Post-Op Instructions for Implants, Bone Grafts, Sinus Elevations



You have just had a surgical procedure. Therefore, it is natural that temporary changes will occur in the  mouth afterward.  You’ll be back to normal functioning typically in just a few days.  Sometimes the after-effects of oral surgery are quite minimal, so not all of these instructions may apply.  Common sense will often dictate what you should do.  However, when in doubt always follow the instructions herein and those given by  Dr. Steve Shufflebarger.  If you have any questions, you can contact the office.  

Although, the post-operative care is fully detailed in these instructions, here are your main key points to a fast recovery after your surgical procedure:

  • IF YOU ARE A SMOKER OR VAPE, DO NOT SMOKE OR VAPE FOR A MINIMUM OF 2 WEEKS.  Smoking and vaping increases the heat and creates suction to the surgical area and significantly lowers the body’s ability to heal the site and can cause an implant to fail.  

SEDATION:  Please remember the Patient’s safety is our concern after sedation. The key items to remember after IV Sedation are as follows:

• Patient must be closely watched and monitored for a minimum of 6 hours or until the effects of sedation have worn off

• Patient must remain seated in an upright position for a minimum of 6 hours or until the effects of sedation have worn off

• Patient will need assistance walking

     • Patient will need assistance with post-operative procedures as indicated in these


• Patient is unable to drive or operate machinery for 24 hours

• If Patient is having difficulty breathing or swallowing or experiencing other emergency circumstances, the escort should report to Dr. Shufflebarger (937-532-5693) and/or emergency medical assistance (911)

IMPLANTS:  If an implant was placed, it will remain submerged for a period of 4-6 months depending  upon your body’s healing properties and the type of implant placed.  The implant is located in the bone,  under the tissue and usually cannot be seen.  

BLEEDING:   Bleeding should never be severe.  Intermittent bleeding or oozing overnight is normal.  If  bleeding continues, biting on a moistened tea bag wrapped in a paper towel is often enough to control  excessive bleeding.  Remember though, that a lot of saliva and a little blood can look like a lot of bleeding.   If heavy bleeding continues, call the office and/or go to the emergency room.

SWELLING:   After surgery you may have some discomfort and notice some swelling.  To help reduce swelling and expedite recovery, use an ice pack on the outside of the affected cheek(s) for the first 48 hours.  The use of ice is very important in your healing process.  We ask that you use ice for 30 minutes at  a time for the first 2 days after surgery.   If it is helpful, you can remember to place ice on your cheeks on the hour.  For example, ice at 11:00, remove the ice at 11:30, ice at 12:00, remove the ice at 12:30, ice at 1:00 remove the ice at 1:30, etc.  If you have been prescribed medicine for the control of  swelling, be sure to take it as directed.

PARESTHESIA:  Paresthesia is the altered sensation of the nerve and typically is a result of compression or inflammation on the nerve.  It is the feeling of numbness, tingling, prickling or “pins and needles”.  If you have significant lingering numbness in your lips, chin, tongue or other parts of your face that remain after 2 days, please contact the office right away.  Although this is a common complication after surgical procedures, we need to be aware and assist you with the right intervention or treatment to try and reduce the duration. 

ANESTHETIC:  The length of time you experience numbness varies depending on the type of anesthetic  you’ve  received.    While  your  mouth  is  numb,  you’ll  want  to  be  careful  not  to  bite  your  cheek,  lip  or  tongue.  The numbness should subside within several hours.  

NAUSEA:  Nausea is not uncommon after surgery.  Often medications are the cause.  Nausea can be  reduced by preceding each medication with a small amount of soft food and moderate volumes of milk or  water. Try to keep taking fluids and possibly minimize taking certain medications.  If you do not feel better please call the office.  

PAIN:  Unfortunately, most oral surgery is accompanied by some degree of discomfort.   You may have  been given prescription medication to control pain and prevent infection.  Use it only as Dr. Shufflebarger  has directed.  If the medication prescribed does not seem to work for you, do not increase the dosage. If  you have prolonged or severe pain, swelling, bleeding, or fever, call the office immediately.  We will give  you instructions on how to care for your problem.  

SUTURES:  Sutures have been placed to hold the tissues together during the healing process.  The sutures will automatically dissolve and should not be removed.  Your sutures should remain intact for approximately 1-2 weeks.   If the sutures have begun to unravel within the first week, please contact us to see if we need to see you.  It is important that we do not have a loss of bone grafting material or tissue issues during your post procedure healing process.  If the sutures are of concern, please contact the office. 

PERIACRYL:  Additionally, it is common that we place Periacryl (a “liquid bandage”) over the sutures and site.  This material assists with maintaining the sutures in place and securing the tissue.  This bandage will release and come out when ready.  We understand that the Periacryl may be annoying as it feels hard, scab like and will start to peel off; however it is important that you do your best to not play with it, remove it, or otherwise disturb it.  The Periacryl may remain intact anywhere from a few days to 2 weeks.  Periacryl is a purplish gray colored material so you recognize it during your recovery. 

SINUS PRECAUTIONS (IF SINUS ELEVATION PERFORMED):  In order to assist with the healing of your sinus membraneit is important that you avoid the following for 2 weeks unless specifically advised by Dr. Shufflebarger of a different time frame:

  • Avoid pressure changes (ex: straws, smoking, vaping, water bottles, etc.)
  • Do NOT blow your nose.  If necessary, just wipe your nose.  If you need to sneeze, do not hold it in, and sneeze with your mouth open.  As an option, you may use nose spray (Neo-Synephrine) for 4 days following a sinus elevation procedure. 
  • Avoid spitting
  • Avoid wind instruments

Please note that nose bleeding for 1-2 days following sinus elevation can be possible.  Nose bleeding for longer than 2 days would be out of the ordinary and you should call the office.   Additionally, if you notice any air/fluid exchanges between your nose and mouth, please contact the office so we are aware.

RINSING:   It is very important that you keep the surgical site clean and free of food particles.  Gentle  rinsing of the mouth should be started the day after surgery and be performed 4-6 times a day for two  weeks following surgery.  Gently rinse your mouth with warm salt water (half a teaspoon of salt in an 8  oz. glass of warm water) by tilting your head from side to side, and then lean over the sink and let the  water fall out.  Do not spit.  Rinsing after meals is important to keep food particles out of the surgery site,  but remember not to rinse your mouth vigorously.  Avoid using other mouth rinses or mouthwash during this healing procedure.  Avoid using a water pick near your implant because it can cause the implant to  fail.

ORAL HYGIENE:  It is important to continue to brush and floss your teeth thoroughly twice a day.   The tongue should also be brushed.  This will help eliminate the bad breath and unpleasant taste that is  common after oral surgical procedures.  Always use a soft bristled brush so that you do not injure the  tissues in your mouth.

DIET:  After  the surgical procedure, drink lots of liquids and eat soft, nutritious  foods.  Avoid alcoholic  beverages and hot liquids and foods.  It is best to avoid foods with seeds, nuts, hulls, or sharp edges like nuts, popcorn, chips, or sharp items which may damage or become lodged in the surgical areas.  Begin eating solid  foods  the next day or as soon as  you can chew comfortably.  For about two days, try to chew food on the side opposite the surgical site if possible.  Food examples:  Eggs, yogurts, oatmeal, pancakes, smoothies, peanut butter, white bread sandwiches with soft lunch meat (no seeded bread), soup, hot dogs/sausages without tough casings, pastas, macaroni and cheese, baked fish of any variety, soft stewed/shredded meats like chicken or pork, soft cooked vegetables, potatoes, cheeses, cottage cheese, canned or soft seasonal fruits like peaches or pears, applesauce, ice cream/frozen yogurt/sorbet/milkshake (without fruit seeds like strawberries), and pudding.

ESSIX RETAINER/IMMEDIATE DENTURE:   If you received a “one piece zirconia implant” you are required to wear the essix retainer that was made for you at all times as directed.  This includes eating and sleeping.  You should only remove it to clean it.  A “two piece zirconia implant” recipient does not typically have an essix retainer or the requirement to wear one at all times.   

If you received a titanium implant you are not required to wear the essix retainer, it is more for cosmetic purposes. 

If you were specifically directed differently about your essix retainer in your particular case, please follow the oral instructions given to you at the time of your appointment.  It is important  to keep  the appliance as clean as possible during  the healing period.  Please remember to maintain proper care of the essix retainer by properly cleaning it using salt water or similar solution. 

If you received an immediate denture you are not required to wear it at all times, in fact, we recommend not wearing it unless you need it.  For example, if you are home for the day, it is ok to keep it out.  If you need to use denture adhesive, avoid placing the adhesive directly on the suture line/surgical site.

We are trying to take great effort to avoid disruption of the tissue healing process to contribute to the success of your implant/bone graft.   Specifically, during the healing process we do not want the device to rub the tissue or irritate the area, or otherwise apply pressure to the area.  If you have questions or concerns with your essix retainer or immediate denture, please contact the office.

HEALING:  A certain amount of pain must be expected with all types of surgery.  The third, fourth or fifth days after surgery are generally most uncomfortable and there is usually some swelling.  On the sixth day or after approximately 1 week, you should be more comfortable, and, although you may still be swollen, can usually start to notice some improvement in symptoms.  Remember however, age plays a factor and sometimes with age the discomfort can last longer.  The remainder of the post-operative course should be gradual, steady improvement.  If you don’t see continued improvement please call the office. 

THANK YOU FOR ALLOWING US TO ASSIST YOU WITH YOUR NEEDED SURGICAL CARE It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office. If possible, calling during office hours will afford a faster response to your question or concern. We are willing and will always offer post-operative care to make sure you are healing properly and can address any concerns you may have.  We hope you have a quick recovery period and heal well after your surgical procedure. Please contact the office (937-532-5693) if you need assistance.