Instructions After All-on-X / Full-Arch Implant Surgery

The following are general recommendations after All-on-X or full-arch dental implant surgery. Please follow any specific instructions given by your surgeon, as these recommendations may be modified for your individual situation. If you have any questions, please call our office.

You have completed an important step toward restoring your smile with full-arch dental implant treatment. During your surgery, multiple dental implants were placed into the jawbone to support your new teeth. Protecting the implants while they heal and integrate with the surrounding bone is extremely important.

Rest & Activity

Rest at home and take it easy for the first 72 hours following surgery. Avoid strenuous exercise and other activities that may increase bleeding, swelling, or discomfort during the early healing period.

If you received IV sedation or general anesthesia, you may experience sleepiness, dizziness, or light-headedness following surgery. A responsible adult should stay with you for the first 12 hours after surgery.

Do not pull on your lips or cheeks to inspect the surgical sites. This can place tension on the incisions and sutures and interfere with healing.

Take all medications prescribed or recommended by your surgeon as directed.

Pain & Discomfort

Some discomfort is normal following full-arch implant surgery, particularly as the local anesthetic wears off. If you are able to take nonsteroidal anti-inflammatory drugs (NSAIDs), good options include one of the following:

  • Aleve (naproxen): 1-2 over-the-counter tablets every 12 hours
  • Advil (ibuprofen 200 mg): up to 3 tablets every 6 hours

Choose either ibuprofen or naproxen. Do not take both together.

If your surgeon prescribed an anti-inflammatory medication such as ibuprofen 600 mg, take it according to the directions provided rather than adding additional over-the-counter doses.

If you are able to take NSAIDs, we generally recommend taking one of these medications on a scheduled basis for the first 2-3 days, even if discomfort is mild. If additional pain relief is needed, you may add 1-2 Regular Strength Tylenol (acetaminophen 325 mg each) every 6 hours.

If you are unable to take NSAIDs, 1 Extra Strength Tylenol (acetaminophen 500 mg), or 1-2 Regular Strength Tylenol (325 mg each), every 6 hours may be used as directed.

Acetaminophen is contained in many prescription pain medications and over-the-counter cold and flu products. Be sure to account for all sources of acetaminophen when taking these medications. If your surgeon has prescribed or recommended a different pain medication regimen, follow those instructions.

Bleeding & Oozing

A small amount of bleeding or oozing is normal after surgery.

  • Roll the gauze and place it under your lips or cheeks next to the new teeth, where the natural gum tissue meets the prosthesis, to absorb bleeding.
  • Leave the gauze in place for approximately 30 minutes. If active bleeding continues, replace the gauze and maintain gentle pressure for another 30-60 minutes.
  • Dampening and gently fluffing the gauze may make it more comfortable.
  • Remove all gauze before going to sleep.

If bleeding is heavy, fills the mouth rapidly, or does not improve with continued pressure, please contact our office.

Swelling & Bruising

Swelling of the face and jaw is expected after surgery and commonly increases during the first 2-3 days before gradually improving. Bruising of the cheeks or neck may also occur.

If bone grafting material such as recombinant bone morphogenetic protein (BMP) was used during your procedure, swelling may be more pronounced.

Please contact our office if swelling continues to worsen after the expected early postoperative period, particularly if it is accompanied by fever, increasing pain, difficulty swallowing or breathing, or other symptoms that concern you.

Antibiotics

If you were prescribed an antibiotic, take it exactly as directed and complete the prescribed course unless your surgeon instructs you otherwise.

If you develop a suspected medication reaction or have difficulty taking the medication, contact our office.

Oral Hygiene

Keeping the area around your new teeth clean is important, but the surgical sites must be treated gently during the early healing period.

Day of Surgery Through the First Two Weeks

  • If you have remaining natural teeth, you may brush and floss those teeth normally, but avoid brushing or flossing directly over the surgical areas.
  • Beginning the night of surgery, use your prescribed chlorhexidine mouth rinse (Peridex) as directed.
  • You may gently clean the visible surfaces of your new teeth with a soft toothbrush as directed, taking care not to traumatize the surgical sites.
  • Do not use a Waterpik or irrigation syringe around the surgical sites during the first two weeks unless your surgeon specifically instructs you to do so.

Beginning Two Weeks After Surgery

  • Discontinue the prescription mouth rinse when instructed and begin gently rinsing with warm salt water. Mix approximately 1/2 teaspoon of salt in a glass of warm water and rinse several times each day, especially after meals.
  • You may begin using a Waterpik on its lowest setting or the curved irrigation syringe provided by our office to clean where your natural gum tissue meets the prosthetic gum tissue.
  • Use the Waterpik or syringe at least twice daily: once in the morning and again before bed. Additional cleaning after meals may be helpful if food or debris accumulates beneath the prosthesis.
  • Continue using a soft toothbrush to clean the new teeth.

At your follow-up appointments, we will guide you regarding when and how to increase the Waterpik pressure as healing progresses.

Diet: No Chewing for 4 Months

A non-chew diet is required for the first 4 months after All-on-X surgery. The implants need time to heal and integrate with the surrounding bone. Even though your temporary teeth may feel secure, they should not be used to chew during this healing period unless your surgeon specifically tells you otherwise.

If a food requires chewing, do not eat it during this period. Choose foods that can be swallowed with little or no chewing and are approximately the consistency of mashed potatoes.

Examples include:

  • Mashed potatoes and pureed vegetables
  • Soups and broths
  • Smoothies
  • Yogurt, applesauce, and pudding
  • Scrambled eggs and cottage cheese
  • Nutritional supplements such as Ensure or Boost

Avoid hot foods and liquids during the first 24 hours. Cool or cold liquids are encouraged during this period.

Do not test the strength of your new teeth by biting or chewing. Your surgeon will let you know when it is appropriate to begin advancing your diet.

Smoking, Vaping & Alcohol

Avoid smoking, vaping, and other nicotine products during healing. Nicotine and tobacco exposure can interfere with healing around dental implants.

Avoid alcoholic beverages during the early healing period and while taking medications that should not be combined with alcohol.

Your Temporary Teeth

In most All-on-X cases, a temporary fixed prosthesis is attached to the implants around the time of surgery. This temporary prosthesis is designed to provide teeth during the healing phase while the implants integrate with the bone.

An appointment with your general dentist or prosthodontist may be needed within the first several days after surgery to evaluate or adjust the temporary prosthesis.

Do not attempt to adjust, remove, or repair the prosthesis yourself. If the prosthesis feels loose, breaks, changes significantly in your bite, or becomes uncomfortable, contact your restorative dentist or our office.

If a Temporary Denture Is Needed Instead

Occasionally, the implants cannot safely support a fixed temporary prosthesis immediately after surgery. This may occur when the initial stability of the implants or the quality of the surrounding bone does not allow immediate loading.

In these situations, the implants may be allowed to heal beneath the gum tissue and uncovered after an appropriate healing period, often approximately 4 months later. A removable temporary denture may be used during this time.

If you receive a temporary denture, it may require adjustment by your general dentist or prosthodontist during healing. Follow the specific instructions provided by your surgeon and restorative dentist regarding when and how to wear it.

Other Things You May Notice

  • Sore throat: Throat discomfort or discomfort with swallowing can occur, particularly if a breathing tube was used during anesthesia.
  • Jaw stiffness: The jaw muscles may feel stiff and opening may be limited for several days. Do not force your mouth open.
  • Nasal bleeding: A small amount of bleeding from the nose may occasionally occur after upper-jaw surgery and is generally temporary. If you were given sinus precautions, follow those instructions carefully.

Follow-Up Care

Keep all scheduled follow-up appointments. These visits allow your surgeon to monitor healing, evaluate the surgical sites and implants, and guide you as oral hygiene and diet progress.

Your restorative dentist or prosthodontist will also be involved in the treatment process and may need to see you during the healing phase for evaluation or adjustment of the temporary prosthesis.

When to Call Our Office

Please contact our office if you experience:

  • Heavy bleeding that does not improve with pressure
  • Swelling that is worsening unexpectedly rather than beginning to improve
  • Fever or other signs of illness or infection
  • Pain that is severe, worsening, or not adequately controlled with the recommended medications
  • A suspected medication reaction
  • Difficulty breathing or swallowing
  • Significant or persistent nasal bleeding
  • A problem with the surgical site, implants, or temporary prosthesis
  • Any other symptoms that concern you

Your surgery and recovery are individual. If the instructions provided specifically by your surgeon differ from these general recommendations, please follow your surgeon’s instructions.

Questions or concerns after surgery?
Please call our office at 336-765-5374.