Post-Operative Care for All-on-4 Dental Implants

After All-on-4 surgery, closely following our instructions on post-operative care is vital. Adhering to these instructions will help you avoid unnecessary discomfort and minimize the risk of complications such as swelling and infection.

It is not unusual for patients to experience minimal side effects after implant surgery, so not all of these instructions will apply, and often it is a matter of common sense. However, if in doubt, then these guidelines will help you.

We recommend reading the following advice carefully to understand it fully. If not, please remember we are only a phone call away and are always available to help you and answer any questions.

The following instructions will help you care for the surgery site immediately and for the first few days after implant placement, controlling bleeding and swelling.

Bleeding

It is normal to experience some bleeding after dental implant surgery and for slight bleeding or some redness in your saliva to remain during the first twenty-four hours.

• Stay sitting upright and use moist, sterile gauze or place a moist teabag over the wound (the tea bag contains tannins that help contract blood vessels, reducing bleeding).
• Bite down gently but firmly, using about 80% of your maximum biting strength. Continue biting down for up to half an hour, allowing the bleeding to stop as a blood clot forms.
• If the bleeding continues, adjust the position of the gauze so it creates a better seal. Even with a good seal, bleeding can take several hours to stop completely.
• Avoid spitting or using a straw, as these actions can cause bleeding to restart.
• Avoid lifting anything heavier than a couple of pounds and all strenuous activity.
• When you go to bed, you might want to cover your pillow with a towel to protect it from minor oozing or drooling.

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Swelling

Swelling is perfectly normal after dental implant surgery and is part of the healing process. It usually reaches a peak within three days and can take several days afterward to subside completely. Our dental practice uses computer-guided surgical techniques that help minimize swelling.

Below is how to deal with any minor swelling using ice packs.

• You can use a ready-made ice pack or create your own by filling a Ziploc bag with ice. Before using, wrap all ice packs in a dish cloth or hand towel. You should not place the ice pack directly on your face.
• You can start using the ice pack on the same day of surgery. Place the covered ice pack against the swollen area for a maximum of 30 minutes, then remove it and wait another 30 minutes before reapplying if needed.
• Continue using the ice pack for up to 72 hours after surgery. From 72 hours onward, switch to warm, moist heat applications, such as a warm, moist washcloth. Use the same 30 minutes on and 30 minutes off application method.

Bruising

You might experience some minor bruising after surgery, causing some skin discoloration. Bruising is perfectly normal and can develop two or three days after your implants are placed. Using moist heat can help to speed up healing, so the bruising fades more quickly.

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Pain Medications

After the anesthesia wears off, you may experience some discomfort or pain, generally during the first 12 to 24 hours after implant placement. We can prescribe medication to relieve pain, so please use it as directed.

Taking pain medication on an empty stomach can cause discomfort. Before taking your pain medication, eat something light and nourishing, like a milkshake or smoothie, half an hour beforehand. Eating something helps reduce the risk of an upset stomach.

If you only have moderate pain, this can be controlled with over-the-counter painkillers like ibuprofen, Motrin, or Advil. You may also take Tylenol, ensuring you follow the dosage instructions on the packaging. If you are unsure of how much you can take and how frequently, please get in touch with us.

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Antibiotics

We may prescribe antibiotics to reduce the risk of infection. If we provide a prescription, please ensure you complete the course of antibiotics, taking them as directed. Before you leave our surgery, we will tell you when to take the first dose.

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Oral Hygiene

Keeping your mouth clean after implant surgery is essential to avoid the risk of infection and aid healing.

First Seven Days After Surgery

We may prescribe chlorhexidine mouth rinse; if so, please use it as instructed. We will provide instructions on how long to use chlorhexidine mouth rinse. Please do not use it any longer than recommended.

You may also rinse your mouth with a warm saltwater rinse two to three times daily. This mouthwash can be made by dissolving a half teaspoon of salt in a cup of warm water. Swish the mouth rinse gently around the mouth; do not rinse vigorously, and do not spit it out, as this could dislodge any blood clot that has formed. Instead, let the mouth rinse gently dribble out of your mouth over your bathroom sink.

Second Week After Surgery

Begin cleaning your mouth using a soft-bristled toothbrush, using small, gentle, circular motions around the junction of the implants and your gums. You must keep these areas clean, but you shouldn’t scrub hard; be gentle and avoid flossing.

Three Weeks After Surgery

Continue cleaning your mouth following the instructions for the second week. Clean underneath your implant teeth using a WaterPik on its lowest setting. If you want to use mouthwash, choose an alcohol-free brand, as alcohol can irritate your gums and dry out your mouth. It may also stain an acrylic bridge; we can advise which mouthwash brands are best.

As your implants continue healing, we can provide more instructions on brushing and cleaning around them and your implant teeth. If you are ever unsure about oral hygiene instructions, please contact our dental office so we can help you; it is extremely important to maintain good oral care after implant surgery.

Dietary Advice

We will give you dietary advice before you leave our surgery, but below are some guidelines to follow.

Hydration

It is important to remain well hydrated after implant surgery, especially if you have sedation dentistry. Keeping your fluid intake up is even more important immediately afterward because your food choices are limited the first few days after surgery. Liquid protein drinks are a good choice and will help provide the energy needed for healing.

Blending protein drinks with ice can make them more palatable, and the cold beverage will help soothe your mouth. Avoid drinking anything hot for the first twenty-four hours after surgery.
Staying properly hydrated will help you avoid feeling nauseous or needing to vomit. If you feel nauseous, try sipping a Coke or another soda slowly until the sensation subsides. Do not use a straw, as the sucking action could cause the surgery site to begin bleeding.

Eating

Initially, stick to soft foods requiring minimal or no chewing. Options include mashed potatoes, scrambled eggs, ice cream, yogurt, pasta, soup and oatmeal. Stick to a softer food diet for the first month after implant surgery.

It is vital to avoid harder foods that could damage your implants or implant teeth and delay healing. Ensure you eat regularly as this will help you feel better and give your body the nutrition it needs to heal more quickly.

Physical Activity

It is important to rest immediately after your surgery, especially if you had sedation dentistry, so be prepared to take it easy for at least the rest of the day. You should not operate machinery, drive, or drink alcohol for 24 hours afterward, and you should not sign any important documents or make any important decisions during this time until any sedatives have been eliminated from your system.

It is advisable to avoid strenuous activity for at least a week after surgery. We can give you more precise instructions on when to gradually reintroduce physical activities based on your circumstances. When you begin exercising, start gently and stop immediately if you feel faint.

Smoking

Smoking negatively affects oral health and can significantly impact the success of implant treatment. If you do smoke, then we will encourage you to consider quitting entirely.

Risks of Smoking for Implant Healing

Smoking after your implant surgery can impact healing in several ways, as outlined below.

Increased Risk of Implant Failure

Nicotine and other toxins in cigarettes make it harder for your dental implants to fuse with your jawbone, a process called osseointegration. Unless osseointegration can occur, there is a risk that your implants will not fuse fully with your jawbone and will not be strong enough to support your implant teeth.

Slower Recovery

The nicotine in cigarettes constricts blood vessels, so it is harder for essential nutrients to travel to your jawbone and gums and trickier for toxins to be transported away from your jaws.

Greater Risk of Infection

Smoking can make it harder for the body to fight infection, weakening your immune system. A reduced ability to fight infection could lead to implant failure or require further treatment to try and save the implant.

Higher Risk of Peri-Implantitis

Peri-implantitis is a condition similar to gum disease and which can cause implant failure. Smokers are at greater risk of developing this condition. An early sign of gum disease and peri-implantitis is gums that bleed more easily. Because smoking constricts the blood vessels in the gums, infections like this can be harder to detect. Without early treatment, there is a greater risk of implant failure.

Monitoring Your Recovery After Implant Surgery

Most people will find their recovery smooth and uneventful, and it is important to remember that implant failure is rare. Only a small percentage of people will experience complications, especially if they smoke or fail to follow our guidelines.

Some signs are normal after implant surgery, and these are listed below.

1. Having a slightly increased body temperature for the first 1-2 days after surgery is perfectly normal. Tylenol or ibuprofen should help lower your temperature. If the fever persists, please get in touch with us immediately.
2. Your facial muscles might feel stiff, so fully opening your mouth is trickier.
3. Your lips may be dry and cracked.
4. You could experience minor earache.
5. A sore throat or discomfort when swallowing.

However, these symptoms should improve after the first few days, and healing begins. Below are signs to be aware of when recovering after your surgery, which persist beyond the first few days or worsen.

• Severe pain.
• Inflamed, bleeding gums.
• Swollen gums around the surgery site where the swelling does not subside after the first few days or worsens.
• Receding gums.
• Pain or discomfort when chewing.
• Noticing your implant teeth or an implant feels loose.

We know it can be alarming to experience these symptoms, which is why we encourage you to get in touch with us if you are at all concerned about your recovery after implant surgery. Our experienced and compassionate dental team is here to support you and can discuss the matter with you and schedule an appointment if needed.

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