Post treatment guide for dental implants

**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.**