Written by Dr. Cristian Dunker, BDSc, MBA
After Your Bone Graft
A bone graft rebuilds the volume of bone in the jaw so that it can support a dental implant, or so that an existing socket heals with enough bone for future treatment. The graft material may be particulate, which has the consistency of coarse granules, or a solid block secured with small screws. It is often covered by a membrane and closed with sutures.
Everything about the first two weeks is aimed at one thing: leaving the graft undisturbed while your own bone grows into it. Grafted bone takes four to nine months to mature, but the first fortnight determines whether it takes at all.
If Your Graft Was Placed With an Implant
Grafting is frequently done on the same day as implant placement. If that applies to you, follow the dental implant surgery instructions as well. This article sits alongside those instructions rather than replacing them. Where advice differs, follow whichever is more cautious, and ask us if you are unsure.
Protecting the Graft
Do not lift your lip or cheek to inspect the area. Stretching the tissue pulls on the sutures and is one of the most common causes of a wound opening.
Do not press, poke, or probe the site with your tongue, finger, or toothbrush.
You may notice a few small granules in your mouth during the first few days. A small number is expected and is not a cause for alarm. A steady loss of granules is not, so let us know.
Do not use straws, and avoid spitting, for at least one week. Suction pressure can disturb both the clot and the graft.
Do not smoke or vape. Smoking is the single largest risk factor for graft failure, and abstaining for at least two weeks is strongly advised.
Managing Bleeding
Bite firmly on the gauze provided for 30 to 60 minutes.
Mild oozing is normal for up to 24 hours.
If bleeding continues, place fresh gauze and apply firm pressure for another 30 minutes.
Avoid forceful rinsing, which can dislodge the clot that protects the graft.
Reducing Swelling
Apply ice externally (10 minutes on, 10 minutes off) for the first 24 to 48 hours.
Swelling usually peaks at 48 to 72 hours before improving.
Keep your head elevated when lying down, including with an extra pillow overnight.
Mild bruising may appear after 2 to 3 days and is normal.
Medications After Bone Grafting
Take antibiotics exactly as prescribed and complete the full course. Infection is a direct threat to a graft.
Begin pain medication before the numbness wears off.
Anti-inflammatory medication helps control both swelling and discomfort.
Use any prescribed antimicrobial mouth rinse, such as chlorhexidine, as directed. Let it bathe the area rather than swishing vigorously.
Do not drive while taking strong pain medication.
Seek urgent medical care if you experience a rash, breathing difficulty, or facial swelling.
Diet After Bone Grafting
For the first 3 to 5 days, eat soft, cool or lukewarm foods only.
Recommended foods: yoghurt, mashed vegetables, scrambled eggs, soft pasta, lukewarm soup.
Avoid hot food and drinks for the first 24 hours.
Avoid crunchy or hard foods, nuts, chips, seeds, and small grains that could lodge in the wound.
Do not chew on the grafted side until we advise you that it is safe.
Stay well hydrated throughout your recovery.
Oral Hygiene After Bone Grafting
First 24 Hours
Do not rinse your mouth.
Do not brush the surgical site.
After 24 Hours
Rinse gently with warm salt water (one teaspoon of salt in a glass of warm water) three to four times daily, especially after meals. Let the water fall out of your mouth rather than spitting.
Resume brushing your other teeth normally.
Avoid brushing directly over the graft site until we advise you otherwise, usually around two weeks.
Sinus Precautions
If your graft involved the upper back jaw or a sinus lift, additional precautions apply for two to three weeks.
Do not blow your nose. If you must sneeze, sneeze with your mouth open so pressure is not forced into the sinus.
Avoid flying, diving, and playing wind instruments.
Avoid heavy lifting and straining.
A small amount of blood-tinged discharge from the nostril in the first few days can occur. Report anything more than this.
Membranes and Sutures
Sutures are often dissolvable and may take 1 to 3 weeks to disappear on their own.
If non-dissolvable sutures were placed, a review appointment will be arranged for removal.
Do not pull on or attempt to remove sutures yourself.
If a small piece of membrane becomes exposed, do not pull at it. Contact us so it can be assessed.
What Is Normal During Recovery
Swelling peaking around Day 2 to 3
Bruising around the jaw or cheek
Mild bleeding or oozing for 24 to 48 hours
Jaw stiffness lasting several days
A few graft granules appearing in the first few days
Gradual improvement in symptoms after Day 3
When to Contact Your Dentist
Severe pain that worsens after Day 3
Heavy bleeding that does not stop with firm gauze pressure
Fever or chills
Pus discharge, or a foul smell or taste from the site
Swelling that increases after Day 3 rather than settling
A wound edge that opens, or graft material coming away steadily
Persistent numbness beyond 24 hours
Fluid or air passing between your mouth and nose after an upper graft
If you experience any of these symptoms, contact ArtSmiles on the Gold Coast for prompt assessment, or see our emergency dentist if you need urgent care. A graft that is developing a problem is far easier to manage early.
You can book a consultation online or get in touch with us if you have concerns during your recovery.
