After Placement of Dental Implants

Healing after implant surgery is a longer process than most oral surgery, and how your mouth heals in the first two weeks sets the stage for the implant’s long-term success. 

Pain

• Take your first dose of pain medication before the freezing wears off, usually within 24 hours of surgery. 
• Take all medications with food or chocolate milk to prevent nausea.
• For the first 3 days, alternate ibuprofen (Advil) with your prescribed pain medication (Tylenol 3 or Tramacet) every three hours: Advil, then Tylenol 3 three hours later, then Advil three hours after that, and so on. This combination controls pain better than either alone.
• Don’t take additional Tylenol or other acetaminophen products if you’re taking Tramacet, it already contains acetaminophen.
• Start your antibiotic tonight with dinner and take it until it’s finished. Eating yogurt with live cultures or taking an over-the-counter probiotic while on the antibiotic helps replace the healthy bacteria it wipes out. If you develop a rash or other reaction, stop taking your antibiotic and call our office.
• Expect the most discomfort in the first 24 to 48 hours, easing by day 3.

Nausea

Nausea is common after anesthesia and pain medication. Stay well hydrated, and take your medications with food or chocolate milk to help prevent it. If nausea continues, Gravol can help. These can be picked up over the counter at your pharmacy.

Bleeding

• Light oozing or blood-tinged saliva is normal for the first 24 to 48 hours.
• Only place gauze if you actually see active bleeding. Gauze can stick to the healing site and pull it loose when removed.
• Place a folded gauze pad directly over the implant site(s), not between your teeth, and bite down with firm, steady pressure for 30 to 45 minutes.
• Change the gauze once it’s soaked through. Once you see only light pink staining, you can stop.
• If bleeding restarts, bite on a moistened tea bag for 30 minutes. The tannic acid helps close the vessels.
• Don’t spit or rinse vigorously for the first 24 hours. Avoid straws for 6 weeks. Any of these can disturb the healing site.

Swelling and Bruising

• Swelling peaks on day 2 or 3 and starts improving by day 4. It’s usually gone within a week.
• Bruising can appear between day 3 and 5 and fades over 7 to 10 days. This is normal, even if it spreads toward your neck.
• For the first 4 days: ice the outside of your face, 30 minutes on and 30 minutes off, as often as you’re awake.
• Starting day 5: switch to a warm compress and gentle facial massage for 15 minutes every hour while awake. Ice stops helping once swelling has peaked.
• A slight fever for the first 2 to 3 days is normal. Call us if it persists longer than that, or if you feel significantly unwell.

Diet

• Liquids only the day of surgery. Move to soft foods the next day: pasta, eggs, fish, mashed potatoes, rice.
• From day 3, you can return to most foods as tolerated, but don’t chew on the implant site(s) for 6 weeks. Any pressure can disturb the implant before it fuses with the bone.
• Avoid hard, crunchy, or seedy foods (chips, nuts, fruit with seeds, popcorn, crusty bread) near the implant for 6 weeks.
• Drink plenty of fluids, at least 3 litres a day for the first week, and skip straws for 6 weeks.

Smoking

Don’t smoke or vape for at least 6 weeks after surgery. Smoking is the number one cause of implant and graft failure, it starves the healing bone and gum tissue of the blood supply they need.

Oral Hygiene

• Don’t brush your teeth or rinse your mouth on the day of surgery.
• Starting the day after surgery, brush and floss your teeth as normal, but don’t brush forcefully on the implant site. Clean the healing abutment with a soft toothbrush held in a “saddle” shape, gently straddling the abutment.
• Starting the day after surgery, use your syringe after every meal and at bedtime for 6 weeks, and after snacks with just warm water. Fill it with half Listerine Zero and half warm water and direct the tip gently to clean around the sutures and abutment. This is the single most important thing you can do to protect the implant while it heals.
• Don’t swish or rinse your mouth for 6 weeks, and don’t use a water flosser near the surgical site. Use the syringe instead.
• Once a week, massage the gum tissue (mucosa) around the implant on both the tongue and cheek sides. This supports healthy bacteria around your new implant.
• Stitches dissolve on their own, usually within 1 to 6 weeks. It’s normal if you notice one has come out.

Abutments and Prosthesis

• If you have a healing abutment, keep it free of plaque. If it becomes loose, turn it clockwise to tighten it. If that doesn’t work, or it comes off completely, call our office right away.
• Don’t wear an old denture or partial until we’ve told you it’s safe, usually once any needed adjustments are made. Wearing it too soon can interfere with healing.
• If you’re given a temporary prosthesis, it’s for appearance only. Don’t chew or put pressure on it until your surgeon clears you.
• You’ll need a follow-up appointment after your implant surgery. This may already be booked for you, or you may need to call our office to schedule it.

Activity

• No driving, operating machinery, or making important decisions for 24 hours or while taking prescription pain medication.
• Rest for the first 24 to 48 hours. Avoid strenuous exercise for one week, it can increase bleeding and swelling.
• You may feel dizzy or lightheaded if you stand up too quickly in the first day or two. Sit up for a minute before getting up.
• No alcohol while taking prescription medication.

Numbness or Tingling

Implants placed in the lower jaw sit close to the nerves that supply feeling to your lip, chin, and tongue. Temporary numbness or tingling in these areas is possible and can last days to weeks. It’s rare for it to take longer. Let us know if it hasn’t improved after two weeks.

Breastfeeding

It’s safe to continue breastfeeding as normal after anesthesia and while taking your prescribed pain medication. There’s no need to pump and discard.

Call Us Right Away If You Notice

• Bleeding that won’t slow down after an hour of firm, steady pressure
• Swelling that keeps increasing after day 4, or returns after it had started to go down
• Fever lasting more than 2 to 3 days, chills, or feeling generally unwell
• Pain that worsens after day 4 instead of improving
• Pus, a bad taste, or a foul odor from the implant site
• A loose or missing healing abutment you can’t tighten yourself
• Difficulty breathing or swallowing — go to the nearest emergency department or call 911

Kingsway Oral & Maxillofacial Surgery

Call us at 780-454-6565 or toll-free at 1-800-379-9474. An oral and maxillofacial surgeon is available by phone 24 hours a day. If the answering service doesn’t pick up, hang up and call again in five minutes, our lines are sometimes busy.

Please call our office first, rather than your family dentist or physician. For severe bleeding or trouble breathing, go directly to the nearest emergency department or dial 911.