Your Implant Surgery Day

The Planning Is Already Done

Everything important is settled before you arrive. At earlier visits you'll have had your consultation and a CT scan on the scanner we keep in the practice, talked through a written treatment plan and signed your consent. Dr Kalsi will have picked the implant's length, width and position on your 3D scan, and a surgical guide has been 3D-printed from that plan. The day itself is about carrying out decisions already made, not making fresh ones while you're reclined in the chair.

The Week Before

• Carry on with your usual tablets unless we've asked you to change something. Anything that thins the blood, treats diabetes or affects the bones will have come up at your consultation.
• Having sedation? Line up a responsible adult who will bring you in, wait for you, see you home and stay with you overnight.
• Stock the kitchen with soft things to eat, such as soup, porridge, yoghurt, scrambled eggs, pasta or mashed potato.
• Have a supply of the everyday painkillers you normally take without trouble.
• Leave alcohol alone the evening before.
• If you smoke, giving up now, even for a few weeks around surgery, gives the implant a better chance of healing well.

On the Morning Itself

Eat a light breakfast as you normally would, sedation or not, unless we've given you different instructions. Clean your teeth well, including in between them. Choose loose clothes with sleeves you can push up, and remove any nail varnish or gel from at least one finger so the oxygen monitor gets a reading. When you arrive, mention any cold or cold sore, or any change to your health or medication since we last saw you. Give yourself time for the journey so you're not rushing, and arrange childcare rather than bringing young children along.

Before We Start

First we recheck your medical history, take your blood pressure and deal with any last questions. Then we numb the area. For most patients, that injection is the only moment they actually notice.

If you've chosen IV sedation, it comes first: a fine cannula goes into a vein in your hand or arm, and the medicine is given little by little until you feel relaxed and heavy. You can still hear us and follow simple requests, yet time seems to slip by and memories of it are usually hazy. We keep a constant watch on your pulse, oxygen level and breathing. Sedation costs £500 for the session, with £250 added for every additional half hour, and our IV sedation guide covers it in detail.

How the Implant Goes In

1. Fitting the guide. The printed guide sits over your teeth or rests on the gum, and we make sure it's seated firmly.
2. Opening the gum. Usually this is only a small round window made through the guide.
3. Shaping the bone. A series of slim drills, kept on course by the guide using MegaGen R2 guided surgery and cooled with a water spray, prepares the site. Expect pressure and a buzzing sensation rather than pain.
4. Placing the implant. A MegaGen AnyRidge implant is eased in slowly until it reaches the depth and angle set in your plan.
5. Adding graft material at this stage, if your plan calls for it.
6. Closing up. Dissolving stitches go in around a small healing cap, or a temporary tooth is fitted on top if the gap shows when you smile.

For one implant, all of that fits into roughly an hour. A full arch takes several hours for each jaw. If you're on the Same-Day or Premium pathway and the bone is suitable, you leave the same day with fixed temporary teeth. ¹

Once You're Home

• Keep firm biting pressure on the gauze for 30 minutes, and swap in a clean pad if there's still oozing.
• For the first few hours, rest a cold pack wrapped in a cloth against your cheek, on and off.
• Take the first dose of painkillers while you're still numb.
• Protect the blood clot today: no rinsing, forceful spitting, straws or hot drinks.
• Take it easy, and sleep with an extra pillow to keep your head up.
• If you were sedated, avoid driving, alcohol, operating machinery, signing anything and important decisions for the next 24 hours.

The First Three Days

Puffiness, and sometimes a bruise, develops over the first day or two, reaches its peak around the second or third day and then subsides. It usually looks more dramatic than it feels. Eat soft food that isn't too hot and chew on the opposite side.

Starting the day after surgery, rinse gently after meals with warm salt water, roughly a teaspoon of salt dissolved in a mug. Brush everywhere else as normal and take great care near the stitches. Hold off strenuous exercise for a couple of days, since a racing pulse can set off bleeding again. Above all, don't smoke: nothing else puts a fresh implant at greater risk.

Weeks One and Two

After a single implant, most people return to work within a day or two and feel comfortable by the end of the first week, with just a little tenderness where the implant went in. The stitches disappear on their own within one to two weeks. Go on chewing on the other side and keeping the area clean.

Beneath the gum, bone has begun growing onto the surface of the implant. Dentists call this osseointegration, and it takes about two to three months. If you've had full-arch treatment, we'll give you a soft-food plan for the first few weeks so the new implants aren't put under too much load while they settle.

When to Ring Us

Please phone 01555 662441 if:

• Bleeding carries on after half an hour of steady pressure on gauze
• The swelling is increasing after the third day instead of going down
• You develop a fever or feel unwell in yourself
• Ordinary painkillers aren't keeping the pain under control
• A healing cap or temporary tooth works loose

Opening hours: Monday to Thursday, 9am to 5.30pm, and Friday, 9am to 5pm. Closed at weekends. When we're closed, ring NHS 24 on 111. Call 999 if swelling makes it hard to breathe or swallow.

After Healing

We'll see you briefly for a review while things heal. Once the implant has bonded, we record the area with the iTero scanner, a digital scan with no impression trays, and the crown is made and then fitted at a separate appointment. Each implant placed at Lanark carries a 5-year guarantee for non-smokers who attend hygiene visits every 3 months. Our implant lifespan guide explains the care that keeps it working for years.

Questions

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