Dental Implants, Bone Grafting, Expose & Bond, and Mouth Biopsy

POST-OP
INSTRUCTIONS:

Implants
Bone Grafting
Expose & Bond
Mouth Biopsy

Our phone number is (406) 727-4322 You may remove gauze 1 hour after procedure

We want your recovery to be as smooth and pleasant as possible. Following these instructions will help you. If you have questions about your progress, please call our office at the number above. Calling the office can eliminate additional expenses of going to the Emergency Department or seeing another doctor. We have a doctor and assistant available 24 hours a day 7 days a week to answer calls. Do not hesitate to call in case of an emergency. However, for routine questions, please call during business hours.

The instructions for Dental Implants, Bone Grafting, and Expose & Bond procedures are very similar

DO NOT DRIVE OR OPERATE MACHINERY FOR 24 HOURS AFTER SEDATION OR AS LONG AS YOU ARE TAKING PRESCRIPTION NARCOTIC MEDICATION.

BLEEDING

Bite gently on original gauze packs for one hour immediately after surgery.
If you replace gauze packs, moisten the new packs slightly before placing them.
Do not chew on the gauze packs or “check” them frequently.
Each pack should be left in place for at least 30 minutes.
Oozing from the sites to a small degree is normal during the first 48 hours.
We recommend placing an old towel on your pillow for the first night as you may drool blood while you sleep.
Persistent bleeding may be treated by applying pressure with a black tea bag or sipping slowly on ice.
Call the office if you feel the bleeding is severe, uncomfortable, or if it does not respond to the above.

PAIN

Almost always, pain from dental implants, bone grafting, and expose & bond procedures can be comfortably controlled with over-the-counter medications:
- For sustained pain relief, alternate between acetaminophen (Tylenol®) and ibuprofen (Advil®, Motrin®, etc.) if you can take these medications. (For adults, 500 mg acetaminophen, 2 hours later 400 mg ibuprofen, 2 hours later acetaminophen, etc.) DO NOT DRIVE OR OPERATE MACHINERY FOR 24 HOURS AFTER SEDATION OR AS LONG AS YOU ARE TAKING PRESCRIPTION NARCOTIC MEDICATION.
- OR – For maximum pain relief at one time, take both acetaminophen (500 mg) and ibuprofen (400 mg) at the same time, then wait 4 hours for the next dose.
- For children, dosing recommendations can be found on the bottle.

If a prescription for a narcotic pain medication is provided, this is to be used for breakthrough pain as a last resort – these medications often have uncomfortable side effects and are very addictive.
Narcotic pain medication (tramadol, codeine, hydrocodone, oxycodone, etc.) are addictive, nauseating, and constipating. If taken incorrectly, they can be deadly. Follow instructions on the bottle, and call if you are concerned.
Most narcotic pain medication has acetaminophen. If you take a dose, treat it like your dose of acetaminophen.
Never consume alcohol or marijuana with narcotic pain medication. It can be deadly.
Refills for prescription pain medications will be considered on a case-by-case basis and will only be filled during business hours. They will not be considered over the weekend. Please plan accordingly. Office hours are Mon – Fri 8:00 AM to 4:00 PM and Friday 7:00 AM to 12:00 PM.

ORAL CARE

It is OK to gently brush your teeth. Take care to avoid disturbing the surgical area with the brush.
Do NOT vigorously rinse with water or any mouth rinse during the first 72 hours.
Do NOT probe or otherwise disturb the surgical site.

Beginning the day after surgery, gently rinse your mouth with mild salt water (½ tsp. salt and ½ tsp. baking soda per cup of water) several times a day and continue for two weeks following surgery.

If prescription mouth rinse was provided, be gentle and follow the instructions on the bottle.

Do NOT rinse your mouth with hydrogen peroxide.

SMOKING

Do NOT vape or smoke tobacco or marijuana after oral surgery. Smoke and vaping vapor contain damaging chemicals that will increase the risk of pain and infection and will delay the healing process leading to higher risks of complications.
The longer you can avoid smoking after surgery, the better.
Patients who smoke tend to have pain that lasts longer than non- smokers.

SWELLING

Swelling peaks 48-72 hours (2-3 days) after surgery. It then takes time to resolve.
Ice packs help reduce swelling. A pattern of 20 minutes on and then 20 minutes off is helpful for the first 48 hours.
Ice directly on the skin can be uncomfortable. Place a cloth between the ice and your skin.

After 48 hours switch to a heating pad over the cheeks, following the same 20-minute rotation schedule.

Keep your head elevated 30° to 45° for the first 48 hours following surgery.

If swelling returns after it has already resolved, please call the office.

GENERAL HEALTH

Do not stand up quickly during the first 24 hours after surgery – you may faint.
You should have assistance when you go to the bathroom.
It is common to run a low-grade fever during the first 48 hours after surgery and anesthesia.

SLEEP APNEA

Unless directed otherwise, you may use your CPAP machine.
Patients who were sedated, or who are taking narcotic pain medication MUST use their CPAP machine anytime they might fall asleep, unless specifically directed otherwise. You are more likely to have life-threatening apnea initially after anesthesia and while under the influence of narcotic pain medication.

NAUSEA

Sometimes pain medication causes nausea. Nausea can be reduced by eating a small amount of food before each pain pill and taking the pill with a large volume of water.
Ginger ale, Dramamine®, and Benadryl® may help with nausea.
Be aware that almost all anti-nausea medicines cause drowsiness.c

DIET

Avoid carbonated drinks, alcohol, citrus juices, coffee, and any extremely hot food or drinks for 48 hours (about 2 days) after your surgery.
Start with foods that are cool and soft during the first 48 hours after surgery.
After 48 hours you may gradually increase your diet to more firm food based on comfort.
For 3-4 weeks after your surgery, it is best to avoid foods like nuts, sunflower seeds, popcorn, etc., which may get lodged in the surgical site.
Do NOT skip meals. This will slow the healing process. Protein in your diet helps with healing.
If you have diabetes, maintain your normal eating habits, or follow instructions given by your doctor. Check your blood sugar regularly. Ideally, your blood sugar should stay below 250

HEALING

Almost every stitch we place is a type that dissolves. They may dissolve 2 days to 3 weeks after your procedure.
Occasionally a sharp edge of bone can be felt at the surgical site. Bone slivers may surface occasionally for several weeks after tooth extraction. Please call if these are causing discomfort, although many can be removed by rubbing a washcloth over the area.
Sometimes implants have small metal caps that stick through the gums. These are designed to be temporary, as your dentist will remove them before placing the crown. They can fall out as you heal. Please bring the small metal cap directly to our office or to your dentist to have it replaced ASAP before the gums start to close.
Some bone graft procedures use membranes to hold the bone graft material in place. Some membranes dissolve on their own. Other membranes need to be removed at your follow-up visit. You may feel something flapping around in your mouth. If you’re concerned, please call our office to be seen.
If you had an expose & bond procedure, make sure you have a follow-up set with your orthodontist to check the progress of tooth movement. Some orthodontists want to see you within a week. Others have longer follow-up timelines. If you’re not sure, please ask.

EXERCISING

When you start exercising is up to you.

Exercise causes an increase in heart rate and blood pressure, which can lead to more bleeding from the site.
If you are taking narcotic pain medication or are within 24 hours from being sedated, you should not exercise.
Aerobic exercise with endurance training in mind may be more comfortable. However, people often feel throbbing. This is fine if it goes away when you are done working out.

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POST-OP INSTRUCTIONS:

Implants Bone Grafting Expose & Bond Mouth Biopsy