What should I expect after dental implant treatment?

Many patients are surprised at how straightforward dental implant placement can be and how they experience very little discomfort afterwards.  Technological advances and detailed preparation beforehand means that implant placement is a relatively simple minor surgical procedure.   Much of the assessment and planning takes place in advance.

Your implant dentist will conduct a thorough examination of your mouth.  This will include taking radiographs (X-rays) and sometimes CT scans of your jaws to assess the shape and condition of your bone.  This allows the dentist to plan exactly how and where the implants will be placed during your treatment.

Once you have decided that dental implants are right for you, your main focus might be on the day the implant procedure takes place.  But it is also a good idea to think about the immediate and long-term aftercare of your new teeth.

After the treatment, it will be your responsibility to practice good oral hygiene every day for the optimum health of your implants.  Like with natural teeth, it is important that you commit to keeping your implants, teeth and mouth healthy to avoid problems.  This will include regular visits to the hygienist.  According to the Oral Health Foundation, “If your implants are well looked after, and if the bone they are fitted to is strong and healthy, you can expect them to last for many years.”

You will be given instructions by your dentist explaining how to look after your mouth immediately after treatment.  The following also provides guidance on what to expect after implant placement and how to keep your dental implants and mouth healthy:

Before your treatment

Will I need to take time off work?
It is unlikely that you will need to take time off work, but you might want to plan a day off or two as a precaution.  Try not to arrange any big social or work commitments for a few days after the treatment.  

Do I need someone to accompany me?
You would be advised to ask someone else to drive you home on the day you have your implants placed.  Implant dentists generally use local anaesthesia, but can offer you sedation if you request it.  This can be given by mouth or through an intravenous line.  If you do opt for sedation, then a responsible adult must accompany you to the appointment, remain at the surgery and escort you home afterwards.  Your dentist will also give you further advice to follow if you choose sedation.

Should I think about pain relief?
You may not need any pain relief, but make sure you have some appropriate painkillers in stock for after the procedure, just in case.  If you are allergic to any medication, please discuss this with your implant dentist.

Implant placement aftercare

Will my mouth bleed?
Some minor bleeding after dental implant placement is normal.  Your dentist may ask you to apply pressure on the area by biting firmly down on a gauze pad for about an hour.  The pad should then be gently removed.   Repeat the process for another 30 minutes with another gauze pad if necessary.  In the unlikely event that bleeding persists, bite down on a moistened tea bag for 30 minutes.  The tannic acid in the tea leaves helps to promote blood clotting.

After having implant placement you are likely to experience much less bleeding compared to having a tooth extracted, because the implant is placed into the gap.  There is no open extraction site left to heal.

How can I encourage healing?
After implant treatment avoid rinsing your mouth and try not to disturb the surgical site with your tongue or fingers for the rest of the day.  This may cause bleeding by dislodging the blood clot that has formed.  Don’t spit, suck on straws or smoke.  This can also dislodge blood clots and slow down the healing process.

Should I rest afterwards?
Restrict your activities on the day of surgery as physical exertion can cause throbbing and encourage bleeding.  If bleeding persists, you should contact your dentist.

Will I have a swollen face?
You may experience swelling and/or bruising following your treatment.  Swelling will not become apparent until the day after surgery and will reach a peak two to three days later.  This is normal and can be reduced by the immediate use of ice packs (or a bag of frozen peas) wrapped in a towel and held to the side of the face where the implants were placed.  Your dentist may advise that on the day of placement, ice packs should be applied for 20 minutes on and 10 minutes off.  After 24 hours, ice will no longer have any effect.  At this point, the application of moist heat can be more beneficial in reducing the size of the swelling.

When should I take pain relief?
It is likely that you will experience no more than mild discomfort after having dental implants.  Your dentist may suggest that you take your first dose of pain killers before the anaesthetic wears off and then take them regularly at the maximum stated dose for the first two days after your surgery.  For most patients, over-the-counter pain medication that you would normally take for headaches will be adequate. 

Any pain or discomfort following surgery should subside gradually each day.   If after a few days you experience increasing pain and swelling, you must contact your dentist, who will advise on the appropriate aftercare and pain medication to keep you comfortable.

Eating and drinking
It is advisable to have only cold drinks on the day of surgery.  It is important to stay hydrated.  Avoid hot drinks, alcohol and hot or spicy food.  Do not eat until the local anaesthetic has worn off.  Although eating meals may be a challenge for the first few days, try to continue to eat nourishing food.  You will heal faster and have more energy.  Try choosing softer foods and chew away from the implant site.  It is best to avoid foods such as popcorn, seeds or seeded fruit, as they can get stuck and cause infection.  Generally most patients can return to a normal diet after seven to ten days.

Oral hygiene
Good oral hygiene is essential to successful healing.  If prescribed by your dentist, use a chlorhexidine mouthwash.  The day after surgery, warm salt-water rinses are also recommended and should be used four to five times a day, especially after meals.  Be gentle when using mouthwashes and avoid vigorous swilling.  Your dentist may encourage you to start cleaning your teeth and healing abutments with a toothbrush straight away, but be careful around the implant sites.

Healing
Healing is generally straightforward with minimal discomfort.   In most cases, dentists will want to leave the gum to heal and the implant to fuse (osseointegrate) with the jawbone, before fitting permanent, replacement teeth.  There is usually a period of healing lasting from six weeks to six months.  The stitches are normally removed or dissolve by themselves after seven to fourteen days.  Your dentist can give you an insight as to what to expect. 

Healthy lifestyle choices are essential to successful healing.   Smoking restricts healing dramatically.  Nicotine in smoke constricts blood vessels and reduces blood flow to the soft tissues, which can affect the immune response.  This slows the process of healing and affects the long-term health of gum and bone.  Smoking increases the risk that implants may not heal properly after they are placed, and makes them more likely to fail over time.  The healing process can also be impaired by a poor diet, excessive alcohol consumption and lack of dental care.

Healing times will be different for each patient.  Your recovery time will depend on your individual case and treatment plan.  Your dentist will schedule follow-up appointments accordingly.

Antibiotics
You may be given antibiotics by your dentist to take before or after the procedure.  If you are prescribed antibiotics make sure that you finish your prescription to help prevent infection.

Can I wear my dentures after treatment?
Partial or full dentures should not be used immediately after surgery.  If you have a denture that covers the implant area, you should wear it as little as possible to protect the implant site during its initial healing period.  If temporary replacement teeth are used during treatment, it is important that they do not apply uncontrolled pressure to the underlying implants.  Your dentist will give you specific instructions about the use of your denture or replacement teeth after having implants placed.

Long-term care
Once your new implants and the surrounding gum have healed, and your replacement teeth have been fitted, they must be cared for in the same way as normal, natural teeth.  To keep your teeth and gums healthy, brush twice daily, floss and visit your dentist and hygienist regularly.  

If tooth cleaning is poor, bacteria can build up and cause inflammation.  If left untreated, the inflammation can cause bone loss around the implant.  Eventually, the implant loses anchorage in the bone, becomes loose and can fall out.

Dental implant success
Patients have reported that having dental implants can be far less painful than having a tooth removed or root canal treatment.  The placement of dental implants is generally easier than most people imagine.  It is one event in a very well planned, organised process.  This means that aftercare and healing is also usually straightforward and uneventful.  

Your commitment to your implant treatment outcome is that you maintain good oral hygiene.   Cleaning your implants is not difficult and once your dentist is satisfied your treatment is going well, ongoing care will be similar to any patient with natural teeth.

The Association of Dental Implantology states, “It is the quality of your personal attention to oral hygiene and willingness to attend regular maintenance reviews that will have most influence on how long they will last.”

This article was compiled with assistance from Dr Steve Larcombe.