Your Implant Surgery Day

Everything That Has Happened Already

The thinking is all done before surgery day arrives. You will have been in for your consultation, had a CT scan taken on our in-house scanner, agreed a written treatment plan and signed the consent form. Our implant dentist has already settled the implant's size and exact position on the 3D images, and a matching surgical guide has been 3D-printed. Nothing is being worked out for the first time while you are in the chair; every decision was made beforehand.

The Run-Up

• Carry on with your usual medicines unless we have told you specifically to stop. Anticoagulants, diabetes medication and bone-strengthening drugs will already have been talked through.
• For sedation, you need an adult to bring you in, wait for you, take you home and remain with you overnight.
• Fill the fridge with soft food: soup, porridge, yoghurt, scrambled egg, mashed potato, pasta.
• Make sure you have the over-the-counter painkillers that you know agree with you.
• No alcohol the evening before.
• Smokers: stopping now, even if only for a few weeks, makes a real difference to healing.

On the Morning

Have a light breakfast as you normally would unless we have said not to, and that applies before sedation too. Give your teeth a thorough brush and clean in between them. Choose comfortable clothes with sleeves you can roll up, and remove nail varnish from one finger so the oxygen monitor can take a reading. If you have picked up a cold or a cold sore, or anything about your health or medication has changed since you last saw us, let us know when you arrive. Allow plenty of time for the journey, whether you are walking from the station or driving in from Monifieth or Dundee, and please do not bring young children along.

Settling Into the Chair

First we go over your medical history once more, check your blood pressure and answer any final questions. Then the area is made numb. For most people, the injection is the one moment they genuinely notice.

If you have chosen IV sedation, a thin cannula is placed in a vein in the back of your hand or your arm before anything else happens, and the sedative is fed in slowly until you feel calm and drowsy. You can still respond and do as asked, but time seems to fly and very little tends to stick in the memory. Your pulse, oxygen levels and breathing are watched throughout. Sedation costs £500 for the session plus £250 for every additional half hour; there is more detail in our IV sedation guide.

The Procedure Itself

1. Fitting the guide. It seats either over your teeth or directly on the gum, and we make sure the fit is snug.
2. Opening the gum. A small access point is made, often just a neat circle cut using the guide as a template.
3. Shaping the bone. A sequence of fine drills, each one directed by the guide and water-cooled, prepares the site. You will feel pressure and some vibration, but no pain.
4. Placing the implant. The MegaGen AnyRidge implant is then wound slowly into place at the depth and angle in the plan.
5. Adding any graft, if your plan calls for one, at the same sitting.
6. Closing up. Dissolvable stitches are placed around a small healing cap, or under a temporary tooth if the gap would otherwise show when you smile.

For one implant that is roughly an hour's work. A full arch occupies several hours per jaw. Fixed temporary teeth that same day belong to the Same-Day Fixed Teeth pathway and to Premium Guided Zirconia, and even there they rest on your bone and on how firmly the implants hold once in, so they are only confirmed during surgery, with your written plan covering what happens instead at no change to the pathway fee; ¹ on Healed Foundation and Staged Treatment you wear a removable denture while the implants settle.

Once You Are Home

• Keep biting on the gauze for thirty minutes, swapping in a fresh piece if it is still oozing.
• Hold a cloth-wrapped cold pack against your cheek, in short spells, through the first few hours.
• Have your first dose of painkillers before the anaesthetic wears off.
• Today, no rinsing, no vigorous spitting, no straws and no hot drinks, as any of these can dislodge the clot.
• Rest up, and tonight sleep with an extra pillow under your head.
• If you were sedated: no driving, alcohol, machinery, signing anything or making important decisions for 24 hours.

The First Three Days

Over the first day or two the swelling, and sometimes bruising, builds up, reaching its worst around day two or three before it starts to go down. It generally looks more dramatic than it feels. Stay on soft, lukewarm food and chew on the opposite side.

From the day after surgery onwards, rinse gently with warm salt water after eating (roughly a teaspoon of salt to a mug). Everywhere else, brush as normal, going very gently around the stitches. Give strenuous exercise a miss for a couple of days, since a rising heart rate can restart bleeding. And whatever you do, do not smoke: nothing endangers a new implant more.

The First Fortnight

Most people are back at their desk within a day or two of a single implant, and by the end of the first week they are comfortable apart from slight tenderness at the site. The stitches melt away on their own over a week or two. Keep chewing on the other side and keep the area clean.

Beneath the gum, bone is beginning to grow onto the surface of the implant. This fusing process, osseointegration, takes about two to three months in most cases. If you have had full-arch surgery, a soft-food plan sees you through the early weeks so the new implants are not put under too much load while they heal.

Reasons to Ring

Phone 01382 477350 if:

• Bleeding carries on despite 30 minutes of firm pressure on gauze
• Swelling is increasing after day three instead of easing
• You develop a temperature or feel unwell in yourself
• Ordinary painkillers are not managing the pain
• A healing cap or temporary tooth has come loose

We are open Monday to Friday 8.30am to 5pm. Closed at weekends. At other times, ring NHS 24 on 111. If swelling is making it hard to breathe or swallow, dial 999.

And After That

There will be a brief review while you heal. When the implant has fused, we take a digital impression with the iTero Lumina, so no trays of putty, and your crown is then made in the laboratory and fitted at a further appointment. Every implant we place carries a 5-year guarantee for non-smokers who attend hygiene visits every 3 months. The care that keeps it going is covered in our guide on how long implants last.

Questions

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