Dental implant placement is a minor surgical procedure today. In fact, 80% of dental implants can be placed with minimal incision in the gum and without the need to place stitches. For this, it is essential to plan these in the CT scan, simulating the surgery there so that it is safe and fast; this way there will be no complications or postoperative pain.
The usual protocol that we follow at Nart Clínica Dental Barcelona for the vast majority of patients is the taking of 1 gr of Amoxicillin – provided they are non-allergic to this substance – prior to the intervention and an anti-inflammatory after it.
One of the biggest concerns of patients is whether implant placement is painful. We can affirm that dental implants placed today do not hurt. Even so, there are some recommendations we advise following for a better care and healing of dental implants.
Wound mobility
The patient should not disturb or mobilize the wound. It is important to avoid rinsing, spitting, or touching the wound on the day of surgery. Also, be as careful as possible around the area of the implant and / or graft, especially the first 24-48h.
Bleeding
Redness in saliva is normal for the first 24 hours. Excessive bleeding (when your mouth quickly fills with blood) can be controlled by biting a cold gauze placed directly on the wound that produces the bleeding for 30-45 minutes. If excessive bleeding continues, the gauze should be soaked with Amchafibrin and pressure put on the wound.
Inflammation or swelling
Inflammation or swelling is a normal occurrence after surgery, and may be if gum or bone grafts have been performed while dental implants are placed. One way to minimize postoperative inflammation is to apply an ice pack (or a plastic freezer bag protected with a paper or rag) to the cheek of the surgery area. Applying the ice 20 minutes uninterruptedly and resting 5 minutes, during the first 2 hours.
The swelling will usually reach its critical point in the first 24–36 hours and then decrease over the next 3 to 5 days, especially after gum and/or bone grafts. If the inflammation begins to increase after the third postoperative day, the specialist should be contacted immediately.
Dental implant diet
Take a bland or gentle diet on the wound for the first two to three days. Avoid hot meals the first 24 hours, while soft meals and liquids can be consumed on the day of surgery. Keep all solid food away from the surgical site.
Pain
Ideally, we advise starting the pain medication before the local anesthesia wears off. In Nart Clínica Dental Barcelona we usually give Enantyum 25 mg –in non-allergic to NSAIDs– after the end of the intervention because its effect against pain is the fastest of the similar medications.
Once 8 hours pass and for moderate pain, it is indicated to take paracetamol, Ibuprofen or Enantyum itself every 8 hours. Currently, most of our patients do not require more medication than we give at Nart Clínica Dental Barcelona.
It is important not to take any of the medications mentioned above in the case of being allergic to these substances or in the case of having received instructions from your specialist doctor not to take them. These recommendations may include patients with liver, kidney, heart or hypertensive diseases.
Antibiotics for the dental implant
In most cases of dental implant placement, scientific evidence indicates that only 1gr. of amoxicillin is necessary prior to implant placement. In cases of implants placed immediately after the extraction of the teeth, it may be that we recommend taking antibiotics, preferably amoxicillin, for 4 days; as in cases of bone regeneration or gum grafts. The reason for prescribing antibiotics is that they are great allies when it comes to preventing an infection.
Oral hygiene
Good oral hygiene is essential for good healing and healing. We will recommend the use of chlorhexidine and cetylpyridinium chloride (CPC) rinses, or gels based on chlorhexidine and hyaluronic acid, twice a day while the wound cannot be sanitized, for the first 3 days.
In cases of gum and bone grafts, the use of mouthwash will be extended up to 10 days. As for brushing, however, both the implant area and the two adjacent teeth on each side of the implant site should be avoided for the first 2 days, or 10-12 days in cases of gum grafts. After that time, if you can gently brush the surfaces of the adjacent teeth, you should even do it on the wound.
Physical activity
The main recommendation is to reduce the practice of physical activity to a minimum immediately after surgery and during the first 4 days. You will be able to perform gentle activities without impact. This is because when exercising, pulsatile discomfort or bleeding may appear, and the exercise should be interrupted.
In addition, we must bear in mind that probably the diet is not the usual one and this can weaken and further limit the ability to exercise.
Provisional prothesis
In cases where we replace with implants all the teeth of the maxilla or jaw, we will also place a fixed provisional immediately after surgery.
In those cases in which the tooth that must be replaced by the implant is in an aesthetic area or is visible in the smile, we will also put a fixed provisional screwed to the implant. In contrast, partial dentures or full dentures should not be used immediately after surgery. The prosthesis should not touch the graft or implant site and needs to be adapted.
Dental implant success stories
Extraction of lost teeth and placement of implants with a fixed temporary at the same time, changing the patient’s smile and chewing immediately. Gum recession and graft healing 15 days later, observing successful treatment, and excellent patient care.
