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Post-Operative Instructions:
All-on-4®/ Zygomatic Implant

All-on-4 / Zygomatic Implant

Congratulations! You are well on your way to rehabilitating your dentition. We want you to know that our office is available to answer any questions you may have at any time after the procedure.

EXPECT some bruising, swelling, tenderness, weakness.

Day 1: You will be experiencing mild discomfort as you recover from sedation and the local anesthesia wears off. Keep as much ice on your face and jaw as you can stand for the next 2 days, changing the ice about every 20 minutes. Nausea may occur today as well. Begin eating today. You may have any food that does not require chewing such as scrambled eggs or oatmeal. Drink plenty of fluids.

Day 2: Although you will be relatively pain free, you should continue to take some pain medication. Take over the counter pain medications such as Advil® if your pain is not severe. If unsure of which OTC pain medication to take, please contact our office. Continue to ice your face and jaw as much as possible.

Day 3: For most patients, day 3 is when the most swelling and bruising will begin to appear. You may notice bruising under your chin and down your neck and also around your eyes. All of this is normal. Drink plenty of liquids. Protein shakes are encouraged.

Give us a call with any questions or concerns at (805) 648-5121.


  • Do not disturb the surgical area.
  • Do NOT rinse vigorously or probe the surgical sites with any object.
  • Gentle swishing with warm salt water or prescribed mouth wash is recommended particularly after eating to remove the large particles.
  • You may brush your artificial or natural teeth gently.
  • PLEASE DO NOT SMOKE for at least 3 weeks following your procedure, since this is very detrimental to healing.
  • In most instances, self-dissolving sutures are used, so there is no need for them to be removed.
  • The sutures will disappear within 10 days or so. If needed they can be removed by your surgeon's staff during your follow-up visit.
  • Do not panic if you feel loose sutures or string in your mouth.
  • Do not blow your nose for the 2 weeks period following your procedure.
  • We recommend you take a decongestant such as Sudafed for 10 days after an upper jaw procedure.
  • If you have to sneeze following surgery of the upper jaw, do with your mouth open for the 2 week period following your procedure.
  • DO NOT use toothpaste for the first 4 days. Dip your toothbrush in water or a prescribed mouthwash.
  • If you feel any movement of your dental prosthesis please alert your dentist. Most often the cause is the loosening of the small screws attaching the teeth to the implants. Do not panic.


Swelling and bruising are sometimes associated with oral surgery. It can be minimized by using a cold pack, ice bag or a bag of frozen peas wrapped in a towel and applied firmly to the face and cheek adjacent to the surgical area. This should be applied twenty minutes on and twenty minutes off during the first 48 hours after surgery. If you have been prescribed medicine for the control of swelling, be sure to take it as directed. Do not use ice after the third day unless instructed to. Apply moist heat to discolored skin areas to accelerate the disappearance of the abnormal color. Moisten a towel and place in microwave oven until warm (not hot) and place on skin until cool. repeat as desired until discoloration disappears.


You will experience some bleeding over the first few days following your procedure. This is normal. The bleeding should decrease and the color should change from red to brown and then disappear by the 5th or 6th day. If bleeding persists or becomes heavy you may substitute a tea bag for the gauze (soaked in warm water, squeezed damp-dry and wrapped in a moist gauze) for 20 or 30 minutes on the affected area. If you continue to experience bright red bleeding for a long period of time, please call our office.


Unfortunately, most oral surgery is accompanied by some degree of discomfort. Acute pain management should always start with over-the-counter pain medications, such as acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®). If your surgeon approves these medications for you, you should take them as directed on the pill bottles, or by your surgeon. If you take the first pill before the anesthetic has worn off, you will be able to manage any discomfort better. Precede each pain pill with a small amount of food, and chances for nausea will be reduced.

The effects of pain medications vary widely among individuals. For severe pain, you may take your prescription opioid (narcotic). Do not take more opioid pills, or more often, than prescribed by your surgeon. If prescribed, Vicodin® / Norco® may be taken every 4-6 hours for pain. DO NOT USE TYLENOL. If you notice that the pain medication is not providing comfort for long enough, alternate the Vicodin / Norco and Ibuprofen throughout the day (ex: take 1 Vicodin, then 2 hours later, take ibuprofen…2 hours later another Vicodin / Norco). If you are unable to achieve a comfortable state, please call us for further advice. Do not drive or drink alcohol while you are taking opioids. Do not use opioids with benzodiazepines, sleeping medications, or other depressants. If you have any questions, ask your surgeon or any pharmacist before using these medications together as they can increase your risk of an accidental overdose.


Vicodin® / Norco® and ibuprofen pain medication. Take every 4-6 hours as needed for pain. Be sure to take the Vicodin / Norco every 4 hours so that you can stay ahead of the pain. Most adults can take up to 800 mg of Ibuprofen every 6 hours (Motrin or Advil) in addition to the Vicodin for a limited time. DO NOT USE TYLENOL.® If you notice that the pain medication is not providing comfort long enough, alternate the Vicodin / Norco and Ibuprofen throughout the day (ex: take 1 Vicodin, then 2 hours later, take ibuprofen…2 hours later another Vicodin / Norco). Do not wait for pain to start before taking medication. If you are unable to achieve a comfortable state please call us for further advice. If you are given antibiotics make sure to follow the prescription instructions for the proper dosage. Take the antibiotics until gone or instructed otherwise.


Keeping your mouth clean after surgery is essential. Rinsing should not be started until 24 hours after surgery. Use 1/4 teaspoon of salt dissolved in an 8-ounce glass of warm water and gently rinse with portions of the solution, taking five minutes to use the entire glassful. Repeat as often as you like, but at least two or three times daily. You may be given a prescription mouthwash as well, please follow the instructions on the bottle and swish for 30 seconds three times a day. Do not use commonly available mouthwashes such as Scope® or Listerine®, they contain alcohol which is detrimental to wound healing.

Give us a call with any questions or concerns.


Nausea is uncommon after surgery but can occur and be unpleasant. Most often the cause of nausea is the prescribed pain medications. Nausea can be reduced by preceding each pain pill with a small amount of soft food, and taking the pill with a large volume of water. Try to keep taking clear fluids and minimize dosing of pain medications, but call us if you do not feel better. A bit of ginger ale may help with nausea. Do not eat until nausea has completely resolved, then start with light foods and advance as tolerated. If nausea and vomiting persists please call our office. You will not hurt any work done in your mouth by vomiting.


DO NOT exercise or do anything strenuous for the next 2-3 days. Relax and enjoy strolls in the park or a few good movies at home.

Instructions after the third day


If you feel something hard or with sharp edges in the surgical areas, it is likely you are feeling the bony walls that once supported the extracted teeth. Occasionally, small slivers of bone may work themselves out during the following week or so. If they cause concern or discomfort, please call the office.


Eat any nourishing food that can be taken with comfort. Avoid very hot or very cold foods. Do not use a straw for the first few days after surgery. It is advisable to limit the first day’s intake to liquids or pureed foods (soups, puddings, yogurt, milkshakes, etc.) Avoid foods such as nuts, sunflower seeds, popcorn, etc., which may get lodged in the surgical area. Over the next several days, you may gradually progress to solid foods. It is important not to skip meals! If you take high protein, high calorie foods regularly you will feel better, gain strength, have less discomfort, and heal faster. If you are a diabetic, maintain your normal eating habits or follow instructions given by your doctor. You will be on a “modified diet” for the next 8-10 months (until you receive your definitive bridge). You can eat anything that you can cut with a fork such as meatloaf, shredded chicken, scrambled eggs, cooked vegetables, mashed potatoes, etc. If you can hear yourself chewing, it’s too hard. Remember, although your gum tissue will appear healed in about 10-14 days, the implants will NOT be strong for 5 months. Initially, the bone around the implants will be very soft.


If you have any questions or concerns please call us at Greater Ventura Oral & Facial Surgery Dental Implant Experts, phone number: (805) 648-5121. We are here for you. Our doctors are on call 24 hours a day to respond to your urgent concerns. In some instances, cell phones, beepers, and satellites do not relay messages properly. If you do not have a response within 30 minutes, please call again.

PLEASE NOTE: telephone calls for narcotic (pain killer) prescription renewals are ONLY accepted during office hours.

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