Post-Operative Instructions – Bone Grafting

The following general instructions are to be considered along with your own personal care instructions provided the day of surgery.

Medication and Antibiotic Mouth Rinse

Be sure to take prescribed medications and Chlorehexidine mouth rinses (such as Peridex) as directed to help reduce the chance of infection. Not all patients will have such prescriptions, depending on the particular situation. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and contact the office immediately.

Bleeding

Avoid trauma to the surgical site or any stitches placed. Avoid rinsing, spitting, or touching the wound on the day of surgery. A certain amount of bleeding is to be expected following surgery.

Slight bleeding, oozing,or redness in the saliva is not uncommon in the first two days. If there is excessive bleeding, fold a moistened piece of gauze thick enough to bite on and place it directly on the bleeding site biting firmly for 30 minutes. Repeat if necessary.

Swelling

After surgery some patients experience swelling around the mouth, cheeks, eyes and sides of the face. The swelling may not become apparent until the day following surgery and may not reach its maximum until two to three days post-operatively. To minimize swelling apply ice on your face for the first 48 hours (15 minutes on then 15 minutes off), then switch to moist heat in order to reduce the size of the swelling (15 minutes on then 15 minutes off for every awakened hour).

Bruising

Bruising is a common post-operative complication of bone grafting and could extend to the cheek, under the eyes or in the lower jaw and neck area. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. Bruising is not dangerous, and will usually resolve a few weeks following surgery. Moist heat applied to the area may speed up the disappearance of bruising.

Stitches

Bruising is a common post-operative complication of bone grafting and could extend to the cheek, under the eyes or in the lower jaw and neck area. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. Bruising is not dangerous, and will usually resolve a few weeks following surgery. Moist heat applied to the area may speed up the disappearance of bruising.

Diet

The day of surgery begin with clear fluids (juice, broth, jello) do not use a straw and progress slowly eating soft foods (pudding, yogurt, soups, pasta, well-cooked veggies) by chewing away from the surgical sites. More complicated cases may require more specific instructions. Remember it is important to hydrate and maintain adequate nutrition for optimal healing to occur.

Oral Hygiene

Good oral hygiene is essential to good healing. Start rinsing your mouth with warm salt water rinses (1/2 tsp of salt in a cup of warm water) 24 hours following surgery. You should do this every 4-6 hours, especially after meals, for several days until the tenderness is gone. It is important to brush and floss your other teeth, but avoid the surgical site(s) until your first follow-up appointment. If you have had implants placed the same day you may have a healing abutment (metal post) or an actual temporary crown (cap or artificial tooth) protruding through the gums. You may use a soft tooth brush to keep the area clean. Avoid flossing the healing abutment or temporary crown/cap until instructed to do so.

Smoking

Studies have proven smoking may lead to many complications, such as implant failure and infection, and causes prolonged pain and delay healing. Avoid smoking until the site has healed over (this could take 2-3 weeks). If you cannot hold off until then, it is in your best interest to avoid smoking as long as possible after the surgery, and then to minimize it.

Temporary Crowns/Prosthesis

During the consultation it will be determined if you will require temporary crown (s), partial dentures or full dentures which may need to be fabricated in advance. Existing prosthesis may need to be modified. This may be coordinated with your general dentist. In some cases you may be recommended you leave the prosthesis out for 7-10 days to allow for proper healing.

Caution for Sinus Lift Patients

If you had a ‘sinus lift’ procedure where the floor of the sinus in the upper jaw was elevated to allow for implant placement, you should avoid any activities that cause excess pressure or suction in the mouth or nose for about 10-14 days. In particular, avoid forceful sucking or blowing from either the mouth or nose, woodwind instruments, scuba diving, and if possible airline travel due to the pressure changes.

Complications

Infection

Occasionally, an infection may occur days or even weeks following surgery. If swelling increases after the initial swelling period (2-3 days), or fails to decrease after several days you may have an infection. Typically, persistent or worsening pain also accompanies it. You may feel unwell and a foul-tasting fluid may drain from the infected site. If you think you may have infection, call the office.

Nose Bleeds

For bone grafting procedures in the upper jaw and more specifically sinus lift procedures, it is normal to have an occasional nose bleed. Avoid blowing your nose, bending down or lifting heavy objects in the first 5-7 days. Should you experience bleeding, use a Kleenex to pinch your nose for a few minutes, this should stop the bleeding, if the bleeding does not stop call our office for advice.