Implant (4 Months: Posterior With Cover Screw) Post-Operative Instructions

Overview of today’s procedure and next steps: We placed your implant below the surface of the gums, so that the implant can heal within the bone without the danger of external forces hindering the healing process. Four months after today’s surgery, we will perform an “uncovering” of the implant, where we will numb the area, re-expose the implant, then take impressions for the implant crown. At the end of this appointment, we will insert an attachment called a healing abutment that extends just above the level of the gums. The shape of this round healing abutment replicates the future crown’s shape at gum level. In this way, it prepares the gums for the implant crown.

The final appointment is relatively quick and does not involve anesthetic or discomfort. Two to three weeks after the uncovering and impression appointment, when we have your case back from the lab, we will deliver the implant crown, which simply involves screwing or cementing the crown to the implant. 

Prescriptions: You will be given three prescription medications after your surgery. An antibiotic and two medications for pain. It’s very important that you take the antibiotic until completion. This will minimize the chance of infection at the surgical site. The pain medications you will only take as needed for pain. Ibuprofen 800 is an anti-inflammatory, so it will help keep swelling down. It will not make you drowsy, so it’s good to take during the day. If you need something stronger, or if you’re having trouble sleeping at night, Tylenol #3 is a stronger pain medication. It contains Codeine, a narcotic, so it will make you drowsy and for some people it can upset their stomach, so please only take it if necessary and with caution. 

After you leave today: You will be numb for a few hours after leaving the clinic, so it is recommended to fill your prescriptions immediately and take an antibiotic and a pain medication as soon as possible. This will ensure that the pain medication takes effect as the anesthetic wears off. 

Most patients admit that the pain from the implant placement was not as severe as they anticipated. The bone itself has little to no nerve endings, so it isn’t the implant in the bone that causes post-op pain, but rather the gum tissue we had to manipulate in order to expose the bone. Usually this is just a small hole punch in the top of the gums, minimizing your post-op discomfort. 

Pain peaks during the first 24-48 hours after surgery, so manage this pain with the provided prescription medications. And remember to finish the antibiotic, even if the pain disappears! An unfinished antibiotic regimen will only WEAKEN the bacteria, and not completely kill it, which could create a relapsed infection or worse, a strain of drug-resistant bacteria! 

Guidelines: Bleeding after placing an implant is usually minimal. If there is any bleeding, we will send you home biting on gauze. You should maintain firm pressure on the gauze for 45 minutes. 

Slight swelling and discomfort is normal, and should begin to subside 72 hours after surgery. If it gets worse, contact the clinic.

If we placed an implant in the area of an upper molar and premolar, there can sometimes be some sinus discomfort and/or pressure. If this occurs, it’s best to take an over-the-counter decongestant, like Sudafed.

Avoid eating on the side of the implant as much as possible until the crown is placed. This will reduce forces placed on the implant as it heals in the bone. 

Stick to softer food for 7 days. Impacts with harder foods can interrupt the healing process, and can be painful and damaging to the tender gum tissue. Foods like bread, mashed potatoes, chicken, rice, noodles, pureed fruit, bananas and ice cream are all great examples. 

Starting the day after surgery and for one week, use a warm salt water rinse after each meal to flush out food particles and debris that may accumulate in the surgical site. Place a teaspoon of salt in warm water, mix and rinse gently. 

Avoid brushing the two teeth directly adjacent to the implant for three days. You can brush the rest of the teeth like normal with a soft-bristled toothbrush, and a Q-tip with toothpaste to gently clean the teeth adjacent to the implant. 

Avoid alcohol-containing mouthrinses for 7 days. 

Avoid strenuous exercise (like heavy weight-lifting) for 7 days. Light exercise (brisk walk, jogging) is fine three days after the surgery. 

Alcohol should be avoided for at least 7 days following implant surgery. It is not recommended to drink while taking an antibiotic.

Smoking should be avoided for at least 7 days after surgery, and preferably for 2 months. Smoking is a leading cause of implant failure.

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