After Grafting for Dental Implants in Toronto, ON

IMPORTANT INFORMATION

1. Exercise Care:

• Do not disturb the surgical area today. Do NOT rinse vigorously or probe the area with any objects or your fingers. Do NOT smoke.

2. Pain:

• Unfortunately most oral surgery is accompanied by some degree of discomfort.
• Take the first pill of your pain medication BEFORE the anaesthetic has worn off. You will be able to manage any discomfort better this way.
• If you do not have a prescription for pain medication: take regular/extra strength advil (ibuprofen) or Tylenol (acetaminophen) as per the instructions listed on the medication package.
• If you have a prescription for pain medication: start with one tablet of the Ibuprofen or one tablet of the pain medication that you were given. If you do not achieve adequate relief, you may supplement with one tablet of the second type of pain medication if given. You may also take a second tablet of medication if allowed on the medication instructions. This may add to the risk of stomach upset.
• Do not operate any motorized vehicle or machinery while taking the stronger narcotic pain medication. Avoid alcoholic beverages while taking pain medication.
• Remember that the most severe discomfort is usually within the first six hours after the anaesthetic wears off. After that your need for medicine should lessen.

3. Bleeding:

• Intermittent bleeding or oozing is normal within the first 24-48 hours. It may be controlled by placing warm wet gauze over the surgical areas and biting down firmly for 30-60 minutes.
• If bleeding increases, it usually means that the packs are between your teeth rather than on the surgical areas. Try repositioning warm wet gauze. If bleeding persists you may substitute a tea bag (soaked in hot water, squeezed damp-dry and wrapped in a moist gauze) for 30-60 minutes and sit upright.
• If bleeding becomes uncontrolled, please call our office.
• DO NOT SLEEP WITH GAUZE in your mouth, as this could become a choking hazard.

4. Swelling:

• Swelling following oral surgery is expected. It typically peaks at day 2 or 3 and then gradually subsides over the next 7-14 days.
• You can minimize this by using a cold pack or ice bag wrapped in a towel and applied firmly to face or cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 12 to 24 hours after surgery.
• If you have been prescribed medicine to reduce swelling like Ibuprofen, be sure to take it as directed.
• After 24 hours, it is usually best to switch from ice to moist heat (moist hot towels) to the same areas to reduce jaw stiffness.

5. Nausea and Vomiting:

• Nausea is not an uncommon event after surgery and it is sometimes caused by stronger pain medicines. Nausea may be reduced by preceding each pill with a small amount of soft food, and then by taking the pill with a large volume of water.
• Try to keep taking clear fluids and minimize the pain medication. Call us if you do not feel better or if repeated vomiting is a problem.
• Sipping on Cola drinks, Ginger Ale, or Tea may help with nausea.

GENERAL INFORMATION

1. Diet:

• Day 1 (day of surgery): Clear liquids only (apple juice, ginger ale, water, broth, jello). Avoid hot liquids.
• Day 2 and 3: Full liquids (cream soup, custards, yogurt, protein drinks -‘Ensure’).
• After Day 3: Soft foods (mashed potatoes, eggs, over-cooked pasta) if tolerated, but avoid chewing on the surgical site. Continue with a soft diet for approximately 2 weeks. Progress to a normal diet when comfortable, but avoid chewing directly on the surgical site for 2 months.
• Use great caution with crunchy/chewy (granola bars/candy) and hard foods (carrots/nuts). They should be strictly avoided for 2 months over surgical areas.
• Avoid foods like sunflower seeds, popcorn, etc. That may get lodged in the wound and cause infection.
• It is important not to skip meals and drink 5-6 glasses of liquid daily! If you take nourishment regularly, you will feel better, gain strength, have less discomfort and heal faster. A high calorie, high protein diet is recommended.

2. Antibiotics:

• Please complete your entire course of antibiotics, even when you start feeling better.
• Please be aware that oral contraceptives (birth control pills) may not work while on antibiotics. Avoid alcoholic beverages while taking antibiotics.
• If you are concerned about a reaction to a medication please call the office.

3. Mouth Rinses:

• These should only be started the day after surgery.
• Salt Water Rinses: Use one-half teaspoon of salt dissolved in a glass of warm water. Gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily for 1 week.
• In addition, use the prescribed antibiotic (chlorhexidine) mouth rinse, as directed twice per day.

4. Activity:

• Avoid strenuous activity and exercise for 7-10 days after surgery.

5. Fever:

• A slight elevation of temperature over the first 24-48 hours is possible. However, if your temperature continues to rise, please call the office.

6. Diabetes:

• If you are a diabetic, please ensure that your sugars levels are closely monitored. If your sugars levels become too high or low, it can be detrimental to the healing process.

7. Smoking:

• Smoking has been clinically proven to decrease the success rates of dental implants. Please avoid smoking as much as possible. It is very detrimental to healing.

ADDITIONAL INFORMATION

1. Brushing Your Teeth:

• You may begin tooth brushing the day after surgery. In the areas where surgery was performed, gently use a very soft child’s toothbrush. It is of utmost importance to keep the teeth clean. However, you must not disturb the gums in the surgical area, especially over the first 2 weeks.

2. Stitches:

• The stitches placed at the time of surgery may not be dissolvable. If so, an appointment will be arranged for their removal in 2-4 weeks. Do not remove them.
• If dissolvable stitches were placed, they will dissolve on their own within 7-10 days, but if they are bothersome, you can return to the office to have them removed at the 1 to 2 week mark.

3. Dentures:

• Generally speaking, avoid all pressure to the surgical site(s).
• Partial dentures typically need to be adjusted prior to re-insertion after surgery.
• If you wear a full denture, it will need to be left out for 1-2 weeks, and then relined and adjusted prior to re-insertion.

4. Bruising:

• Bruising of the skin may occur and is more noticeable with a fair skin complexion. It can move down one’s neck and onto the chest due to gravity, but will resolve with time. Moist heat applied to the area can speed up the removal of the discoloration.

5. Stretching/Cracking of lips:

• The corners of the mouth may be stretched, and may dry out and crack. If so, the lips should be kept moist with Vaseline.

6. Stiffness of the jaw muscles:

• This may cause difficulty in opening your mouth for a several days following surgery. This is a normal event after surgery and will resolve in time.

If you were prescribed a narcotic medication, please remember they are to be used for break-through pain only and pain uncontrolled by over-the-counter medications. Return all unused medication to your pharmacy after 10 days.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office during office hours at 416.461.0424. If there is an after hours concern please do not hesitate to call Dr. Kaplan on his personal mobile at 647.539.6565.