Instructions Following Implant Placement, Bone Graft, or Sinus Lift

If you have any questions about your post-operative course, please contact our office.

After office hours & weekends, please have Dr. Farbod paged via Marquette General Hospital at 906-228-9440. There may be a delay in returning your call if the doctor is in the emergency or operating room caring for another patient. Please call again if there is not a timely response.

 

 

IF YOU HAD GENERAL ANESTHESIA OR SEDATION

• Do not drive or operate machinery for 24 hours.

• Do not consume alcohol, tranquilizers, sleeping medications or any nonprescribed medication for 24 hours.

• Do not make important decisions or sign any important papers in the next 24 hours.

• You should have someone stay with you at home for the next 24 hours.

 

ACTIVITY

• Restrict your activities and rest for a day. Resume light to normal activity for the next few days.

• Avoid heavy lifting, bending over, excessive physical exertion, exercise during the first few days following your surgery. For optimal results we ask that you refrain from these activities for 2 weeks.

• Do not smoke for at least 2 weeks. Doing so will compromise healing and may lead to failure of the surgery.

 

FLUIDS AND DIET

Do not use a straw, drink carbonated beverages (pop, beer etc.), or chew on the surgical site for at least 2 weeks.

NOTHING HOT TODAY or for 2 weeks following surgery! Hot foods/drink can dissolve stitches and harm the surgical site. You may drink cold and room temperature items. Cold coffee, tea etc. is OK!

You may begin with soft foods (smoothies eaten with a spoon, mashed potatoes, soft pasta, soups, eggs, tender fish etc.). Ensure thata your diet is adequate and do not skip meals. Avoid big, hard, chewy, crunchy foods for at least 5-10 days  (e.g. steak, pizza, tortilla chips, hamburger sandwich etc.)

 

MEDICATIONS

You should resume your daily prescription medication schedule per your physician’s instructions. If you are diabetic, consult your primary care physician. Any medications prescribed by our office should be taken as directed unless advised against it.

• If nausea occurs, it is most likely due to the medication. Always take medication with food to help with nausea. If this does not help, please contact our office. You may need to discontinue the medication.

 

SWELLING

• Facial swelling after surgery is normal. The worst of the swelling is expected on or around the third day after surgery. It should progressively get better after that day. Most of the swelling will normally resolve within the first 7 to 10 days. Ice packs are used for the first 24 to 48 hours. Plastic bags filled with crushed ice and wrapped in a towel or a commercial ice bag are convenient forms of application. Apply for 20 minutes each hour while awake (on 20 minutes/off 40 minutes). After discontinuing ice, you may switch to moist heat (warm water bottle or warm wash cloth) using the same time periods.

 

BRUISING

• Black and blue marks on the face are caused by bleeding internally. This appears first as swelling, but often on the second or third day, it may discolor the face black or blue then yellow. It will usually disappear within 10 days.

 

ORAL HYGIENE

• This is the single most important thing that you can do to minimize the possibility of wound infection following surgery. Please use a soft bristle toothbrush with toothpaste (along with dental flossing) to keep the teeth clean. It is recommended that you avoid brushing the surgical area the day of surgery, however you may brush other teeth normally. The day after surgery, brush and floss your teeth after meals, being very careful and gentle around the surgical wound; followed by gentle rinsing (NO SWISHING or SPITTING) with a Chlorhexidine (Peridex) rinse that we may prescribe. Otherwise, warm salt water rinses may also be used. Be very careful during the first 24 hours following the surgery – Do not be too vigorous in your rinsing as this may stimulate bleeding.

If you have had a Healing Cap Placed: (the final stage of implant surgery), we want you to use a Q-tip dipped in prescription mouth rinse to clean your dental implant healing cap twice a day while the gums are too tender for brushing.

Additonally, you may gently irrigate the area after about 5-7 days with the irrigating syringe provided. Use the prescribed mouthwash to gently direct a stream towards the surgery site to remove any food and plaque debris.

 

NOTE: Please avoid toothpaste and oral rinses containing whitening agents for 7 days as they can interrupt clotting.

 

IMPORTANT: Please DO NOT TOUCH your wound with your tongue, fingers, or any other object. This may cause significant problems with healing, may cause the tissue to become damaged, and the stitches to come undone.

Avoid vigorous rinsing, spitting, smoking, carbonated soda drinks, and drinking through a straw for the first 2 weeks after surgery as this may interrupt the healing process.

 

 

BLEEDING

Intermittent bleeding or oozing overnight is normal.  Bleeding may be controlled by placing fresh gauze over the areas and biting on the gauze for 30-45 minutes at a time.

Persistent bleeding:  Bleeding should never be severe. If so, it may mean that the pack is not exerting pressure on the surgical areas. Try repositioning the gauze. If bleeding persists or becomes heavy you may substitute a black tea bag (soaked in hot water, squeezed damp-dry, allow it to cool, & wrapped in moist gauze) for 30-45 minutes.  If bleeding remains uncontrolled, please call our office.

Remove the gauze when sleeping, eating or taking medications. You may wish to cover your pillow with a towel to avoid staining. Rest with your head elevated by pillows at least 35 degrees.

 

SINUS INSTRUCTIONS

If you had a sinus lift surgery or any other surgery involving the sinus, blowing the nose, sucking liquid through a straw, heavy lifting/bending over, and smoking, all of which create negative pressure, should be avoided for 3 weeks after surgery. Coughing or sneezing should be done with mouth open to relieve pressure.

 

HEALING

It is normal for the surgical site to look very unappealing for the first two weeks. If bone grafting was performed, it is normal to have small pieces of bone particles (they may be white or yellow) to be expelled from the surgical site. This may be apparent when rinsing. If a membrane was placed, the surgical site may have a white appearance to it, surrounded by mild redness. Do not be alarmed, as this is normal. If you are not experiencing any of the signs of infection (severe swelling, fever, drainage of pus, severe pain, etc.) then there is no need to worry. However, if you have any concerns or doubts about the healing process, please contact our office for an appointment so Dr. Farbod can check the surgical site.

 

PLEASE SEEK ATTENTION IMMEDIATELY IF ANY OF THE FOLLOWING OCCUR:

• Possible allergic reaction – rash, sudden swelling, difficulty breathing. You develop difficulty seeing, become dizzy or pass out. You have difficulty speaking, breathing or swallowing. (Call 911!!)

• You have severe headaches or notice changes in your vision.

• Fever over 101 degrees by mouth.

• Uncontrollable bleeding not resolved by methods named above (contact Dr. Farbod immediately).

Unexpected swelling around the surgical site.

• Signs of infection (warmth, drainage/pus, severe pain, severe swelling etc.)

• Increased redness, warmth, hardness of the IV site.

• New numbness or tingling in your face (persistent numbness beyond 24 hours).

• Inability to urinate. Continued nausea, vomiting, diarrhea or constipation.

• Jaw stiffness is expected after surgery and usually begins to improve within 5 to 7 days. Notify us if it does not improve.

• Any other unusual or abnormal symptoms.

 

NOTE: Typically, pain and swelling will peak on the third day postoperatively. If the pain medications are keeping you comfortable and the swelling is not severe, then you are probably doing as we would expect.

 

FOLLOW UP CARE

You were given a follow-up appointment. Dr. Farbod will need to re-evaluate you (to check your progress) in approximately 1 week.

 

NOTICE:

You may have been given a temporary partial (AKA flipper) or denture to wear following your surgery. Dr. Farbod will let you know when you may begin to wear it. You must take it out during meals (Do not wear while chewing).

 

You MUST LEAVE IT OUT for the first TWO WEEKS following bone-graft surgery to prevent pressure and damage to the wound. Please bring it with you for evaluation (and any needed adjustment) to every follow-up appointment.

 

THE TEMPORARY PARTIAL OR DENTURE SHOULD NOT CONTACT THE DENTAL IMPLANT (for at least 12 weeks) OR THE SOFT TISSUE OVER THE BONE GRAFT (for at least 20 weeks). If this is not followed, it may lead to failure of the implant and/or bone graft and require further surgery. 

 

It is our desire that your recovery be as smooth and pleasant as possible.  Following these instructions will assist you, but if you have questions about your progress, please call our office.