Keeping the mouth as clean as possible, maintaining the instructed diet, not smoking will set you up for success in the healing process.
In all implant cases it is best to let the implant rest in the bone. However, you have received a fixed (screwed in) hybrid denture immediately following your surgery. Since you must use this new set of teeth to chew, IT IS VERY IMPORTANT to understand that you maintain a very soft diet for 12 weeks and chew with even biting pressure. Chewing more on one side than the other causes stress on the implants on the chewing side. Even after 12 weeks, you still need to be gentle on your implants and chew with caution, eating food that doesn’t require “mashing”.
Some bleeding is expected for up to 24 hours after the surgery. Your gum tissue was closed with resorbable sutures that will dissolve on their own over 4 days, however, your tissue will begin healing together more quickly. Permanent sutures may have been placed to which Dr. Keon Ahghar will inform you. Rest quietly with your head elevated. Blood-tinged saliva may be seen for 2-3 days following the surgery, especially after brushing and rinsing; this does not indicate a problem. Suture material should be left alone as it dissolves.
You will be asked to return to the office for a 2-week follow-up appointment, at which time we will evaluate your bite and adjust if necessary. Due to numbness associated with the local anesthetic and/or sedation used for the surgery, we are not always able to determine or set the bite definitively. Your bite will further adjust over the coming months and a final bite adjustment could be required at the 3 month mark. This is OK as you are required to be on a soft/mashed up diet and your bite will be adjusted in the temporary and set appropriately in the final set. If you notice yourself clenching or grinding, you should notify us. This may indicate that you should use a transitional Night guard.
Swelling is the body’s normal reaction to surgery and healing. Often, it will not become apparent until 24 hours after your surgery and will not reach its peak for 2-3 days. After this time, the swelling should not decrease but may persist for 7-10 days. Swelling may be minimized by the immediate use of ice packs. Apply the ice packs to the outside of the face for 20 minutes on then 20 minutes off while awake for the first 24 hours. Some patients will develop bruising, often seen in women more than men. Patients who develop bruising will commonly see the bruise move around the face; if this happens, you do not need to be alarmed. Bruising resolves within the first 5-10 days. Some patient will experience numbness on due to the swelling. This may resolve as the swelling reduces.
As can be expected, most oral surgery is accompanied by some degree of discomfort. If you do not have an allergy to a non-steroidal anti-inflammatory medication (ibuprofen, generic name for Motrin or Advil) we recommend taking this prior to the local anesthetic wearing off. Ibuprofen is both a pain reliever and anti-inflammatory medications so it will help reduce swelling. Alternate between the ibuprofen and the Tylenol medication as described in pain regimen. In most cases, the doctor prescribed you an antibiotic which you should finish completely to prevent infection. You are also prescribed an antibacterial mouth rinse which should be used twice daily in the first two weeks following implant surgery. All medications should not exceed the recommended dosage.
Sedation( if received); Patient must be monitored after surgery by another adult until the morning.
Diet:
Until numbness wears off after surgery, check the temperature of the food with you finger prior to putting it in your mouth. Patients with fixed temporary teeth may have foods such as applesauce, pudding, Jell-O and soup in the following surgery. For example, soft foods are things LIKE:
You may increase your diet BUT do not chew anything tougher than the foods listed above for 4-6 month or until the healing process is complete. An easy way to understand your diet: if you cannot cut the food easily with the side of a fork then it is NOT a part of the soft food diet. For instance, salad leaves require grinding between the teeth to chew the leaves, so you should not eat this during the healing period, although you may think of it as a “soft food”. Patients with screwed in dentures should avoid popcorn and any foods with small seeds as they wedge between the implant and tissue underneath the denture; this can reverse the healing by irritation.
The best way to prevent infection and ensure proper healing is to keep your mouth clean. Brush thoroughly between each meal beginning the day after your surgery at least morning and night. Use the Chlorhexidine rinse that was prescribed on the night of your surgery and for 2 weeks following. Fixed (screwed in place) denture patients should use the Hydroflosser (i.e. Waterpik) at least twice daily except the first 48 hours after surgery. After 48 hours, you may begin using the hydroflosser on Level 3, you will increase levels everyday until you get to the maximum level 9. It is very important to get the water steam underneath the denture, between the gums and the denture.
Night of Surgery: Use only the rinse prescribed
Days 1-3 after surgery: Gently brush and use the rinse prescribed 2x/daily
Day 4 and beyond: Brush, use prescribed rinse AND water flosser 2x/daily. If water flossing is too uncomfortable use the syringe provided.
After 2 weeks: Stop the prescribed rinse; Continue brushing and water flossing after gums are closed together. You can keep it on the highest level.
Activity:
For the first 48 hours, you should rest and relax with no physical activity. Try to sleep with your head slightly elevated. After 48 hours, you may resume activity as tolerated.
Healing:
Bad breath is common and will reside as healing occurs. 2-3 days following surgery, white and possibly hard tissue may be seen at the surgical site. This signifies normal, healing tissue. It is normal to see the silver healing abutment appear through gum tissue following the procedure. If your abutment shows, you should be gently cleaning it with your toothbrush when you brush your teeth.
Other Considerations:
Upper implants usually take about 6 months to heal, while lower implants usually take 4 months to heal. This is due to the body’s natural anatomy in which the upper jaw bone is spongy and less dense than the lower jaw bone, which is more dense. Adequate healing time is crucial to the successful integration of the implants into the bone.
Your tissue will swell and shrink; a space is likely to develop between the hybrid denture and your tissue. This is ideal for optimal healing because it allows you to keep the tissue, abutments and hybrid denture clean. When it comes time to restore the implants with the final Hybrid denture, it will be fabricated to fit your tissue after the swelling has gone down, so the space between the denture and tissue will be significantly decreased and fit against the tissue comfortably.
You will have several check-up visits after the surgery so the doctor can monitor your healing and integration of the implants to the bone. He/She will determine when they are ready to be restored. Restoring the implant means taking the necessary impressions or digital scans to have your final set of teeth made by our laboratory.
If you have any questions or concerns, please let Dr Keon Ahghar or staff know.