Before having dental implant everyone thinks of Dental implant pain and they have these questions in mind Is there pain after dental implant surgery? How long it lasts and what is the intensity of pain? How to get rid of this pain? In this article I will try to make clear to these queries.
Pain is unpleasant sensation of stimulus that every one of us just wants to avoid and escape from it. Whenever there is question regarding dental pain most of us feel annoying and irritating. We even don’t want to remember our single episode of toothache.
Dental Implant is one of the superior most treatment strategies that dentistry is practicing for replacement of missing tooth in 21st century. Many people are willing to replace their missing teeth with Dental Implant but their worries is regarding the pain that might occur during and after the procedure, its complication and chance of failure. After complete evaluation, necessary investigation and preparation of implant site implantologist will arrange appointment for implant placement.
What is done during dental implant surgery?
Now immediate placed implant are also available in market but most of the time completion of implant placement require few months to year. To place dental implant screw first incision is given over gum and drill the titanium implant body inside the jaw bone which basically acts as the root of missing teeth.
After fixing this implant suturing is done and waits for healing of the tissue and formation of bridge between metal and bone so that our implant can withstand the force of the mastication afterward. In between final crown placement there is placement of temporary crown which will help to eat and give pleasant smile.
Would I have Pain during dental implant surgery?
As the dental implant procedure is minor surgical procedure there is no requirement of general anesthesia in most of the cases but it might require in some complicated cases. So, implant placement procedure is done under local anesthesia in minor OT setting. The site is under local anesthesia so there is or minimal pain. As long as effect of local anesthesia remains there is no pain but as it ware off then patient feel mild pain in the area of the surgery. But your dentist will prescribe some medication which will help to reduce the pain.
Is there pain after dental implant surgery?
As mention previously that mild pain will be there after surgery which will last long for week to 10 days. Generally after the surgical area start to heal then slowly pain will also disappear but in some cases pain will last or longer period as well. More the no of implant and complicated the procedure longer will be the pain afterward.
How long it lasts and what is the intensity of pain?
As dentist we are also not sure exactly how long does it last but it basically depends upon individual patient their health status and healing ability of individual. But there is less chance of suffering from intense pain after surgery if you have the medication prescribed by your dentist.
In the day of implant placement
As soon as local anesthetic action start to wear off then you will feel mild type of pain around the surgical site. To counteract that pain the medications prescribed by dentist will help to feel good. As there is incision given over the gum so there might be some bleeding over that site but worry with that.
What to eat in the day of implant placement?
Patient can eat food after 2/3 hours of surgery but avoid hot foods, sticky foods, hard foods, too cold food and hot food and also advice to take rest from heavy exercise. We advice to be on soft diet for few weeks which will prevent bleeding and support healing of the surgical site.
First week of implant placement
Avoid gentle brushing and flushing for 1/2 days of implant placement at site of implant placed. After 1 day of placement of implant the site start healing on its natural way with sign such as swelling, bruising and start bleeding if hard food are taken. After 24 hour of surgery it is advised to take hot food and warm saline mouth rinse which will increased blood circulation to the area and accelerate healing. At this stage there is dull pain which subsides by medication.
After 2/3 days of surgery swelling progresses and with 4/5 days it reaches at its peak then slowly it declines within week the swelling start disappearing and pain will also slowly narrow down by first week if it’s alright. Regarding diet for speed recovery and boosting immune system add soft fruits in diet but still avoid hard foods. Ice pack can be placed in swollen area to compress is.
Second week of dental implant placement
By the end of first week slowly healing procedure will sum up and you can start your normal diet if you feel comfortable with it but egarding physical exercise heavy cardiovascular exercise these might aggravate bleeding and dull pain over surgical site. If everything is fine visit your dentist once at end of second week. But if you are suffering from pain then its alarming condition to connected with your dentist.
If Pain occur after months
In most of the cases this type of late pain doesn’t occur but in some cases it might occur so immediately visit your dentist if this occurs. Most likely causes that will leads so pain after a month seems to be poor oral hygiene, interaction with certain medications, rejection of implant it occurs with very less people but it might occur, titanium allergy to patient, patient with poor general health status where there are high chance of infection.
Dental Implant pain after years
This occurs in least no of cases but If you are suffering from pain even after years then there might be chances of patient having clenching or bruxism habit so it should be predetermined before starting the procedure, infection of the area, lack of jaw bone, poor oral hygiene maintenance. Smoking even after implant placement and have radiation of head and neck is one another cause for such pain.
5 possible causes of long-lasting pain after implant placement
There are some cases recorded which complain of pain since years after implant placement is known to be due to nerve injury during implant placement. Before implant is imbedded inside jaw bone there is CBCT done and other detailed investigation so that dentist try to avoid nerve injury sometimes due to lack of experiences and some time due to lack of adequate bone nerve get injured which leads to painful condition even after years of placement.
It is a complication that is associated with inflammatory pathological change in the soft and hard tissues surrounding an osseointegrated implant. Peri-implantitis occurs as the consequence of imbalance of host defense and bacterial invasion and loading around the gums. Literature suggest that peri-implantitis usually occurs after 5/6 years of the peri-implant disease to proceed and exhibit their clinical signs and symptoms. The American Academy of Periodontology explains that you may have peri-implantitis if you experience these symptoms: Painful, red or tender gums, bleeding when brushing.
These are some conditions which are thought to be leading to peri-implantitis disease
- Systemic disease
- Faulty surgical technique
- Other factors
Loose healing cap and Implant
After placement of dental implant in some cases it is noticed that after years of placement dental implant get loosened due to low bone density and also might be due to bone disease. If such condition occurs then this implant is removed and fixes the existing problem and replacement should be done.
And in some condition there is loosening of healing screw which is placed above the implant. With the process of healing that screw get loosened and it might causes discomfort which can be easily fixed by visiting your dentist where he/she will remove the healing cap, clean the site and rearrange it on top of dental implant.
Success rate of implant is about 90-95% in healthy patient but it decreases in patient with systemic diseases. In such condition where implant placement is problematic and shows clinical signs that could indicate pain from peri-implant soft tissue infection also there is bleeding on probing from implant site, probing depth is increased, suppuration might be seen, friable tissue, and ulceration is there. Radiographic finding will add in diagnosing the cause of failure or problematic situation. Literature has noted some cause of failure of implant such as Violations of the anterior loop of the inferior alveolar canal (IAC), Violations of a branch of a bifid or trifid mandibular canal, Poor bone-to-implant contact; Inadequate keratinized tissue around the dental implant crown, predisposing risk factors toward postoperative dental pain.
Bone damage during drilling
This condition is less frequent but there are some cases recorded with such condition. During placement of implant screw within the bone via drilling with rotary instrument which can damage the bone with the heat of that instrument. If unfortunately such condition occurs then it will good to remove placed implant and also remove the affected bone.
Unfortunately if you get peri-implant disease don’t worry then there are various treatment strategy that can be done in such cases
In initial stage there is non-surgical therapy
(a) Occlusal Therapy
- Analysis of the fit of prosthesis and its correction
- Analysis of number and position of implants
- Occlusal equilibration
(b) Mechanical therapy (Plastic Instruments):
- Conventional manual and ultrasonic instrumentation not suitable (Harder than Titanium)
- High pressure air powder abrasive (Mixture of sodium bicarbonate & sterile water) is the method of choice Prophy-jet
(c) Anti-infective Therapy:
- Chlorhexidine Gluconate (Subgingival Irrigation)
- Antibiotics – for 10 consecutive days
If non surgical therapy is not successful then move towards surgical therapy
Indications for Osseous Resection:
1. Moderate to severe bone loss
2. One and two walled bone defects
3. Implant position in unaesthetic area
Indications for Regeneration:
4. Two and three walled bone defects
5. Mod. to severe circumferential intrabony defects
Indications for implant removal:
1. Severe periimplant bone loss (>50% of implant length)
2. Bone loss involving implant vents/holes
3. Rapid, severe bone destruction within one year of loading
4. Ineffective non-surgical or surgical therapy
How to mage dental implant pain
Best way to react with pain is to inform your dentist regarding the situation and do accordingly to suggestion of your dentist. Here are post procedure instructions which should be followed.
- Medication; Please take prescribed medication after surgery which will help to subside pain.
- Ice Pack
- You can use ice pack in first few days of surgery which help to decrease swelling.
- Warm saline rinse
- After one day of surgery start rinsing mouth with warm saline water which will help to speed recovery.
- Avoid hard and sticky foods
- During first 2 week of surgery avoid hard food and candies which will provoke bleeding and stick within site and may cause infection. So have soft diet for at least for 2 weeks.
In day of surgery don’t brush at the site of surgery which will provoke bleeding but it is mandatory for brushing in rest of the area. If you are not able to keep your oral health hygiene better it will leads to infection.
After reading this whole article you must have idea regarding dental implant pain. With new joy of having permanent solution to missing teeth there is lesser pain and there are various strategies to manage that pain as well. Some cases will be there with complain of long term pain as well but they are rare and can be managed. So main key point is that choose expert on implant not search for the economical option. Another thing that I noticed is many people are hurry to their treatment so doesn’t be take time and provide adequate time to dentist to schedule your appointment.