The following information applies when the upper jawbone height or width has been restored. Bone grafting material has been placed and the maxillary sinus membrane lifted in preparation for possible implant replacement of a missing tooth or several teeth in that area.
The bone that has been grafted is most commonly a combination of freeze-dried bone, artificial synthetic bone and your own bone. Because of this you may have two post-surgical wounds: the donor site and the recipient site.
DO NOT UNDER ANY CIRCUMSTANCES BLOW YOUR NOSE FOR THE NEXT FOUR (4) WEEKS. This may be longer if indicated.
Do not blow your nose or sneeze holding your nose. Sneeze with your mouth open. Do not drink with straws and do not spit. Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should be avoided. Decongestants such as Drixoral, Dimetapp, or Sudafed will help reduce pressure in the sinuses. You may also be given a prescription for antibiotics. Please take these as directed. Anything that causes pressure in your nasal cavity must be avoided. Avoid “bearing down”—as when lifting heavy objects, blowing up balloons, playing musical instruments that require a blowing action or any other activity that increases nasal or oral pressure.
Be sure to take the prescribed antibiotics as directed to help prevent infection.
Do not rinse or spit on the day of your surgery. This tends to disturb the blood clot, open the wound and can prolong bleeding and slow healing. You should not have a significant amount of blood in your mouth. Saliva can be swallowed, even if slightly blood tinged.
Keeping your mouth clean after surgery is essential to reduce the risk of infection. Start salt water rinses the day following your procedure. Use one-half teaspoon of salt dissolved in an 8 ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least four to five times daily and always after eating for the next five days.
Do not brush the teeth in the area of surgery for 48 hours. When brushing, be very gentle. When expectorating, also be gentle.
We may prescribe an antibiotic rinse (Chlorhexadine, Periogard, Peridex) for certain procedures. This rinse should be used in the morning and at bedtime after routine mouth care. Do not eat or drink or rinse your mouth after using the medicated rinse. Using this rinse more than two times a day will cause staining of your teeth.
Do not smoke for at least two weeks after surgery, if at all. As discussed at your consultation, smoking dramatically increases the risk of bone graft and sinus augmentation failure. Dr. Rothenberg or Dr. Tien can prescribe a Nicoderm patch if you feel you need it.
Wearing your Prosthesis or Night Guard
Partial dentures, flippers, or full dentures should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. Please contact the office if there is any question. If you have a temporary “flipper” to wear do not place it until the numbness in the area is gone. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. This can lead to loss of the graft. If you have questions about the fit of your flipper, partial or complete denture, do not wear it until your general dentist or Dr. Rothenberg or Dr. Tien can see you.
Post-Operative Problems or Complications
As with any procedure, unexpected post-operative healing can occur. If you notice the unexpected flow of air or liquids between your mouth and nose, increase swelling of the mouth/check/eye after day 3, small particles of graft material discharged from your nose or severe sinus congestion, please let us know immediately.