1 . Bleeding . After
your oral surgery, you will usually be kept under observation in the Jaw Face
Clinic until the bleeding from your socket or surgical wound has stopped. You
may have some blood stained saliva for several days following surgery.
This is quite common and there is
no need to worry. If, however, the bleeding does start again, it can be stopped by placing a rolled up gauze or clean handkerchief
directly over the bleeding area
and biting gently for three quarters of an hour or more. If the bleeding does not stop after this, it is advisable to seek advice
from the office on 01689862118 If unavailable,
please leave a message.
For all emergencies, the nearest
NHS Hospitals are: Princess Royal University Hospital on 01689 863000 or Queen Marys Hospital,Sidcup, 0208 3022678
2 Stiches used are usually dissolvable. Occasionally they
become loose and some even may fall out the same day. Do not worry, there are
usually enough of others to keep the edges together.
3 Rinsing . You
should not rinse your mouth for six hours following surgery. This allows a good blood clot to form in the socket or site of
surgery. If you rinse your mouth
out too soon you may dislodge the clot and cause yourself further
discomfort or bleeding. If you want to eat or drink during the
six hours following surgery, it is
advisable to keep the food and drink away from the site of surgery eg. By drinking through a straw.
4 Mouthwashes .After six hours have elapsed, you should start to
use a warm salt water mouth wash.
Take an ordinary mug or tumbler, fill it with boiling hot water and stir in a teaspoon of salt. When it has cooled down and is as
hot as a cup of tea, take a mouthful and hold it
over the socket or wound. Repeat this until you have used the whole mug
up.You should do this at least four times a day for the week following surgery.
5 Clean. It
is worth while remembering that a tooth extraction socket or surgical wound will heal faster if the mouth and other teeth
are kept clean. You should try
to clean gently with a brush as soon as possible.
6 .Pain.
You may well experience some pain or discomfort following surgery. If you have had surgery under local anaesthetic, it may be
a good idea to take a couple of
painkillers before the local anaesthetic wears off. Minor analgesics (eg
Nurofen one to two tablets six hourly - Nurofen is the
brand name of Ibuprofen) are usually
adequate to control pain. If the pain
persists for more than a few days or gets worse you should contact the
office.
7.Diet. You
are advised to have a soft diet for 48 hours eg. Soft fruit, vegetables, mince, fish, pasta. No hard fruit/vegetables or
meat.
8.Sedation.
If you have had sedation, you should rest at home, supervised. You must not drive
a car, operate machinery or sign important documents for the first 24 to 48
hours
9.Biopsy
results will be posted to you when available .Usually two
weeks later.
Copyright
Bone
Grafting for Dental
Implants
A successful implant requires a solid
foundation of bone. Once a
tooth has been removed, then the bone which supported it, will gradually
diminish in size. By the time a decision is made to replace the tooth with an implant, the
remaining bone may have become insufficient to act as a good foundation. So
strengthening it by increasing the volume of bone is necessary. There are
different techniques of bringing extra bone to a site where is it deficient. Some
surgeons use animal or other human products. However it is generally considered
that your own bone is the best and this is the main type of bone grafting that
I offer.
The treatment is carried out under sedation and local
anaesthesia, so during the surgery most patients are not significantly aware of
the operation.
The bone is taken either from the side of the jaw or the front of the
chin, from within the mouth. Each site has got its own benefits and potential
problems.
If the bone is taken from the front of the chin, the adjacent
teeth do often feel numb and wooden though generally speaking these recover and
improve within a few months.
When the bone is taken from the side of the jaw at the back in the region
of the wisdom teeth, there is often facial swelling and restriction of mouth
opening.
Although appropriate instruments are used to remove the
blocks of bone away from the nerves there is a theoretical risk of developing a
numb lip but the chances of this is quite small .
The blocks of bone which have been harvested are then placed
into the deficient area. For successful fusion of the new bone to
the base, there should be no movement of the grafted bone while it is healing.
This is achieved by various means. Those which are superficial are stabilised
with bone screws. In other occasions the bone may be slotted into a prepared
gap. In another technique developed by myself some seven years ago, the bone ,
whilst still attached to the gum , is separated and draped over the
additional bone graft .
Often some additional synthetic bone is used to round off the
treated sites. Occasionally a dissolvable layer (membrane) is placed over the
graft which in some situations helps with consolidation of the grafted area.
Final part of the operation involves repositioning of the gum and
use of dissolvable and non dissolvable stitches to cover the site of the
surgery and isolate the grafted area from the mouth.
Once the anaesthetic has worn off, the site of surgery could
become painful. This would be similar to having had a wisdom tooth removed. You
are therefore prescribed pain medication before and after the
procedure to keep the symptoms under control. Following the operation it would
be advisable to take a few days off work to rest at home
You are then seen for follow up about a week and then three weeks
following the surgery and some of the stitches removed. Others are
dissolvable and are left alone.
All being well ,the
grafted bone attains its blood supply in about three to six months and
fuses to the prepared base. Then a dental implant can be inserted.
It should be
pointed out however that bone consolidation is unpredictable and if a
significant part of the graft dissolves, then further bone grafting is
necessary. If the patient wishes, then the procedure can be repeated but at no
extra fee.
·
As a summary
·
If you are
sedated you must have a responsible adult at your surgery and with you until
you recover. Recovery is considered to be through the evening of the surgery.
·
If you have very
numb lip or tongue a few hours after surgery, contact me.
·
Rest the first
day or two following surgery.
·
Follow the
post-operative instructions.
·
Take your
medications as prescribed.
·
Eat soft
food and avoid chewing in the area of surgery when possible .
·
If wearing a
temporary or permanent denture after surgery, make sure it is clean and not
putting pressure on the site of the grafted area.
·
Sutures will be
removed two to three weeks later at post-operative visit.
·
Bone grafting may take three to six
months to complete.
I
hope this brief leaflet is informative. Should you wish any additional
information please do not hesitate to ask.
Jaw Face Clinic , Oral
and Maxillofacial Surgery , Chelsfield Park Hospital.
Please note this is not general
anaesthesia. It is simply a method of relaxing you.
Some of the surgical
procedures we carry out for dental implants are time consuming. Patients find
it more pleasant if during these procedure they are sedated.
Before the
beginning of the operation
the blood pressure is taken by one of the nurses
present . Then a monitoring device is placed on a finger. Through a vein on the back of the hand or
front of the elbow, medication (
Midazolam ) is given which has an effect similar to drinking
spirits quickly.
When sedation has been achieved, the area of surgery is made numb and surgery
is carried out. During this period monitoring equipment is used to
assess pulse and breathing . If the oxygenation of blood is reduced through slow
breathing , you may be asked to take a few deep breaths .
Most of the effect of the sedation wears off in half an hour, but patients are
unsteady on their feet and often cannot remember the
surgery. Hence most of the information and verbal instructions are given to the accompanying
adult.
- You
should have a light breakfast , and
attend hospital accompanied by a responsible adult.
- Following
surgery, you will be kept in the clinic or recovery area until the sedation
has mostly worn off.
- You
should be taken home by taxi, or private car, under
the care of the accompanying adult to
rest further .
-
Do not take other sedating medicines or alcohol .
- If you have had intravenous
sedation, you must not drive a car, operate machinery or make
important decisions for at
least 48 hours.
If there is anything
which you do not understand please ask us.
