Implant Surgery Day

The Day Before

By now you'll have had your consultation, your CT scan and a written plan with a fixed fee, and the 3D-printed surgical guide has been made from that plan. The day before:

• Take your usual medicines unless we've told you otherwise. Blood thinners and anything else that matters will have been discussed at your consultation
• Don't drink alcohol the night before, especially if you're having sedation
• If you're nervous, message us with any last questions
• If you're having sedation, confirm the adult who'll bring you, wait, and take you home, and plan for them to stay with you for the rest of the day
• Stock up on soft, cool food: soup, yoghurt, eggs, smoothies

The Morning of Surgery

• Eat a light meal a couple of hours before. Don't come on an empty stomach, even for sedation, unless we've said otherwise
• Brush and clean between your teeth thoroughly, so your mouth is as clean as possible
• Wear comfortable, loose clothes with sleeves that roll up easily, for the blood pressure cuff and, if you're having sedation, the cannula
• Remove nail varnish from at least one finger, for the oxygen monitor
• Leave plenty of time
• Don't bring young children you'd need to look after
• If anything has changed with your health since your consultation, even a cold, let us know when you arrive

When You Arrive, and Sedation

We go through your medical history again, check your blood pressure, answer any last questions and confirm your consent. Then the area is numbed with local anaesthetic. If you've chosen sedation, a small cannula goes into the back of your hand or arm first, which is the only sharp part, and the sedative is given slowly until you're calm, heavy and unconcerned. You can still answer questions and open wider when asked, but time passes quickly and most people remember little of it afterwards. Your breathing, pulse and oxygen levels are monitored throughout, and the area is numbed as usual. It's £500 per session, plus £250 for each additional 30 minutes, and our sedation guide has more.

The Surgery Itself, Step by Step

• The guide goes in. For most implants we use a 3D-printed guide made from your CT scan and digital plan. It sits on your teeth or gum and sets the position, angle and depth of each implant exactly as planned, using MegaGen's R2 guided system
• A small opening in the gum, often just a small circle through the guide rather than a larger cut
• The site is shaped with a series of small drills, with water to keep the bone cool. You'll feel pressure and vibration, but not pain
• The implant is placed, a MegaGen AnyRidge titanium implant, turned gently in
• A bone graft, if your plan includes one, is placed around the implant at the same time
• The gum is closed, usually with dissolvable stitches, with a small cover on the implant, or a temporary tooth if the gap is at the front

A single implant takes about an hour. Full-arch treatment takes several hours per arch, and with our Same-Day or Premium pathways, fixed temporary teeth usually go in before you head home.¹

Straight Afterwards

• Bite gently on the gauze we give you for 30 minutes to stop any bleeding, and replace it if needed
• Hold a cold pack wrapped in a cloth against your cheek, ten minutes on and ten off, for the first few hours
• Take painkillers as directed on the packet before the numbness wears off, so you stay ahead of any discomfort. Ordinary painkillers are enough for most people
• Don't rinse, spit forcefully or drink through a straw today, as that can disturb the clot
• Rest for the remainder of the day
• After sedation, no driving, alcohol, machinery or important decisions for 24 hours

The First 72 Hours

• Swelling and bruising usually peak around day two or three, then settle. It can look worse than it feels
• Eat soft, cool foods and chew away from the implant. Nothing hot, crunchy or sharp
• Don't rinse for the first 24 hours. After that, rinse gently with warm salt water after meals, a teaspoon of salt in a cup of warm water
• Brush the rest of your mouth as normal, and very gently around the stitches from day two
• Don't smoke. It slows healing and raises the risk of the implant failing
• Avoid strenuous exercise for two days, as a raised heart rate can restart bleeding

The First Fortnight

By the end of the first week most people are back at work and eating normally on the other side, with only a little tenderness at the site. Stitches dissolve on their own over a couple of weeks, and any that are still there are removed at your review. The gum settles around the cover or temporary tooth, and the implant below it is beginning to bond with the bone, a process called osseointegration. Keep the area clean, keep chewing on the other side, and keep off cigarettes. If you have fixed temporary teeth after full-arch surgery, you'll be given a soft-food plan for the first weeks so the implants aren't loaded while they heal.

Calling Us, and What's Next

Call the practice on 0141 248 1183 if bleeding doesn't stop after 30 minutes of firm pressure, if swelling is getting worse after day three, if you have a fever, if pain isn't controlled by ordinary painkillers, or if a temporary tooth or cover comes loose. Out of hours, call the practice number for our out-of-hours message, or NHS 24 on 111. The implant bonds with the bone over 8 to 12 weeks, with a short review along the way. Once it has healed, your crown is made from a digital scan, with no putty impressions, and fitted in one visit. Every implant comes with a 5-year guarantee for non-smokers who attend hygiene visits every 3 months.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.