After Sinus Lift
The following information applies when upper jaw bone height or width have been lost. The graft is placed to help restore your jawbone in preparation for possible implant replacement of the missing tooth or teeth.
You have had a Sinus Lift Augmentation procedure in your upper jaw. This procedure regains lost bone height in the area of your first and second molar and occasionally second premolar. It is an important procedure as it allows implant placement in an area that could not be implanted otherwise because of insufficient bone height due to an enlarged sinus.
The bone that has been grafted is most commonly a combination 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 BLOW YOUR NOSE for at least 4 weeks, even though your sinus may feel “stuffy” or there may be some nasal drainage.
- Try not to sneeze; it will cause undesired sinus pressure. If you must sneeze, keep your mouth open.
- No sucking action including avoidance of using a straw
- If you notice some bloody secretions from the nose or post nasal area for several days after surgery, this is normal and not to be alarmed about
- Do not forcefully spit
- No smoking
- Eat only soft foods for several days, always trying to chew on the opposite side of your mouth
- Do not rinse vigorously for several days, only GENTLE salt water swishes
- Scuba diving and flying in pressurized aircraft may also increase sinus pressure and should 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
- Decongestants such as Drixoral, Dimetapp or Sudafed will help reduce pressure in the sinuses.
PRESCRIPTION MEDICATIONS: It is essential that you get something soft and cold to eat or drink immediately after the surgery. Start the pain medication AFTER you get something to eat or drink but BEFORE the pain sets in. Start your next dose of antibiotics a couple hours after you start taking the pain medication.
For moderate pain, 1 or 2 Tylenol or Extra Strength Tylenol may be taken every 3-4 hours. Ibuprofen (Advil, Motrin) may be taken instead of Tylenol. Ibuprofen bought over the counter comes in 200 mg tablets: 2-3 tablets may be taken every 3-4 hours as needed for pain. For severe pain, the prescribed medication should be taken as directed.
EATING: Drink plenty of fluids. Soft cold foods are best for the first 72 hours following surgery. However, do not eat any foods with small seeds, for example popcorn, nuts or berries. Make sure to AVOID ANY BITING ON THE SIDE OF THE IMPLANT(s). Avoid chewing on that side for as long as possible. Avoid using any straws for a few weeks following the procedure.
GAUZE PACKS: You will have gauze in your mouth following surgery. Take the gauze out when you eat and replace with new gauze after. The gauze will help control the bleeding after the surgery. Apply firm pressure by biting down on the gauze. Place a couple pieces of the gauze folded up on the surgical site and bite down on it. Keep an eye on the gauze and replace when it becomes dark, red and saturated. It is normal to experience some bleeding following surgery throughout the first 24 hours after surgery, however there should be a trend that it will taper down. If bleeding continues after that, contact our office. Be sure to have the gauze removed before you go to sleep for the night.
MOIST HEAT: Apply warm moist heat to the OUTSIDE cheek area where the Graft(s) were placed. This will help provide better blood supply to the surgical site. Use a warm, damp cloth and continue to heat in the microwave or use a heating pad with a moist cloth over that.
SWELLING: It is normal following surgery for swelling to occur. It takes about 3 days for surgical swelling to peak. After 3 days the swelling should slowly decrease. Remember the use of warm moist heat will promote more swelling than average but will help with the implant area. Swelling that increases after the fourth day of surgery should immediately be brought to the attention of our office.
RINSING: Following the second day, very gentle rinsing would be allowed but not too vigorously as you can again disturb some of the bone graft granules.
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.
BE SURE TO DO GENTLE RINSING SO THE BONE GRAFTING ISN’T DISTURED.
Warm Salt Water: Very gentle warm salt water rinsing is important to start the day after surgery. Mix just a little bit of warm water and some table salt to rinse around in your mouth for 30 seconds to 1 minute and then spit out. Do this as frequently as you can throughout the day (10-20 times a day if you can). Make sure to rinse after any meals or snacks throughout the day. The more rinsing you do, the cleaner the areas will be and help with the healing.
Peridex Rinse: We have prescribed you an antibiotic rinse to start using prior to surgery. Continue using again 1 day after surgery, using twice a day (once after lunch time and once right before bed). Try to use this rinse right before bed to ensure it stays on the tissue. Do not eat or drink anything 2 hours after you use the rinse.
After you return for your post-op appointment and are given further instructions, you still need to continue using the Peridex rinse however, you don’t need to fully rinse with it. Just apply some on a q-tip and dab around the graft area. Continue doing this around the graft area(s)
TOOTH BRUSHING: You may brush your teeth, but avoid the surgical areas until you return for a follow up appointment in the office. After that, you should GENTLY brush on the surgical areas to help with the healing and keeping the areas clean, but do so very softly to not disrupt the bone graft.
SMOKING: 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.
SUTURES: A variety of sutures may have been used as a part of your treatment. These sutures will either dissolve on their own or be removed at the appropriate post-operative appointment. The sutures that need to be removed are usually done at the 2nd or 3rd post-operative appointment.
ACTIVITY: Keep physical activity to a minimum following surgery. If you are considering exercise, throbbing or bleeding may occur. If it does, discontinue exercise. Be sure to get plenty of nutrition including being properly hydrated.
Wearing your Prosthesis or Nightguards:
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 our office 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, please let us know immediately.
If you are aware of several small particles of graft material being discharged from your nose, let us know as well.
If you experience sinus or nasal congestion on the side your surgery was performed, let us know.
If there is an increase in swelling in your mouth, cheek or under your eye after 3 days, let us know.
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. Please try to call during office hours; however a 24-hour answering service is available for after hours contact with a doctor. The after hours telephone number is (253)770-1000.