soft contact. Do not brush the temporary but instead rinse 3 - 7 times daily
with baking soda solution
[ ] Phase two - still continue to completely avoid eating on the temporary.
Brush with most gentle brush
and method Do Not Floss the
area
[ ] Phase three - Now we are in transition
toward the final replacement tooth crown or bridge. Start eating very soft
foods on the temporary. Brush with normal massage of the gum tissue like you
would for any other teeth. Begin flossing around the temporary very gently with
light force only against the temporary and no force from the floss exerted
against the gum tissue
Special Instructions
You have been recommended to
wear an appliance at night - either your temporary denture, a second denture or
a night guard retainer. This is extremely important since we need to remove all
risk of forces on the healing site, any implants with healing in progress, any
implants that will stand alone (when usual day time denture is removed) even
after they have fully integrated within the bone (we need to assure that they
will not loosen, break screws, etc.) We also need to avoid unbalanced forces on
any remaining teeth or trauma to your lips or tongue, etc. caused by clenching
teeth during sleep especially when there are few remaining teeth that would be
very vulnerable to problems.
In addition to protection,
this allows the opportunity for soaking of removable dentures or retainers for
maximum disinfection when they are out of your mouth.
Other:
After PERMANENT restoration
Gradually increase chewing
reaching normal frequency and texture of foods.
Always avoid extremely hard chewing such as ice, hard
candy, shells, stale nuts
and using your teeth as a tool or for bad habits.
Keep in mind that anything
too strong will cause damage to natural tooth enamel, porcelain and other
restorative materials, dental cements (even permanent) and can result in broken
screws, loosening of crowns, bridges, posts, implants or teeth themselves.
Brush normally and often Floss gently around any
Crown, etc. placed on top of the implant . Do not force floss deep under the gums
around the body of the implant gums do not attach as firmly to an implant as
a tooth root Gum and bone grow closely around an implant, but do
not biologically connect
Implants will not be subject
to cavities, but they are highly vulnerable to gingivitis.
Eat well without overloading Use excellent cleaning at home and be
consistent with follow up care every 3 - 6 months as recommended
Summary - Instructions
for Dental implants
1) Day before / day of
surgical placement
Take anti-inflammatory pain
medication 1 - 12 hours in advance to prevent excess swelling and pain
Take antibiotic starting day
before to prevent infection
2)After surgery through two
weeks - removal of stitches
Completely avoid eating in
area
Completely avoid brushing and
flossing in area
Instead rinse gently and
frequently ( 5 - 10 times a day) with baking soda solution or baking soda mouth
wash only
Completely avoid use of any
removable false teeth, temporary, retainer, night guard unless you were
specifically instructed to do so and given special instructions for wearing and
cleaning, removal
3) Following removal of
stitches
brush adjacent teeth gently
but thoroughly
rinse briskly with any type
of mouthwash at least 3 times daily in area of implants
still do not floss the gum
tissue next to any implant
If a screw or healing
abutment is exposed now or becomes exposed in later weeks, begin gently
brushing the exposed metal with a circular motion.
Under no circumstance should any force be
placed from chewing upon an implant prior to a minimum 3 month period for
integration (healing within your jaw bone)
exceptions are specially
given when a patient has received a full arch set of implants that are joined
by a rigid bar and a special secure temporary - still use great caution to chew
very softly for the initial 3 month period
4) After restoration of
implants
once any single crown, bridge
or removable restoration is attached to the implant:
Chew softly at first then
gradually increase until normal (mildly crunchy) can be accomplished - usually
over a period of a week.
brush the fixed restorations
the same as any natural tooth covered with a crown, bridge
Do floss the gum tissue over
the implant - extremely gently - wipe gently against the implant and crown - do
not use any force pushing against the gums surrounding any implant now or ever
in the future
removable partials and full
dentures are removed for cleaning three times daily and the implants should be
brushed with a gentle circular motion.
**These are GENERALIZED instructions for your information only; it is not to be used for self-diagnosis or self-treatment. Please see your personal dentist for your own care.**
