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General Information
 You are about to start on the first stage of improving the appearance, comfort and function of your teeth. We will provide you with the information to do everything we can to make your experience
as comfortable and pleasant as possible. Please read these instructions to help clarify any concerns you may
have. Once you are seen in consultation, the dental office will prescribe medications, if required, and schedule an appointment
for implant placement. After the implants are placed, we allow a period of 4 to 6 months for the bone to
knit “osseointegrate” with the implants. In our experience, over 99% of the implants will knit. If for some reason
the implants do not knit, we can easily remove the implant, wait 2 to 3 months and replace it.
Once the implants knit, we will uncover the implant and
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| Fig 1 |
attach
an extension to come into the mouth (Fig 1). If
you are If you are wearing a full denture, you can be seen immediately by the person making the denture and have the O
ring attachments added. If having a crown or bridge made, you will need will take an impression and select the proper tooth
shade at that time to fabricate the crown or bridge. The crown or bridge will be inserted one to two weeks later.
Appointments
Most dentists respect your time as being valuable and will make every attempt to
meet your appointment promptly. You will have an have reserved a personal
appointment for you to perform the placement of the implants.
If for any
reason you are unable to keep the appointment, please advise your dentist
immediately. Failure to keep this appointment or cancellation
without giving the office sufficient time to book this time for
another patient severely disrupts the effective running of the
office. You may be charged a fee if the appointment is
cancelled within 24 hours of the appointment. As well, you may
not receive another appointment ifl the cancellation was
without reasonable cause or without adequate advance warning.
Pre Surgical Instructions
 Your dentist will prescribe a number
of medicines to control your symptoms after the surgery. Usually, these
will include an antibiotic to prevent the possibility of infection, a steroid to
reduce swelling and for an analgesic to control pain. Please ensure that you have
your prescription filled prior to surgery. Usually you will start all medicines one (1) hour prior to your appointment.
Continue the antibiotics and steroids until used up. Stop using the analgesics
once any discomfort disappears. If it is felt that your bone healing process
is in jeopardy, we will prescribe medicine to improve your healing. These
medicines must be taken for a minimum of four to five months. Your body uses more protein,
vitamins and minerals during the healing process. Although the diet of most people includes
sufficient amounts of these necessary items, the dentist may recommend that you augment your diet with
protein supplements such as “Boost” or “ Ensure” and with multi-vitamins during the healing
period. These are available at pharmacies and most grocery stores without prescription.
Anxiety
 It is normal that you are anxious about having this procedure performed. If you
take one or two analgesics beforehand, this anxiety will be reduced. If you feel you would like something
stronger such as sedation or general anaesthetic, please advise us prior to surgery in order to arrange this for
you. Patients undergoing general anaesthetic will be scheduled at a comprehensive clinical facility designed
and equipped especially for this purpose. We will require forms to be filled by your physician and possibly
an EKG taken beforehand. The anesthetists fee is covered under your medical insurance. However, you
will probably be charged a facility fee.
Implant Placement Procedure
The procedure usually takes 30 to 45 minutes
and is performed under local anaesthetic in the dental office. It is not
an extensive procedure but equivalent to having a few teeth extracted. Once the local anaesthetic
is in place, you will be quite comfortable. If you are wearing dentures, you will
be able to wear them afterwards.
Healing
 Reaction to the placement of implants varies from patient to patient and
is directly related to the number of implants placed. You should experience the same degree
of problems afterwards as found with the extraction of one to several teeth. You should be
able to leave the dental office afterwards unescorted. However, when you are taking either 1) large doses of analgesics, 2) having
sedation or 3) general anaesthetic, 4) are elderly, we recommend strongly that you have an escort home afterwards. Please
arrange for the escort to arrive with you at the time of the appointment. Other than the stronger analgesics, sedation or general
anaesthetic, neither the medicines nor the procedure should prevent you from driving an automobile afterwards. Typically, you
can resume normal activities the day following surgery. In those cases where extensive surgery is performed, you may require
3 or 4 days to resume normal activity. We do not recommend that you return to work the same day as the surgery. You should
return home afterwards and rest for the remainder of the day. Depending upon the number of implants placed, you should be
able to return to your usual workplace within a day or two.
Some discomfort is normal but usually minimal. Over the counter Aspirin or Tylenol, Plain or Extra Strength, 1 or 2 tablets, 3 or
4 times daily should ease mild discomfort. For greater pain, please take the anti-pain medicine prescribed. Swelling around the
surgical area may occur after surgery. Normally, it will reach its maximum within 48 to 72 hours following surgery, and begin
to disappear after 4 to 5 days. If swelling is expected, The dentist may prescribe the steroid, Decadron for a day or two. However, we
recommend that you apply an ice bag, frozen peas or a towel wrapped around ice cubes to the outside of
your face for 10 to 20 minutes at 10 to 20 minute intervals during the first two days. After 72 hours, heat
may then be applied, if needed, to reduce the swelling. Some patients, notably redheads, appear to swell
more than others do. Bleeding generally ceases after 10 minutes and is easily controlled with pressure and
cold compresses to the area or by the placement of sutures. It is not unusual for you to salivate more than
usual tinted a pinkish color by the blood. This should not be confused with outright bleeding which will be
darker in color and may contain clots. If bleeding occurs, keep your head elevated, apply cold compresses
to your face, place a folded piece of gauze on the bleeding site and bite firmly on the bleeding site for 15
to 20 minutes. Repeat several times, if required. If the bleeding persists, contact the surgeon.
 Bruising results from bleeding into the tissues. If this should occur, the resulting blood clot will
undergo color changes after several days, with both the swelling and coloring eventually disappearing
after 10 days. Gravity can cause
the bleeding to travel into the neck area involving a fairly large area. While unsightly, there is little concern medically. Following
surgery, it is common for your temperature to become slightly elevated. This is a normal reaction by the body and can
be treated by Adult Strength Aspirin, 1 or 2 tablets every 4 to 6 hours. Prolonged (after 4 days), high temperatures could be
indicative of infection and should be reported to the surgeon. Most sutures, if placed, are of the dissolvable variety and should
dissolve on their own within 7 to 10 days. Silk sutures are black in color, and must be removed by the dentist after 7 -14 days.
 Numbness or abnormal sensation around the lip and corners of the mouth may develop. If this occurs,
please notify the surgeon. Numbness is usually temporary but could last for several months.
Do not rinse your mouth or use a mouthwash for at least 12 hours. After this time, use either a
glass of warm salt solution (1 teaspoon of salt in a glass of warm water) or a .02% Chlorhexidine rinse available from the dentist. During the first 24 hours, avoid hot and hard foods that cause
discomfort while eating. Keep the diet liquid or soft, high in protein, vitamins and calcium. As
healing progresses, you will be the best person to judge the consistency of the diet. As well, you may find that the dentures will settle and sore spots result. A simple adjustment
by your dentist or denturist will correct this problem.
You will be contacted the day following surgery by the office to assure that you are comfortable and to address any concerns you
may have. The implants must be allowed to heal undisturbed for at least four months at which time the implant is uncovered and
the final components attached. As this date approaches, be sure you have an appointment with our office for these procedures.
Placing the Final Prosthesis
New dentures fabrication or relining your existing denture can be
started 3 months after implant placement. Please contact whomever is performing this service for an appointment. If crowns
or bridges are contemplated, an impression will be taken at the uncovering stage and the crown or bridge inserted about 2 to 3
weeks later.
Using Your Implants
The bone surrounding your implants at 4 to 5 months after implant placement
is still healing and considered relatively immature and weak. Over the next 1 to 2 years, this weaker bone will be replaced by
stronger, more mature bone. It is important to not over use or abuse the implants during the first year or so
while they are integrating with the bone and becoming stronger. We frequently recommend a transitional, removable appliance during
this period to prevent abuse.
Care of Your Implants
 Keep your implants clean and the tissue around them
healthy by daily brushing the implants and the crown, bridge or denture. As well, we will frequently
recommend a chlorhexedine mouthrinse available from the pharmacist by prescription or from the office.
Six month to yearly checkups are required, especially during the first two years, to assess the healing and
prevent problems.
If at any time you have any concerns or problems, please do not hesitate to contact your dentist.
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