Recovery Instructions After All-on-X Surgery
Every surgical case is unique. Although the advice of well-intended friends and family members may alleviate some of your anxiety, please call our office with questions about your individual case.
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Bleeding
It is normal to experience some bleeding or redness in your saliva 24 hours after the procedure. If you experience this, place a moistened gauze pad directly on the wound and bite down firmly for at least 30–45 minutes.
With each exchange of gauze you will observe a lighter color of redness; some people may require 5–6 exchanges to control the bleeding. If it continues to persist, bite down on a moistened black tea bag — black tea contains tannic acid, which constricts blood vessels and helps form a clot.
Doing any of the above will dislodge the clot and slow the healing process.
Swelling
Ice for the first 48 hours. Moist heat after that.
Swelling is your body's natural reaction to surgery and eventual repair, and the amount you experience depends on the extent of the surgery. It is normal to experience swelling of the cheeks, eyes, sides of the face, and around the mouth. Swelling will not be visible until the day after surgery and will not reach its maximum until the second postoperative day.
Swelling can be minimized by applying ice packs immediately following surgery. Apply ice during the first 48 hours in a pattern of 20 minutes on and 20 minutes off. After 48 hours, ice is no longer beneficial for reducing swelling. It may also help to sleep with your head elevated at 30 degrees during this time.
If swelling and jaw stiffness persist for several days, do not be alarmed — this is a normal reaction to surgery. Forty-eight hours after surgery you may begin applying moist heat to the outside of your face, also 20 minutes on and 20 minutes off.
On the day of surgery, begin aggressive oral stretching and manual massage to the sides of the face. This will help with muscle tightness and reestablish a normal oral opening, ensuring a quicker recovery with less swelling and post-operative pain.
Pain
As with any surgery, some degree of discomfort is to be expected. We recommend taking pain medication before the numbing medication has worn off for the best pain management. You will experience the most severe pain within 6 hours of the anesthesia wearing off; after that, your need for medication should decrease.
For moderate pain, take a dose (400–600mg) of ibuprofen (Advil or Motrin) every 4–6 hours as needed. Do not exceed the maximum daily dosage suggested on the bottle. For severe pain, the prescribed medication should be taken as directed — take it after a meal or with a small snack to avoid stomach upset. If you have allergies to any medication, or your doctor has advised you not to take a particular medication, do not take it.
If you still experience significant pain that is not improving 3–5 days after surgery, notify the clinic.
Do not take ibuprofen if you
While taking pain medication, do not
Recommended dosing protocol
Take each medication with a small snack and a full glass of liquid.
The prescription dosage can be increased to 1½–2 times the normal dosage if needed for pain management.
Prescription pain medication has the potential to be addictive, so it is very important that you only take it if you are experiencing significant postoperative pain. If you do not finish all your prescription medication, take the unused medication to an authorized collection site — law enforcement facilities, retail pharmacies, or a hospital — for responsible disposal. Never leave unused medication in your medicine cabinet at home.
Diet
If you can hear yourself chewing the food, it is too hard.
Eat soft foods only. Chewing hard foods on your new teeth and implants is not allowed until the implants have fully healed. For the next three to six months it is critical to follow a strict soft diet — nothing harder than soft pasta, scrambled eggs, or soft fish like salmon. We will inform you once it is okay to begin chewing hard foods.
Failure to follow the recommended diet will result in the implants failing to heal, which means more surgery and a prolonged treatment time.
After general anesthetic or I.V. sedation, take only fluids until feeling has completely returned to your mouth — chewing while numb can result in biting your cheeks and tongue, causing painful ulcers once sensation returns. Do not use a straw for the first two weeks, as this can dislodge the clot forming in the socket.
Eating regularly and not missing meals will help you feel better, have more strength, and heal faster. Since food intake will be limited the first 1–2 days, compensate by drinking at least 1–2 liters of fluid per day.
You may feel dizzy or faint when standing up from a lying or sitting position. Sit up slowly, place your feet on the ground, and stay seated with your head elevated for one minute before standing. If an escort or family member sees you feeling faint, elevate your legs above your head for 30 seconds to increase blood flow. Staying well hydrated also helps prevent these symptoms.
Discoloration
You may notice your skin turns blue, green, black, or yellow in the days following surgery. This bruising is a result of blood spreading beneath the tissues. After the first 48 hours, applying moist heat to the area may help the color fade.
Nausea & Vomiting
Nausea can be a side effect of anesthesia and pain medication. Eat a small snack and drink plenty of fluids before taking medication. If you are nauseous or vomiting, avoid eating, drinking, or taking medication for at least one hour, then sip ginger ale, tea, or Coke slowly over fifteen minutes — no straw. Resume solid foods and medication once the nausea passes.
Smoking
Do not smoke following surgery. The toxic chemicals and heat in cigarette or marijuana smoke are harmful to the healing of wounds and implants. Smoking after implant placement results in a four times greater risk that the implants will not heal.
Antibiotics
Take the prescribed antibiotics as directed and complete the entire course to help prevent infection. If you experience a rash or unfavorable reaction, discontinue use and notify our office. For an upset stomach, we recommend acidophilus or a probiotic alongside the antibiotic. Antibiotics may make oral contraceptives less effective — use an alternate form of birth control during the course.
Healing Timeline
Usually the most uncomfortable. Expect swelling and bruising, peaking on the second day. You need to see your dentist during this time so they can adjust the bite of your new teeth. Begin wearing your new occlusal mouth guard to sleep at night — you will wear this guard at night for the rest of your life. Failure to wear it can interfere with implant healing and longevity, and can result in loss of the implants and the denture.
You should start feeling more comfortable and notice a reduction in swelling. From here you should see steady and gradual improvement.
Pain usually fully resolves by the two-week mark, once the sutures have been removed or dissolved. Full soft tissue closure over the extraction site can take up to 8 weeks.
Begin using the Waterpik and floss threaders to clean under your new denture and around your implants. Keep all appointments with your dentist and our office so we can confirm healing is progressing as expected. If something feels off with your bite, or your pain increases during this time, contact us immediately.
Depending on the strength of the bone at the time of surgery, we will check implant healing between three and six months. Once healing is confirmed, your dentist will begin fabrication of your final denture and you will be cleared to begin a regular diet.
Oral Hygiene
Keeping your mouth clean is one of the best ways to avoid infection.
If you have any natural teeth remaining, brush and floss them the night of surgery, and brush your new denture teeth as well. Avoid brushing the gingival tissue and sutures around the surgery sites, and be gentle initially when cleaning those areas.
You will be prescribed a bottle of mouth rinse. Begin using it the night of surgery after brushing and flossing, twice daily — after breakfast and before bed — until gone. Rinse for at least 30 seconds before spitting it out, and do not eat or drink for 15 minutes afterward.
The day after surgery, rinse with a 50/50 mixture of warm salt water and 3% hydrogen peroxide at least 5–6 times a day, especially after eating. To make the salt water, mix one teaspoon of salt with a cup of warm water. In addition to rinsing, dip a Q-tip in the solution and gently wipe over the surgery sites so plaque doesn't accumulate on the sutures. Avoid over-the-counter mouthwashes that contain alcohol.
After the post-operative visit at two weeks, begin using the Waterpik and floss threaders to clean under your new denture and around your implants.
Sinus Precautions
Only applies if we told you a sinus perforation occurred during your procedure.
The upper back teeth and the maxillary sinus are located in very close proximity, so a communication — an unnatural space — between the sinus and mouth can occur.
Your sinuses may feel stuffy, or you may experience some nasal drainage, but it is important that you do not blow your nose or drink through a straw for at least 14 days after surgery. You may experience slight bleeding from the nose for several days. To avoid pressure on the sinuses, sneeze with your mouth open for two weeks after surgery — do not try to hold in the sneeze.
Take all medications and nasal sprays as prescribed, and do not smoke. Notify our office if drainage or pain increases, or if you experience any change in your condition. Sinus exposures often heal slowly and with difficulty, so you must keep all scheduled appointments until you have fully recovered.
Other Complications
You may experience numbness of the lip, chin, or tongue immediately following surgery. This is usually temporary. If your tongue or lip is numb you could bite it without realizing, so be careful. If numbness persists beyond 72 hours, call our office — we may prescribe an additional medication to help resolve it.
You may notice a slight elevation of temperature immediately after surgery. Tylenol or ibuprofen will reduce the fever. If a fever above 101.5°F develops, notify the office immediately.
If you had IV sedation you were not able to eat or drink before surgery, so you may feel dizzy — pain medications can add to this. Be careful going from lying down to standing: sit for one minute first, then stand.
You may feel hard projections in your mouth with your tongue. These are small splinters of the bony walls that supported the tooth. They usually smooth out on their own; if not, they can be removed in the office with an additional procedure.
The corners of your mouth may feel stretched and may dry out and crack. Apply an ointment such as Vaseline or lip balm to your lips and the corners of your mouth.
It is not uncommon to have a sore throat or pain when swallowing. This will subside in 5–6 days.
You may feel stiffness (trismus) of the jaw muscles, making it difficult to open your mouth for a few days. This is normal and will resolve in time. Massaging the muscles on the side of the face and performing oral stretching exercises will decrease stiffness and is a very important part of your recovery.
Sutures were placed in the area of surgery to minimize postoperative bleeding and help with healing. They may become dislodged — do not be alarmed if this happens.
Questions about your recovery?
Every surgical case is unique. Please call our office with questions about your individual case.