Dental Implant Healing Abutments

The first phase of implant therapy has been completed; the surgical placement of your dental implant(s). Do not disturb the wound. Avoid rinsing, spitting, or touching the wound on the day of surgery. There may be a metal healing abutment protruding through the gingival (gum) tissue. This is normal.

Prescriptions

• Pain Medication – You have been given a prescription for pain pills (Vicodin/ Hydrocodone). This is a strong pain medication and does, on occasion, make some people feel tired or somewhat nauseous. Consequently, the following pain control regime has been found by our office to give our patients superior pain control, minimizing the side effects found with narcotics. Take 800 mg of Ibuprofen (4 tablets of Advil, Motrin, or generic Ibuprofen) every 4 – 6 hrs. as needed for pain. If you have breakthrough pain before your next dose of Ibuprofen is due, or if the Ibuprofen alone is inadequate for pain control, you may take 1 of the stronger pain pills (Vicodin/ Hydrocodone) every 4 hours, alternating with the Ibuprofen. This regime of medication should provide superior pain control, more than if you were taking the stronger narcotic medication alone. The Ibuprofen also has the added advantage of reducing inflammation and swelling much better than the narcotic pain medication, and may actually help the surgical site heal. If you have any questions regarding this pain control regime, please contact our office.

• Antibiotic – You may have been given an antibiotic. Please take it as directed until it is gone.

• Peridex (Chlorhexidine) Mouth Rinse – GENTLY rinse with ½ ounce twice daily after brushing the remaining teeth in the nonsurgical sites. Please note that a light stain may develop on the teeth and tongue in patients that smoke or drink coffee. The stain can be easily polished off and should not worry you. The antibacterial effects of the mouthwash are significant and play a very important role in helping to prevent postoperative infection.

Diet

For the next 4 – 6 hours you are to have cold liquids only (iced teas, carbonated beverages, fruit juice, lemonade, water). The cold liquids will allow proper clotting to take place and reduce some amount of discomfort. Do not use a straw; allow the cold liquids to pass over the surgical area. Drink plenty of liquids, at least 2 8-ounce glasses for every pain pill.

After the first 6 hours you may have something to eat, either warm or cold. Start with mushy foods: soup, yogurt, scrambled eggs, for example. You should then gradually go to a soft diet for the rest of the week. A soft diet is anything you can cut with a fork (ground meat dishes, casseroles, cooked vegetables, chicken, fish, macaroni, etc.). As a rule of thumb, if it hurts, don’t eat it. The only foods to avoid are popcorn, nuts, and foods with seeds or berries in them.

Swelling

It is natural to expect some swelling after surgery. To keep swelling to a minimum, apply an ice pack to the outside of your face for 15 minutes on and then 15 minutes off for the next 24 hours (except while sleeping). Do not be alarmed if you wake up more swollen than you were when you went to bed. Resume the ice pack in the morning. Sleep with your head on two pillows. Keeping the head slightly elevated helps minimize swelling.

Bleeding

It is natural to have some blood mixed with your saliva for the first two or three days after surgery. It will not hurt you to swallow it, as it is mostly saliva. However, a bleeding problem would be considered if your mouth were to fill rapidly with blood in just a few minutes. Should this occur, do not rinse to stop the bleeding. Take a wet tea bag and place it over the bleeding area and press firmly for twenty minutes. If the bleeding will not stop, call the office.

Hygiene

In the first 24 hours you are not to rinse or spit as this may disrupt the blood clot and cause further bleeding. After 24 hours you may begin to brush your teeth and gums gently. You should also brush your tongue. Do not floss. Begin rinsing with ½ ounce Peridex twice daily after brushing. Remember, the cleaner you keep your teeth and gums, the faster they will heal and the better they will feel.

If a denture or partial is worn, it may be relined at the time of your surgery. Because of swelling, it may not fit well the first week or two, but should settle in over time. Please leave the denture out as much as possible the first 3 weeks after surgery, especially at night. If the partial or denture is hitting an implant, please call our office immediately to have the denture adjusted. Early trauma to the implant could cause it to be compromised.

If a sinus lift was done, refrain from nose blowing for 2 weeks after surgery. Use a decongestant/antihistamine (such as Claritin D) as needed for any nasal congestion.

Healing Abutments

Following your surgery you will notice a small shiny button protruding through the gum tissue. This button is your implant healing abutment. In some cases, swelling may cover the healing abutment for a few weeks until the swelling subsides. The healing abutment is a temporary part of your implant and will hold the gum tissue back from the implant until your dentist is ready to place the final crown. It should be cleaned daily with your toothbrush and the Peridex mouthwash. The healing abutment is only tightened to light finger pressure and may, on occasion, come loose or even fall out during the healing period. If this occurs please call the office ) and it will be tightened or replaced. Loosening or loss of the healing abutment will not damage the implant if it is addressed promptly. Failure to inform your surgeon of a loose abutment could cause infection or even loss of the implant if ignored.

Fever

You may experience a slight feeling of weakness or chills during the first 24 hours. It is also possible to run a low-grade fever. If this persists for more than 24 hours, please call the office. Get plenty of rest this week and do not over exert yourself.