Post-Operative Instructions: All-On-Four Treatment Concept

Oral Hygiene

• Standards of good oral hygiene are critical for the success and functionality of the implants and restoration. The best way to prevent infection and ensure healing is to keep your mouth clean. Clean your mouth thoroughly after each meal beginning the day after surgery. Use a soft bristle toothbrush and toothpaste after meals and at bedtime. Use of a dental Waterpik^® is highly recommended to irrigate underneath the denture to flush out debris.

Bleeding

• Minimal bleeding is expected after this implant procedure. The best way to stop bleeding is to place a damp piece of gauze in the mouth and gently bite for 30 minutes. Rest quietly with your head elevated. If bleeding continues, use gauze for an additional 30 minutes. Pink or blood-tinged saliva may be seen for 2–3 days following the surgery and does not indicate a problem. Suture material may last 2 to 3 weeks and should be left alone. You will be asked to return to the office for a 2-week follow-up appointment. Any sutures remaining may be removed at the surgeon's discretion. Do not pull or cut the sutures yourself.

Swelling

• Swelling is the body's normal reaction to surgery and healing. The swelling will not become apparent until 24 hours after surgery and will not reach its peak for 2–3 days. After this time, the swelling should decrease but may persist for 7–10 days. Swelling may be minimized by immediately using ice packs. Apply the ice packs to the outside of the face 20 minutes on and then 20 minutes off while awake for the first 24 hours.

Medication/Pain

• Unfortunately, most oral surgery is accompanied by some discomfort. If you do not have an allergy to non-steroidal anti-inflammatory medications (ibuprofen, Motrin^®, Advil^®) we recommend taking this prior to the local anesthetic wearing off. More severe pain may require a narcotic pain medication. Narcotic pain medication will make you drowsy, do not drive or operate mechanical machinery while taking the prescription. Alternate ibuprofen (2 tablets/200 mg each) and the narcotic medication every 2 hours if needed. Once you feel like you can stop the narcotic, use ibuprofen or Tylenol^®. You may also be prescribed an antibacterial mouth rinse which should be used twice daily in the first 2 weeks following implant surgery. Post-operative antibiotics should be taken as directed and always take the entire course of the prescription. All medications should not exceed the recommended dosage.
• *NOTE: If you are taking PLAVIX^® or COUMADIN^®, do NOT take ibuprofen or aspirin products.

Activity

• For the first 48 hours, you should rest and relax with no physical activity. After 48 hours, you may resume activity as tolerated.

Diet

• After local anesthetic or IV sedation, start with liquids. While numb, patients should avoid hot liquids or foods. Your food intake will be limited for the first few days, compensate for this by increasing your fluid intake. We recommend high protein shakes/smoothies (Ensure^®, Special K^®, etc.) as meal replacement supplements.

Patients are restricted to a SOFT CHEW diet for the first 6 weeks. If food cannot be easily cut with a fork... DO NOT eat it!!!

Add soft foods when numbness is gone/increase diet as tolerated.

FOOD SUGGESTIONS FOR THE FIRST 6 WEEKS

• Drink
• Water
• Juice
• Ice chips
• Popsicles
• Smoothies/protein shakes
• Milkshakes
• DO NOT use straws for eating & drinking
• Eat
• Jell-O^®
• Pudding
• Yogurt
• Ice cream
• Scrambled eggs
• Cream of Wheat^®
• Oatmeal
• Soup
• Mashed potatoes
• Fish
• Pasta
• Pancakes
• Cottage cheese
• Applesauce
• Additional Information

If the corners of your mouth are stretched, they may dry and crack. Your lips should be kept moist with an ointment such as Vaseline^®.

Sore throats and pain when swallowing are not uncommon. The muscles get swollen and the normal act of swallowing can become painful. This will subside in 2 to 3 days.

Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days. Do not force your mouth open. Massage the muscles and apply moist heat.

With upper jaw implant treatment, you may develop bleeding from the nose. This is usually a temporary finding and wiII not persist past 2 to 3 days. Avoid blowing your nose for several days.

An appointment with your general dentist may be needed within a few days of surgery to make any adjustments to your temporary denture.

Your case is unique as no two mouths are alike. Discuss all questions or concerns with your oral surgeon or implant coordinator.

If you have any questions, feel free to contact our office at any time.