Your Implant Surgery Day

The Day Before

Before surgery day arrives, the planning is complete: consultation, CT scan, a written plan with its fixed fee, and a surgical guide printed from that plan. The evening before:

• Keep taking your normal medication unless we have advised otherwise. Blood thinners and anything else relevant will already have been covered at your consultation.
• Skip alcohol that evening, particularly if you are having sedation.
• Send us any last-minute questions; nerves are normal and we would rather you asked.
• If you are being sedated, check that your escort is booked for the whole visit and can keep you company until bedtime. Plan a car or taxi home rather than the Jubilee line.
• Fill the fridge with soft, cool food: yoghurt, soup, eggs, smoothies.

On the Morning

• Have a light meal two hours or so beforehand. Unless we have told you otherwise, do not arrive hungry, even if you are being sedated.
• Give your teeth an especially thorough brush and interdental clean before you leave home.
• Choose loose layers with sleeves that roll up, since we need your arm for blood pressure readings and, with sedation, a cannula.
• Take the varnish off at least one fingernail so the oxygen monitor can read it.
• Allow plenty of travel time. The practice is about ten minutes' walk from North Greenwich station.
• Arrange childcare; you will not be able to look after small children that day.
• Tell us on arrival if your health has changed since the consultation, even if it is only a cold.

Arriving, and Sedation

First we recheck your medical history and blood pressure, deal with any final questions and confirm your consent. Then local anaesthetic numbs the area. If you have opted for sedation, our oral surgeon Dr Imran Riaz begins by placing a fine cannula in a vein on your hand or forearm, which is the only needle you are likely to notice. The sedative then goes in slowly until you feel calm, heavy and unbothered. You stay able to follow instructions, yet the time seems to fly and most people recall very little. A monitor tracks your oxygen, pulse and breathing from start to finish. Sedation is £500 per session, plus £250 for every additional 30 minutes; our IV sedation guide explains more.

The Procedure, Stage by Stage

• Fitting the guide. In most cases a template printed from your scan and digital plan clips over your teeth or gum. Working with the MegaGen R2 guided system, it holds every drill to the depth, angle and spot Dr Riaz chose on screen.
• Opening the gum. Often this is only a small circular opening through the guide rather than a wider incision.
• Preparing the site. A sequence of fine drills shapes the bone, cooled by water. You feel pressure and vibration, not pain.
• Placing the implant. A MegaGen AnyRidge titanium implant is turned gently into position.
• Grafting, if planned. Any bone graft in your plan is added around the implant at this point.
• Closing up. The gum is closed, usually with stitches that dissolve, over a small healing cap, or a temporary tooth goes on if the gap is visible.

One implant takes about an hour. A full arch is a longer session of several hours for each jaw. On our Same-Day and Premium pathways you usually leave that evening with fixed temporary teeth where the bone allows;¹ with Healed Foundation or Staged Treatment, you heal in a denture first.

Straight After

• Bite gently on the gauze we provide for 30 minutes to control bleeding, and swap it for fresh gauze if needed.
• For the first few hours, hold a cloth-wrapped cold pack to your face over the area, alternating ten-minute spells on and off.
• Take painkillers as the packet directs before the numbness fades, so discomfort never gets ahead of you. Over-the-counter painkillers are enough for most people.
• Avoid rinsing, spitting hard or using a straw today, because they can dislodge the clot.
• Take the rest of the day easy.
• After sedation, do not drive, drink alcohol, operate machinery or make important decisions for 24 hours.

The First Three Days

• Swelling and bruising normally reach their worst around day two or three and then subside. They often look worse than they feel.
• Stick to soft, cool food and chew on the other side. Avoid anything hot, crunchy or sharp.
• Leave the mouth unrinsed on day one. From day two, after each meal, swirl gently with warm water mixed with a teaspoon of salt.
• Keep brushing your other teeth as usual; around the stitches, start very gently from day two.
• Do not smoke. It slows healing and increases the chance of the implant failing.
• Skip strenuous exercise for 48 hours, as a raised heart rate can start bleeding again.

The First Two Weeks

Seven days on, most people are working again and eating as usual on the untreated side, with only mild tenderness where the implant went in. The stitches dissolve by themselves over a couple of weeks, and we remove any stragglers at your review. On the surface the gum heals around the cap or temporary tooth; below it, bone is starting to grow onto the implant surface, which dentists call osseointegration. Clean carefully, favour the other side for chewing and stay away from cigarettes. If you had full-arch surgery and went home with fixed temporary teeth, a soft-food plan protects the implants from overloading for the first few weeks. The review is short, and North Greenwich is five minutes from Canary Wharf on the Jubilee line.

When to Call, and What Happens Next

Phone us on 020 8788 6688 if firm pressure for 30 minutes has not stopped the bleeding, if swelling is still growing after the third day, if you run a fever, if over-the-counter painkillers are not keeping pain in check, or if a healing cap or temporary tooth works loose. When we are closed, the practice line plays our out-of-hours message, and NHS 111 can also advise. Fusion takes 8 to 12 weeks, and we see you briefly partway through. When the implant is ready, the crown is designed from a scan on our iTero Element scanner, so there are no putty moulds, and fitted at one appointment. Every implant we place carries a five-year guarantee for non-smokers who keep up three-monthly hygiene visits.

Questions

This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.