Controlling Pain After Implant Placement

Jen, a dentist, asks:

I am getting ready to do my first dental implant cases. I am a general practitioner with residency experience.

What do you usually prescribe for patients to control their pain after dental implant placement and what do you prescribe to decrease swelling? I want my dental implant patients to be comfortable but I do not want to over-prescribe. Thanks for any advice.

95 thoughts on “Controlling Pain After Implant Placement

  1. Oddly enough there is not a problem with post operative pain when placing implants.To the point that if there is swelling or pain a day or two after placement you generally have a problem which should be dealt with.(infection???)
    Even in sinus lift cases now that I only use synthetic graft materials nearly all patients do not even need a mild pain remedy (asprin) the following day.

  2. After 14 years in implant practice , I would always recommend using antibiotics, anti inflamatory and anelgesics
    my choice of antibiotics is either clindamycine, or Amoxicillin, as for NSAID I prefer Ibuprofen 600mg tid plus mild anelgesics such as tyllenol when needed , I assure you that placing implants or performing surgeries in the right technique with least trauma to bone or tissues will make your patient comfortabable and the healing phase uneventful, 90% of my patients rarely need tylenol after implant placement, good luck to you and start your implant practice with simple cases

  3. I am a patient with two dental implants placed in the lower posterior region. I can tell you from experience that there was minimal swelling and no post operative pain. I was given instructions to keep the area clean and free from debris and to take it easy the next day. Having an implant was a lot easier and a lot less pain than having a root canal.

  4. Dear Jen,

    I follow a protocol that includes Clindamycin 300mg one hour pre-op then 150mg TID for 7 days. I also give Decadron 4mg one hour before and then One qid for 3 days. I also have the patient take 800 mg Advil QID starting one day pre-op. My patients have almost no pain or swelling and I have been placing implants for six years. The ones I have the most problems with are those with GI disorders and they can’t take NSAIDs. Tylenol or T3 are not very good for reducing inflammation. I also tell the patients that if any of the medications cause an upset stomach or diarrhea then they should discontinue everything and call me ASAP. The Clindamycin can be hard on the GI tract ( pseudomembranous colitis).
    I have never had to prescribe a narcotic for implant surgery and I can’t understand the horror stories that I sometimes hear about other patients and their awful implant surgery experiences. Good Luck with your case.

  5. If you follow proper infection control during surgery,you do not need antibiotics.
    AND EVEN IF YOU WANT TO PRESCRIBE ANTIBIOTICS JUST INTIAL PRE-OP LOADING DOSE OF AMOXICILLIN SHOULD BE ENOUGH unless you are doing GBR WITH IT.
    There is no need for clindamycin or heigher antibiotics unless patient is allergic to amoxicillin.
    And forget about steroid or narcotics.Atraumatic implant surgery does not need more than advil or tylenol FOR ONE OR TWO DAYS.
    It is more prudent to prescribe chlorehexidine mouth wash for one week unless patient develops infection.
    Simple implant placement is less traumatic than surgical extraction.
    Good luck for first case.
    I am just wondering;if you have proper implant training you should have known this.

  6. I usually give my patients 800 mg of Ibuprofen PO pre-op then 8 mg of Dexamethasone IM. This seems to reduce the pain and swelling tremendously. Also I use minimal or no flap as much as I can since soft tissue pain is a lot more intense than bone pain.

  7. Jen:
    There is one comment that you should realy pay attention to… Dr. Joshi is reporting the guidlines established by major implant placement centers including the most famous NYU post-graduate implant program. Follow his guidlines. Also using digital radiography allows you to check your placement during the procedure rapidely and effieintly reducing surgery time to a minimum. Please sign up and take a proper course on implants before you go and experiment on your patients. I’m a very experienced surgical prosthodontist and my practice is dedicated to implant surgry and restoration. I face challenges everyday and find that with today’s esthetic demands, there are realy no “easy cases.” If you are confident that something is easy, you might not have enough training to see the difficulties. If you do not wish to take formal training and specialize in Prosthodontics, Periodontics, or Oral Surgery, at least take one of the excellent university/hospital based implant programs which are available across the country to general practitioners. There are many excellent general dentists who place and restore implants, but most, or at least the one’s that I know personally, have taken extensive continual educations courses and surgical training programs to get the proper skill and scientific background. If you were a patient, what type of training do you want your dentist to have? especially when implant surgery often times poses irreverssible risks. I wish you luck.

  8. As a patient that has undergone sinus lift and extensive implants, I suffered alot of pain and swelling. My face swelled up and bruised so much it looked and felt like I had been beaten up. Even the area around my eye area was bruised.

    I was advised to just take paracetemol for the pain. However, within a couple of hours of taking them the pain relief wore off and the pain was excruitiating. The only way I ended up coping with it was by buying the highest strength Ibuprofen and paracetemol I could buy over the counter and alternating them every two hours for about four days after the surgery. A friend very kindly gave me some strong painkillers she had been given when she had had back pain.

  9. At NYU the standard was 2g Amox an hour before the surgical procedure followed by one 500mg dose every 6 hours for 7 days.We loaded the pt on 600 mg ibuprofen at the same time as the loading dose of AB.In addition peridex oral rinse was prescribed to be used twice a day until finished usually 2 weeks. I’ve used this regimen for 7 years and never had a problem.I’m certain it has alot to do with how long thepatient is kept open. In training these patients are kept open much longer than in skilled hands and private practice.As mentioned earlier in the posts digital x ray is a blessing too.I haven’t used anything but Ibuprofen 600 for post op pain.Most of the time the patients report that they took one or 2 tabs more out of anticipation than need. If the surgeon is proficient in what they’re doing they should be in and out.I’m not saying rush,I’m saying feeling 100% in control get in do the job and get out. The patient will be the winner.

  10. My dentist put a implant into my mandable nerve and 8 months latretr Iam trying to control the pain by using medicines that make me wobbly.Is it too late to remove it and whatis much complex Thanks Paco

  11. Hi Jen,
    Welcome to the exciting world of dental implants.
    since all patients response differently it is good to be on a cautious side, especially since this is your first case.
    your concern “control their pain” and “decrease swelling”
    is related.
    Motrin I find is the simplest and effective mean to do both. I would start the motrin 800mg an hour before the surgery and tid for 1 day. (even if the patient does not have pain. this high dose will help control the swelling. I usually dispense about 8 tablet of 800mg.) thereafter motrin 600mg q6h prn pain, give an Rx.

    Antibiotic is given to minimize the chance of infection. rx 500mg tid for 7 days. patient to start on the antibiotic the night before the surgery.
    Good luck

  12. i had 4 implants on my left and 4 implants on my right jaw. my righr has no problem at all. my left had swelling and numbness i went the next day he removed 2 swrews amd inserted 2 smaller ones. i still feel a numness on jaw and sweling, there is no pain. please advise.

  13. I just had an implant placed this morning.

    I was given no antibiotic pre-surgery. I am to take 500mg Amoxicillin 3x a day for 23 days. Isn’t that a bit excessive?

    I am also to take a 6-day course of methylpred.

    I was told to take 400-800mg of Ibuprofen as needed for pain, and a prescription for Hydrocodone that I have the option to fill if my pain gets bad enough.

    The pain is not unbearable, but it’s bad enough that I am taking the Ibuprofen.

  14. I wouldn’t prescribe any antibiotic for my implant patients before the operation unless there is a strict indication for A.B. prophylaxis upon their systemic health status or their past medical history,and, I wouldn’t ask the patient to take them more than 10 days in the post-operative course.Ibuprofen 400 mgs t.i.d or Acetaminophen 325 mgs+Codeine 30 mgs p.r.n, has always been fine with my patients and I have never heard them to complain of pain or discomfor.

  15. Amixicillin 500mg 3x a day for 7 days + Ibuprofen 400 mg 3x a day for 3 or 4 days are fair enough. Ice paks applications on the sheek facing implants are very usefull
    Dr Elie Victor DDS

  16. As far as I know, multiple studies have failed to show any effectiveness of ice packs or cold applications in reduction of post-operative pain, facial swelling, trismus or even edema.The latest was a South African study by van der Westhuijzen et. al. which was published in International Journal of Oral and Maxillofacial surgery (2005: 34: 281-286).

  17. I had 2 implants placed last week.I was given Amoxicillin 2g/6days + Prednisolone 60mg disp tab /3days + Paracetamol as needed + many ice packs. The pain was minimal during the first 3 days of the treatement.
    After the 3 day i felt a terrible kidney pain at night;it was unbearable. I reduced the dose to 1g /day. Now I feel better:no pain,no swelling,no infecions.
    I m ++ worried about the side effects of the medication cause i’ve just started a long rehabilitation plan i have to extract the third molar,place other implant …etc .Thanks for any comment.

  18. So why was I prescribed a 23 day course of antibiotics? Is there any precedent for doing that? My case was very run-of-the-mill …nothing unusual as far as I know. I had no pain after the first day, btw…no more need for pain meds.

  19. Hi,
    I have a new implant (upper jaw) after wearing a temporary. Each time the dentist tried the permanent implant he had to give me novocain because it was painful. I had the implant cemented in permanently 11 days ago. I have had pain and a strange sensation in the area above my upper lip. It feels as if the implant (tooth #10?) might be screwed in too tight. Could the implant be pinching a nerve? The dentist checked my gums and filed the sides of the implant today. I am still in pain, and concerned about my options at this stage. I haven’t slept through the night for over a week. I would appreciate your advice.

  20. If an implant hurts take it out. They do not get better and you should not be in pain.

    I have been placing implants for over 17 years and even though I really want them to stop hurting, when one hurts, it never gets better.

    Remove it now and let it heal for several months and then do it over with a bone graft. You will be glad you did and it IS worth it.

  21. I am now six days post-op; had a sinus-lift with bone graft and two implant posts placed. Was prescribed Hydrocodone and an anti-biotic. The pain is unbearbale, espscially at night. Double-dosing with the Hydrocodone licks it, but takes an hour to kick-in, makes me stupid for hours, and seems to affect my heart rate (30bpm) and respiration. I’m cranky, easily startled, and in constant fear of reocurring uncontrolable pain. This is hard work.

  22. Generally, mild or low grade pain around 4 days post-surgery is normal. Depending on the nature of the surgery and the amount of “stretching” of the tissue during suturing. If it’s been more than a week and pain is still constant, then I would agree with the previous posts about removing the implant, regraft, heal, and re-implant months later.

    I have done full mouth cases with block grafting, sinus lifts, and ridge splitting and I never needed to double doses of drugs. There will be pain but it should be better after a week or so.

    The times that I have persistent pain usually is a sign of early failure. If you have an infection associated with the sinus lift, then removal of the graft maybe necessary.

    Nobody can give definitive answers without seeing the full case. Implants shouldn’t be hard work for the patient…

  23. Hi, I’ve sent my question several weeks before but haven’t seen any response! I had 8 implants June 14 in the maxilla. I had previously received bone graft/sinus lift Oct 5 2006 and second bone graft Feb. 9, 2007. I had excruciating pain after the implants were placed! My doctor kept saying he did not know why. The ridge has changed as the “denture” I was using prior to June 14 will not fit. I still feel tremendous pressure at all the implant sites. Is that normal? I’m now playing a wait/see game and don’t want anything more done to my mouth until the pain quits.

  24. Thanks for a response. I’m wondering if it’s normal to have the “pressure pain” as I’m feeling. Because of abuse I had several upper teeth pulled 44 years ago at age 12. No denture would stay in so I had to start this whole procedure. If the implants have to be removed then what? I now have a “fabricated” ridge as my surgeon said and if all will work out I’m looking forward to a fixed prosthesis. Another question is implant supported bridges or one piece bar with Procera crowns? Thanks for your reply. I think that before I was sending wrong and never a response.

  25. I had an implant in my upper left side. I was given an antibiotic before the surgery and given a mouthwash for 2 days before and 7 days after twice a day including saline rinses. (I also had to do the mouthwash 5 minutes right before the surgery.)I was given 600 motrin prescription. Only took it for one day. There was not much pain after. I would much rather do this if I could afford it vs. the bridge I almost had to have. Pretty happy with the results and would recommend it!

  26. I had a tremendous implant failure on a patient in December. I had placed 2 implants and this one was a little red 2 weeks later. The short of it is that it failed and without pain. It looked very normal after 2 weeks and after 5 months. I uncovered it to find a mess. The patient is now happy but things CAN happen under the best of circumstances. If you are having pain, check it out and do not load these with anything until there isnt any more pain. Pain is an indicator that something isnt right. Something is happening to promote it. Find out why.

    My SX/ABX regimen is different for different patients. prior to SX, I give 800mg ibuprophen and Amoxil 2g 1 hr prior to SX . Then 500mg amox qid 5-10 days. If there is a sinus lift, I go 7-10 and premed with a medrol dose pack. Peridex to blot site with a cu-tip q 1 week following SX, not swish. For pain, 600mg ibuprophen and .0-1g tylenol q6-8hr for the next 3 days if need be. Take the NSAID anyway for antiinflammation. Very occasionally, I’ll give a few Lorcets or Darvocets but they always come back saying they didnt need them. I dont routinely rx narcotics for implants – dont need to. If something is going to hurt, I dont want it covered up. it may be early surgical failure as previously mentioned. If someone has to take clindamycin, I give 600mg before SX and 300mg qid for 5-10 days depending on their health, age, etc. I also imcorporate clindamycin 300mg/2ml into the graft now. ABX are always a prophylactic measure. An OMFS started me on the Clin and reported that dosage would prevent Clostridium from proliferating into a GI colitis. Whether anecdotal or not, it has worked so far. Bill

  27. I’m a patient. My first implant failed to integrate and was painful for five months. Although it didn’t integrate well enough to use (or not be painful)it was difficult to remove and tool provided by the implant manufacturer didn’t work well at all. It has now been two years of messing around (grafting and so on) and I just got my second try five days ago – it is still very painful. Let’s hope it works. Implants may be a good idea but they ARE NOT without complications. To make matters worse, the implant manufacturers don’t plan for them when the do occur.

  28. I have a question similar to Karen’s.

    An implant was placed in my number #10 slot. I don’t have constant pain or anything that keeps me up at night. However, I have little sensations of pressure occasionally.

    I have a plastic retainer that covers all of my upper teeth and rests against the gumline. The fake tooth for #10 is part of that plastic but a space has been cut away for the implant. Would the retainer be putting pressure on my gumline and cause the implant to ache a little?

  29. I don’t know if it’s okay for me to say something about Kate’s response about the “pressure” but that is what I’ve had problems with since June 14 when the 8 implants were put in. Obviously I have an interim denture and when it’s in I feel an almost throbbing pressure. The denture fit great before the implants and then afterward had to be modified. I did mention this site to my surgeon in that others have experienced pain so he did more checking yesterday. One implant feels not okay. I don’t know how to describe but not okay. He just said I may have a “sick” implant. Whatever that may mean. I’ve had all the grafting etc. going on since Oct. and sure hope it’s not “sick”. Does everyone feel that pressure? Without the denture it’s better or at least if I don’t touch the ridge.

  30. Sorry but here’s another question. My tissue has completely covered 3 of the implants so how much pain is there to do a “punch” for the abutment? I’ve had so much pain that I’d like to know beforehand. And is it okay that the implants get covered? I’m waiting for 6-8 months before a fixed prosthesis as I’ve had so much trouble with the graft.

  31. It has been five weeks since I had two implants. One implant there was little or no pain, The other implant was the worst pain imaginable- worse than child birth. I had the tooth next to it removed. The Dr thought that was the problem. Two weeks after having my tooth pulled I am still in the worst pain. the Doctor insists the implant is good. I am taking ibuporfen and sometimes stronger stuff. I am going to beg the Dr. to remove it. I am getting depressed and it is becoming hard to function.

  32. Sir,Dr. Mehdi Jafari,
    Please kindly explain in detail and favour me to understand effectiveness of ice packs or cold fermentation in reduction of post operative pain, edema, swelling and trismus? what is your supportive advice for the patient to make him/her more comfortable other than medication after implant placement like; saline gargles, diet etc.?
    kumardental@yahoo.com

  33. Dear Baffled,
    Please give more details like where exactly in the mouth and type of pain. Is the pain continous, or throbbing, or off and on. Is it getting less or more,etc. Xray pictures and other scans. Any swelling? Do you have any medical condition? What other medication are you on besides for dental purposes? What did your dentist say that you think might be helpful. Give all the details possible and very likely we can give you the lowdown on it.

  34. I was given 4 implants right side upper.. THe first 3 days I was fine but by the fourth I had excruciating pain in the region. I tried the Percocet . It made me sick. I then got Vicadin and I became violently ill. I have now tried advil-800 mgs. which seems to work but makes me tired. Does it sound like the dentist did something wrong? Why I am in pain almost a week later?

  35. I wanted to add from the last post that I also got a bone graft using my own blood and bovine?
    Does it sound like the implants are pressing on a nerve?
    thanks for you help
    ps: If I had known I would have been in such pain I would have never gotten the implants/

  36. Implants should be relatively pain free , grafting with bovine products can cause a foriegn body response which could be an issue.But generally if there is intense pain ,could be a problem ,consult your surgeon..

  37. Dr. Fairbairn,

    I would like to respectfully disagree with your comment about foreign body response associated with bovine bone (like Bioss). I am aware of literature on delayed resorption but not on foreign body response. If you have any I would be interested.

    Pain around the 4th day is not uncommon with large grafts. Certainly not excruciating pain like the one Dave is explaining but some discomfort is not out of the ordinary. Pain from nerve impingement is usually continuous after surgery and not in the maxilla…at least not that I’ve heard of. I have placed implants in the incisive canal but they were never associated with nerve pain.

  38. Sounds Like you need to take another course to get some more training…placing is easy…it is how to maintain and restore is the hard part. Good luck! Dr. Callan has a great course in Little Rock that might help you for future cases!

  39. I had 2 sinus lifts on both sides (upper). I need to take pain medication (tylenol, or 600 Motrin ) every 4-5 hours. Why do I suffer so much after 2 weeks???? Is that normaL? I also have a constant headache.

  40. Hi, again. I sent a question a few days ago but haven’t had a response so will try again. I had first bone graft/sinus lift Oct. ’06 and then a second graft Feb. 07. The 8 implants in the maxilla were placed June 14 ’07. I’ve had off and on pain/pressure but in the past 3 weeks am sluffing off more bone pieces with some white stuff. I’m not sure if it indicates an infection or failure? The “pressure” feeling has intensified but I want to know if this is another “normal” thing. I am wearing an interim denture which I remove at night and then all the gum tissue swelling goes down. However, within 1-2 hours of wearing the teeth the gum swelling resumes. I read all over of implant problems. Am I going to be a success or a failure? I appreciate any response!

  41. I have been undergoing implant placement (full mouth w/exception of teeth #22-27). Upon initial extractions of 4/05, #27 had 1+-2+ mobility & moderate bone loss (I had periodontal disease w/some deep pockets). Now #25-#27 have bone loss w/receding gingiva. Originally I was told that augmentation was possible for that area & now I’ve been told no it won’t work.
    The work is being done @ a dental college by a graduate pros. student. I also have a high smile & have been advised that the crowns should have a pink flange to avoid having unnatural size crowns on the sides which I don’t want to do. Is there another way around this?
    I have had numerous complications especially a failed sinus lift w/development of a fistula, bone & soft tissue destruction & blocked osteomeatal unit. I eventually need debridement since the infection never resolved.
    Thank you.
    Sincerely, linda y

  42. dear Karen,i read your email and will try to answersome of your questions.before i do that u should understand that communication this way isnt complete and full since there is no direct contact.still,loosing stuff from your nose that being bone pieces or that other”white stuff” is NOT a good sign.possibly your bone graft wasnt succesfull,meaning that it hasnt turned into strong condense “own” bone.the pressure and swellinwg feeling u describe after this time is ANOTHER bad sign/symptom.the different procedures u underwent are pretty serious and discussing over the internet about them isnt enough.obviously u need to explain all this to the fellow practicioner who perfofmed the various procedures and see what he has to say.only then and if his explanations and help isnt enough for u,u should seek someone elses professional opinion.in any case ACT NOW since the symptoms u describe are serious and need accute,professional HELP.hope i was able to help u a bit.

  43. Hi, again. I asked a question Oct 17 and received a reply but now here’s the problem. I saw the surgeon today and a new pano was taken. After 1 hip graft Oct 06 and a bovine Feb. 07 I’m still having small pieces of bone come through the tissue. I had 8 implants in the maxilla June 07. Two in the front are small because of so little bone. The pano today showed that between 2 implants on the right side I’ve lost the bone from there. So, my surgeon says it’s okay to still use 6. One on the right in the back, the 2 close together (smaller) in the front and the 3 on the left side. I’m supposed to have the fixed super-structure. Help. From what I’ve read 8 should be the minimum for the maxilla. I still have some pain (not bad) where the bone pieces come out. Is there any place I can research this? What would you do? Thanks for your help.

  44. dear Karen,again ill try to adress your questions.1)you dont need to be a dentist to understand that having 8 implants supporting a fixed prosthesis(bridge)is BETTER than having 6.whether 6 are enough isnt a simple question to answer(and definately shouldnt be answered by a surgeon).other factors such as what kind of dention(teeth) you have in the lower jaw,your food habits and expectations,how well the remaining 6 implants are osseointegrated(stuck in the bone)SHOULD play an important role in the RESTORATIVE DENTISTS(prosthodontist,implantologist or general dentist)mind in taking the decision,as to what kind of prosthesis(teeth)you should get.

  45. 2)the fact that you continue to “have some pain and loose bone pieces 1 year from your 1st graft and 8 months after your 2nd graft ISNT a good sign.this is further supported from what you sayabout the panoramic xray you had.3)let me ask you smth which drew my attention in your last email.if i understood you correctly, you said that the surgeon informed you that 2 implants on the right side have failed.is this all he said?didnt he/she advise you as to what to do with them(for example extract them)?4)and most important to my opinion.YOU MUST UNDERSTAND THAT SUCH MATTERS CANNOT BE RESPONSIBLY DIAGNOSED AND SOLVED OVER THE INTERNET.yes we can dicuss them,exchange opinions even enswer questions

  46. but NOTHING can replace live face to face interaction.from your messages it seems to me that you have some serious concerns about your situation and for some reason it seems your surgeons answers arent enough for you.THE RIGHT THING TO DO if my assumptions are correct,is to SEEK A SECOND OPINION BY MAKING AN APPOINTMENT AND TAKING ALL INFO AND QUETIONS YOU MAY HAVE THERE WITH YOU.hope my message has cleared things a bit,will look forward to news fom you.

  47. To George Koukos, thank you for all your comments. My appt yesterday was brief as the surgeon had to get to the hospital for an emergency so I came home with all my questions. He said that in other countries doctors use less implants with great success so I should be fine. There showed black between the 2 implants but he said the remainder of those 2 “look to be in solid bone”. My cost is over $50,000 due to damage from child abuse 44 yrs ago and with all the problems I had this past full year I’m not willing to risk using 6 for the titanium fixed/porcelain structure. He said he didn’t want to have to put more bone in…hence another wait? What would you advise your patient to do?

  48. Sorry, another PS……..what if another implant fails later? I choose 8 because I was afraid of any failure so now I’m down to 6??? Now what? AND I DON’T EVEN HAVE THE FIXTURE IN YET. Thanks for your comments. You supported what I was thinking.

  49. dear Karen,thank you for your swift response.i must admit that the more info i get from you,the more puzzled i get about the situation you are in.let me try to adress all your questions.1)your surgeon must decide whether these 2 implants on the right are worth keeping or not.if no,they should be taken out.keeping them in can potentialy cause you problems(inflammation,swelling,further desytruction of bone).POTENTIALY.2)if the info you have given me is accurate i would suggest getting a removable prosthesis on your remaining implants.this will obviously not be as stable as a fixed one but will give you PLENTY of stability(believe me)and most important wont apply as much pressure to the implants,thus helping them last longer.

  50. furthermore it will enable you too keep a better oral hygiene.obviously you will hear other opinions stating the various pros and contras.each with his/her opinion…3)i am a foreign dentist who has received years long implant training in the implant center of one of the leading universities of the US and am practicing implant dentistry in Europe for years now.let me tell you that dentistry and implant dentistry has very little difference here or there in its basic principles.some differences excist but they are secondary.PLEASE TAKE MY ADVICE AND SEEK A SECOND OPINION.will look forward to news from you

  51. i had an implant placed in my upper right premolar area two days back. some bone graft material was pushed in the socket due to a low lying sinus as i was told.

    i have had pain for the first day which dissapeared on the second day but mild swelling without any pain persists.i had been put on three days of antibiotics which finish tommorow.

    i have been told to wait up for 7 days before i receive another implant for the molar on the same side.

    i want to know if the pain and swelling is normal and the treatment planning is as per norms

    thanks

  52. I thank you for your opinion about the removable/fixed choice. I’ve had an upper denture since age 12 and it was at the point that it wouldn’t stay in….no bone. My “dream” was to have “teeth” and it seems that it won’t be a reality for me. I’m 56 and have had a horrible year with all this. I do trust my surgeon and he listens to me when I get info such as yours. I’ve been thinking about the ease of cleaning the removable, also. I see him next week so will ask him about the 2 implants whether to leave them or not. I don’t see how ONE at the right back and 2 little in the front and 3 on the left could support the whole superstructure! Will let you know. THANK YOU SO VERY MUCH for “listening and giving advice!”

  53. Hi,
    I had a dental implant done 5 days ago. The first day and a half were fine with very little pain. The last 3 1/2 days though I have had EXTREEM pain around the implant site. I went back to the dentist today and they could find nothing wrong, no infection,etc. They said that maybe it is the little nerve endings growing back. I have never had this much dental pain in my life. Why would I hurt so bad if pain normally is not a problem with this procedure? please help, I am tired of hurting so badly.

  54. dear Karen, you are wellcome.i am sending you all the info i can hoping itll help you a bit.a small reminder:a simple denture or even a partial denture supported on a few teeth and a REMOVABLE PARTIAL DENTURE IMPLANT SUPPORTED are 2 different things,believe me.a good planned and manufactured prosthesis like that can meet very high standards and expectations,believe me.I have plenty of patients who live many years very satysfied with this solution.please thing about this option carefully.To D Axis unfortunately the info you give is too limiteg for anyone to be able to answer your questions responsibly.1)where exactly did you have the bone graft why and kind of graft was it?2)implant placement in a fresh(1 week)graft is an absolute NO-NO.please get back and ill try to help you

  55. I have a dental implant to replace my right front tooth. 2 years ago was the beginning of the implant process.

    The screw itself went in fine and healed completely and cleanly.

    When the surgeon applied the healing abutment, shortly afterward I developed a tiny fistula of pus on my gum. He tightened the abutment and the fistula disappeared.

    Several months later, the fistula reappeared, after the application of the crown. The surgeon cut a small hole in the site and irrigated it, I healed. Drainage (foul-smelling and -tasting) continued from below the gumline, between my teeth, from the implant site. A month passed. The situation was repeated 4 or 5 times, always draining, always healing.

    Finally, 6 months ago the crown was removed, and the cement replaced with a hypo-allergenic formula. A temporary crown was placed. Drainage continued after the site healed. Surgeon gave in a and cut/lifted my gums for closer look, found some chunks of cement, continued to site allergic reaction. Now the drainage STILL continues, and the surgeon wants to, yet again, cut/lift my gums to look for more cement.
    **************************

    Has ANYONE seen evidence of continued pus drainage from an otherwise apparently healthy implant? No pain, no itching… just smelly, white/yellow drainage? Is this a precursor to failure/rejection? I don’t know how much more cutting my gums can handle.

    Thanks you to anyone who has suggestions for biopsy/treatment.
    ~M

  56. Also, to supplement my above (long) entry… The drainage is NOT clear, it’s white and foul-tasting. The drainage appeared BEFORE the application of any cement, and still continues. I have no discomfort or swelling.

  57. I’m not understanding your last comments. I’ve had no upper teeth since age 12 due to abuse. So, now what’s left of the 8 implants is down to 6. One at the right back, 2 smaller close together in the front and 3 on the left. The fixed titanium superstructure with porcelain teeth couldn’t be safe that way? I will see the surgeon Thurs and then go back to the restorative doctor for another opinion. From what I read there’s a huge risk of implant failures anyway. I’ve cried so much with this and wanted fixed to “feel” like teeth. The removable feels like another denture after $50,000. I’ll let you know what the surgeon says as he said nothing about removing the other 2 implants. I hope to keep them to try to retain bone. Any comment about that? Thanks for all your comments and I feel for everyone else that is having problems!

  58. My last response was Nov. 7th so I’ll update now. I saw the surgeon yesterday, Nov 21, and another small peice of bone came through the tissue between the 2 implants and a little higher up where it appeared dark on the pano. I’m also still having “drainage” there. The surgeon said he thinks he needs to open the area up, scrape it all out and then I don’t know what else. He said he needs to “think about it” before my appt next week. He still thinks the 2 implants are “stable” high up and just not between them. What do you think? Would you recommend they not be used or have more bone put in? I started all this October 5, 2006 and even today I’m having the “pressure pain” increasing. Doctor thinks I may have an infection as well. I’m afraid to trust that everything will ever heal to get to the next phase and have a prosthesis attached!

  59. dear Karen,i read your latest post and see that unfortunately things dont go well for you.once again i will advise you to simply have those 2 implants TAKEN OUT,the whole area thoroughly cleaned and left alone for atleast 6 months.dont know what else to tell you to make you understand and finaly find a solution to your problems.if the info you give is accurate,then stop wasting time,have them extracted,the site cleaned and then see what you can have with the rest remaining implants.I am sorry if what i tell you is bad news and disappoints you.think about the bright side:you will finaly stop having pain and other symptoms there and move on to the restoration.take care.

  60. Again, thank you for your comments! I do understand what you are saying as to the removal of the 2 implants. One last question is that the 2 implants feel “stable” as the surgeon says so he doesn’t believe they need to be removed. Only most likely to clean out. I’m assuming he’d add more bone but he said that the pano showed the ends of the implants were in “good, solid bone”. Would you recommend they still be removed? Or is it safe to just add more bone and do the wait process again? I’ve told the surgeon of your suggestions/comments on this site and he always listens. Think I’ve become his worst problem case!

    “Meech” from the post along with mine sounds like he’s got the same problem as I do with the drainage. The bone fragments (tiny) have increased with the drainage. Hope my comments will help Meech…………..
    Again, thanks.

  61. dear Karen,the question whether to remove the implants or not is a difficult one.different people will tell you different things.trying to remove implants which are partially osseointegrated(FIXED IN THE BONE) can be a pain….what i know certainly is the following:1)get the site thorougly and responsibly surgicaly CLEANED.2)adding bone there especially at the same time of the cleaning will most certainly ADD NOTHING.it will only cause you further infections(and everything which comes with it,pain,swelling).it will also cost you money,which i am sure you can use for your prosthesis.3)if the implants are not in good bone your restorative dentist TOGETHER with your surgeon should decide if they should be used for the prosthesis.4)no patient who listens and follows drs orders should be “a problem case”be well.

  62. Oh, it’s so disturbing to hear this process for you Karen… I have heard that to be removed, an implant must be cut out – a U-shaped chunk of bone and all – when it fails. I sincerely wish there is some other healing option for you.

    I myself am going to see another surgeon – a periodontist who also specializes in implants. I have never received bone grafts and I only have one implant, but I should not be having drainage at all. I will update my results if it is helpful.

    Are you sure the pieces coming through your gums are bone? I saw some white flecks come through a hole in my gums months ago, but it turned out to be cement from the crown application. My surgeon at the time said that if it was pieces of bone or tooth, it would be black or decayed. But I guess by now you’re sure it’s bone.

    Good luck to you; I am interested in what happens next…

  63. recently (several weeks ago) had implants started. All seemed well until about 1 week after surg. Terrific pain eminating from the bottom side of site (lower jaw) where one implant placed. OS reopened-stated everything looked fine. Sutured up, approx 1 week passed again and developed terrific pain at same site-pain above at drill implant site is mild Is removal of this implant warranted-can hardly take pain felt in the bone?

  64. In response to Meech: none of the pieces of bone have been black. All white and the surgeon himself has helped a few finish coming out and the pressure increases until it does. I have a lot of drainage now as well.

    To George Koukos: My surgeon plans to open up the area, clean it all out and then wait. Again. I’m having drainage most days. Because of my work schedule I cannot have the procedure done until Dec. 28 and the doctor is not happy about the delay. So, we’re making sure it doesn’t increase. Why the drainage? If I understand correctly you recommend to wait before adding more bone? Or will it grow in by itself? I do not want to lose any of the implants! And I want all to be available for the prosthesis. I am truly tired of this. Most of the time I have a lot of pressure and I just want it to heal.
    Thanks for giving me so much info. The surgeon sees me weekly most of the time. Since Oct ’06 I’ve had almost 60 appointments! Again, thanks.

  65. I have avoided being opened up again so that another specialist can culture the bacteria around my tooth. Painful – jamming paper points under my gum – but less invasive than another flap cut. :(

    If the bone in the front of my implant has become thin or developed a hole, I may need bone/tissue grafting, but the fist step to most gently diagnosing the drainage is the cultures. Results in about a week.

    I am very interesting in hearing others’ implant adventures; though sad, it provides a bit of “peace in numbers”. :) Best of luck; I’ll check back.

  66. dear Karen i think you have misunderstood me.and i am sorry to say,i think either you cannot understand what i am telling you or you donnot want to understand them,cause this is bad news for you.if you read my past comments carefully,you will see that from the beginning i keep advising you the same things and keep repeating myself.1)get the site cleaned NOW.not tommorow.not the day after tommorow.your business schedule and everything else is secondary.if what you tell me is true about the drainage is accurate,you should understand that you have a focus in your body(an area full of germs,puss)which apart of the damage it does to the bone in the area,it also can potentially through blood circulation infect other parts of your body)small chance, but still considerable.2)DO NOT attempt a second graft on this area EVER.period.especially do not do it at the time of the cleaning of the area.grafting around these 2 implants,regardless of the time performed wont add anything to the stability of them.it will fail again and cost you more frustration and money.3)i undersatand that you want all implants part of the prosthesis and i also understand that you are tired of all this procedure and pain.still, i MUST observe that you continue to hit your head on the wall instead of trying to go around it.for gods sake seek a second opinion(surgical) and AT LAST visit the professional who has the responsibility of restoring the implants(prosthesis)to discuss your options.i appologise if what i tell you sounds harsh or cold blooded to you.please understand that the advise i give you each time is based on my professional knowledge and ethics and ALWAYS for what i believe to be your interest.hope i helped you a bit.take care

  67. Update. My surgeon has decided not to go in to clean it out as the inflamation has subsided for now. Still a few bone pieces. My next appt is not till the middle of Jan. if all goes well. Thank you for your suggestions. The implants are not loose at all so that’s good.

    With all that’s gone wrong I’m now leaning to not having any prosthesis made at all. The problem area is still sore and I’m not willing to put another $20,000 or more into a prosthesis if there’s a chance of failure of any kind. I’m wondering about just another denture that will fit the implants. Have you heard of anyone doing that? The metal part hold the “interim” denture keeps it from slipping around as well I now have bone again and won’t lose it with the implants in. You have to remember that I’ve had a denture since age 12 so it feels “normal” to not have teeth. What do you think?

    The only reason that I started this whole thing was that nothing (denture)would stay in any more. I had no idea what the complications and expense would be. And the high risk of failure. I said I wanted “teeth” and the prosthesis feels to me to be just an expensive fixed denture with the palate uncovered which feels foreign to me. Have you any comment of my choosing to not have any prosthesis made?

    Thanks

  68. To add to the above…what I have are abutments. 8 of them. Can they be left in as they are and just have a denture made with them? I’m searching all over the internet to see what I can find out……

  69. Karen
    Why is your surgeon and Prosthodontist not giving you these answers?
    I would be a little concerned if my patient had a need to search the internet for information
    I see it as a failing on your DRs part not ensuring trust and total understanding
    You must get a second oppinion in the light of the questions you are asking
    It is very difficult and potentially damaging to try to diagnose and help you like this
    You cannot possibly provide the requisite information with written words
    You also cannot search the internet to solve your problems as you cannot possibly know what is clinically and radiologically relevant
    If I had all the information in front of me,
    all the notes x rays and scans there will still be at least 2 or 3 ways to handle this .
    The very best and most relevant advice is ..
    Get a second oppinion

  70. I thought this was a site for info other than the local DRs. give. I’ve not seen the restorative DR. since early June when the 8 implants were put in. I’ve had many problems and only now my surgeon thinks I may be able to go to the next step of having something made. Only IF no problems in the next month! I’m asking if anyone has heard of a patient deciding NOT to have a fixed/removable prosthesis after implants? Just a denture as I’m used to having over 45 years. I recently thought of it and don’t see the surgeon till mid January. Only after that will I see the restorative DR. So, I was asking if anyone knew of this as a possibility.

  71. This again is a sign of a serious failing in planning on your Drs side
    There is no way the surgeon should be designing the set up for the prosthesis if he is not doing it!

    Karen I sympathise totally , we as a profession (through your surgeon) are letting you down .
    It is an irritating example of the specialist in one field dictating in the whole treatment plan…
    And assuming he can change it according to his failure rate
    I wish your surgeon would step into this arena and offer your case as a discussion amongst his peers here

    You should have been seen FIRST by the restoring Dr, who is the conductor of the orchestra, who then refers you to the Surgeon for his expertise for very specific work DICTATED by restoring Dr
    They should never have stopped communicating from the very beginning
    All restorative options should have been laid out clearly in writting to you
    modifications or failure should either be corrected (re implanted)or a second letter to you advising of options from the failure onwards
    This is ELEMENTARY implantology and I find it appalling that a specialist in one part of this discipline is dictating the entire coarse of treatment
    If I am a pastry chef I dont get to do the wine list
    You are paying for it and you deserve it
    If you really want help from the proffessionals on this forum….
    Get your current panoramic x ray and submit it on to this web site on the appropriate section ..I se e others presenting cases
    The Dr s here are conscientious and you will find a far better oppinion than we can possibly give you by text

    The generic answer to your question of what you can do from here
    a) You can have a fixed on six implants IF the 6 are well integrated /well positioned /big enough bone to metal surface area /longer and wider implants better and the Restorative guy knows what he is doing
    b) you can also have a removable almost certainly /it will be much better than a regular denture
    c) You could replace the 2 failures (I personally would provide these at a much reduced cost or free) if i placed implants that failed so soon
    d) Do nothing and wear a denture as before
    Yes… but this seems pointless
    Consider posting your x ray, you will get a lot o f guys giving you very valuable and pertitnent information on this site
    Good luck
    Dr SS

  72. I currently have all implants placed (8 maxillary and 6 mandibular-trying to keep #22-#27). 11/7/07, a day after having mandibular impressions for permanent crowns, I awoke w/intractable pain rt. mandible,ear,neck and head (all rt. side). started ees 400 tid w/decrease in jaw pain only to rebound near time for next dose. pain then started to occur rt. rear maxilla which has been intermittent along w/rear mandibular. finally saw dds after ees for over 1 mo. while waiting for ent appt. also couldn’t breathe though rt. nostil. after clinical exam and x-rays told not dental and to f/u w/ent which I did following day. after pressing face approx. 1″ ant. to rt. ear he said it was dental, but insisted on cat and audiol. exam-both neg. and said to tell dentist result of consult. did same and have not heard from since I left message.
    this ent was the one who dx. alpha strep infection from fistula which developed after failed sinus lift which I mentioned in another post. any ideas? many thanks.
    sincerely, linda y

  73. dear Karen,i read your lasts posts and realise you still seem not to have understood and followed ANY of the advise ive given you.i was suprised to see that although another collegue(Dr SS) gave you EXACTLY the same advise,you keep on asking the same things over and over again as if you havent read anything of the things weve been writting here.i must add that i totally agree with each and every advise Dr SS has given you out here,some of which i couldnt have stated better.in any case,saddly i must inform you that i have nothing else to advise you.read the past posts both by Dr SS and me and you will know what to do if what you sat is true and accurate.unfortunately,i have nothing other to advise you and help you with.take care

  74. To Dr. SS I must reply to the comments! My surgeon is NOT dictating what the final will be. The restorative DR let me think that “sure, I can have this or that” but without my understanding all the complications along the way. I have not seen her since June when the implants were put in. It’s not necessary to go back until I’m healed OR until the surgeon feels that the inflamation or whatever is okay. He is in communication w/her!

    My last question was answered (by you)as far as just having another denture made to fit now that I have bone and implants to stabilize it. I know that it seems costly to do but at least there won’t be any future problems of implant failure with the prosthesis depending on any one of the 8 implants.

    Thank you for your comments and I will continue to wait until all the “problems” have been resolved and I choose which direction I want to go. Implants are risky and I only wanted to have something that would no longer fall out while eating/talking/laughing. I will not request any more of those on this forum and I hope that others with my complications will benefit from what I’ve submitted.

    Thanks again.

  75. On Dec. 29, 07 I inserted four implants (#28, 29 and 30 on lower right side, and # 19 on the left) Since than I had pain, especially on left side, which required pain killers for 6 or 7 nights. I took amoxicillin for seven days following the procedure. On right side, my canine (#27) originally very painful apparently from closely installed # 28 implant, subsided somewhat, but still the nerve is sore and uncomfortable after all this time.

    I complained of the pain to my dentist. He took X-ray of #19, it shows black area (about a mm deep) all around bottom of that #19, 10 mm-long implant.(There appears to be enough space between nerve with all 10 mm fully seated). The dentist called it some bone loss, but he is not sure what is it, may be infection. He said that it makes no sense to take another course of antibiotics since amoxicillin did not get rid of it during this past week anyway. He thinks that it should be no pain after two weeks and will remove it if no improvement follows. He did not take X-rays from right side, which he took during drilling holes.

    The last couple days, when I thought it was an improvement (because one day it appeared that pain was gone from left side)it returned again, and I again started to rinse with salt and soda.

    My question is whether it is possible to save that implant, and if so, what should be done. If not, how is it removed at about post three weeks and what will happened to my bone since the hole should fill out – should any filling material be put in it to preserve it if there is an infection?
    Thank you!

  76. I recently had three implants placed in my lower jaw (Nov.07)…The worst part FOR ME was the stiches coming undone the day after my surgery..I was left with a gaping hole in my lower gum that hurt & throbbed with every heartbeat for 5 or 6 days & nights.
    My Dr. gave me some Hydrocodone which helped, but it was more of a ‘mask’.The pain came right back 4 or 5 hours after I took the Rx.
    My gum has since healed, but I have strange pains that shoot through my jaw, and this creates terrible headaches.
    I’ve told my Dr. about this, and he insists everything is fine. 2 of my implants have healed with the top of the implant exposed, and One has tissue totally grown over it, which will be removed in another month when I return…The implants themselves DO NOT hurt..which I am thankful for, but I wish I knew what caused these headaches.

  77. I had single implant placed in #19 one week ago. Three days later, I developed very tender area straight down from implant near floor of mouth. Have noticed a sore bump down there which has not worsened. There is also sore glands under jaw below same area. No pain right around implant itself. Am taking 600 mg ibuprofen when intolerable. So far, oral surgeon is ignoring me and told me to call if it worsens. I assume this is pain from swelling as it does also affect my tongue. I will give this two more weeks to resolve, then I will have it removed and have a bridge placed. I wonder if an infection is present. I took antibiotic one hour before and for five days after. A very reputable OS placed the implant.

  78. To Dr. SS My update is that I saw my surgeon (the best one around!) on Jan. 9th and his intent was to torque the 8 implants and see what happened. On the right side the 2 back were fine but the third one felt “like metal” and I don’t know how else to describe it. I told him it just didn’t feel “right” so Jan 16 I was under anesthesia (again) and he opened that whole area and cleaned everything out. On the “sophisticated” pano the implantlooked fine. Appeared stable. When he tried to torque it while I was “sleeping” it appeared to be stable but then it started spinning (his words)so he removed it. Now I have more new bone (don’t know what type), membrane, a mouth full of stitches, back on meds etc. and the waiting begins again. He said I can still have another implant there later.

    Interesting thought, acording to all the scans etc.the implant “looked” fine and seemed tight yet it still had not intergrated after 7 months! The biggest clue of anything wrong was the pressure I felt all along and the drainage.

    I’m following the comments of others experiencing complications along the same line as me. I hope my “experience” will help you. This site is awesome for information. My opinion is that if it doesn’t feel right then most likely there’s something wrong and it might take some time to figure out what’s wrong. Have a surgeon that you trust as I trust mine. It just has baffled him that I’ve had so many complications…………..
    He did say that it would be nice if success stories would be posted here as well. So, I will post mine. When it’s all a success, that is.
    Hope I’ve helped someone.!

  79. My Diagnosis: periimplantitis (how anti-climactic)

    My gum pocket is too deep to NOT gather the bacteria causing the recurrent infections… just like a person with advanced periodontis! ARGH!

    Pro: found the cause
    Con: 6,000 dollars so far on a single tooth; no insurance coverage for implant work; a surgeon who chose the wrong implant shape; doomed to recurrent infection no matter how excellent my home care.

    :(

  80. To the doctors who offered advice…..thank you. Thought I’d let you know how my case has turned out for the moment. I had my appt. this week w/surgeon and things were explained to me. Guess the “sophisticated” scan machine did not show the back side of the implant where I was losing bone as well had drainage. During the torquing the implant started spinning so it was removed and only then did the surgeon see a hole going clear up to the sinus. Not through it but at least it explains all the drainage and constant pain. The surgeon was relying on current technology (scan) which did not indicate that failure. Don’t know if I’ll have another implant yet but I’m being steered to choosing a fixed bar removable overdenture thing. We’ll see.

    For Meech, I’m sorry that you are having problems as well. Implants come with huge problems. I hope your is doing better!
    K

  81. dear Karen, i am happy that after approx. 3 months you FINALY came to EXACTLY the same concclusion we have been trying to bring you to,since NOVEMBER 07.VISIT YOUR RESTORATIVE DENTIST!!!spend less time online searching for answers,rely less on your surgeon(how many times do you have to have the same area cleaned?)and go and get TEETH!i am sure thats what you have been waiting all this time after all the troubles and money…good luck

  82. Dear Dr. or anyone that can offer advice

    It has been one month since I had a sinus lift, bone grafting and implants. I was OK the first week, only had healing pain. Then I had an infection which put me in a terrific amount of pain. After two rounds of antibiotics I felt pretty good, the left side face/sinus pain was gone. Week 3 I started feeling as if my face was on fire/burning/inflamed (not to the touch) but it has got me feeling so bad that I cannot concentrate and the inflammation/heat/burning is very painful feeling. I’ve been checked out by an ENT and neurologist and nothing has been found.

    My question is could this be a foreign body reaction to bovine bone grafting? Fifteen years ago I had a very bad systemic reaction to bovine collagen injections that had to be reported to the FDA. I was sick for over a year. I did not know what kind of bone the dentist he was using when he did the grafting. I asked him after I started feeling bad. He said it was bovine bone, but he didn’t think there was any connection. Well, I’m not getting better and don’t know what to do. He said worst case scenario he takes the bovine bone out (within a 2 month period) and replaces it with another type of bone. Is this pretty aggresive or is it an easy procedure? He said he would unscrew the implants and take out the bone and replace. Please help. I am desperate.

    Thanks

  83. Had an implant done 3 days ago, pain now is horrible. whole left side of my jaw hurts. hydrocodone does not help at all. any advice?

  84. I had an implant Upper Right placed 10 months ago No problems. Last week, My crown came out and the Healing cap came out with it. My Dentist replaced it and now I have vague pain in that area, for 3 days Tylenol takes it away.. My Dentist took about 1 hour putting it back. Is this wierd?? Never had a problem before.

  85. Hello Everyone;

    I’ve read all of the above postings and am now wondering if there is something wrong with me: I just had a tooth extraction and bone graft. I was given 3 extra strength motrin before leaving the office. An hour later, I was in excruciating pain. I ended up filling the prescription of vicodin ES that was prescribed, and followed the perio’s instruction to a tee (i.e, took the antibiotics, used the two rinses that were prescribed,used ice compresses, took motrin and the vicodin as prescribed). To make a long story short, I kept waking up all night with excruciating pain and swelling. I didn’t want to take too much motrin and tylenol because I am health conscious and don’t want to destroy my kidneys, liver, stomach, etc.I waited for a reasonable hour and called the doctor to ask for a different pain medication. At my request, she gave me vicoprofen , which is 200 mgs motrin and 7.5 mgs narcotic(I know she would have given me something stronger, but I have had good luck w/ vicoprofen in the past with tooth pain). Since the surgery, three days ago, I have been taking 1 vicoprofen and 1/2 vicodin es twice a day, along with the rinses and amoxicillen. Today, I tried not taking any pain mads at all, and was absolutely miserable, again with the swelling, and pain . Despite all of the antibiotics, I still feel like I have a raging infection combined with the feeling like someone punched me really hard in the jaw. Is this normal? Why is it I always read that this procedure is not painful, and yet I am in pain? Also, I have white stuff caked on the top of my gum where the extraction , bone graft, and stitches are. This, even though I am following the instructions of using a qtip with the one antibiotic liquid and then swish the other antibiotic liquid right after.

    Thanks for any comments.

  86. This is what I read on the FDA’s site:

    Indefinite deferral from donations blood or tissue for ALL xenotransplant recipients.

    Indefinite deferral for all individuals who have had intimate contact with xenotransplant recipients. Intimate contact includes sexual contacts.

    If this is true why are implant specialists using bovine bone?

    Thanks

  87. I had a root extraction and a dental implant placed on the tooth directly behind my upper right eye-tooth (not sure of the number) one week ago. For the first few days, I had minimal pain. 5 days following the implant I developed throbbing pain above the implant and pain in the maxillary sinus. I have been taking Penicillin 500mg qid. I called my dentist and I went in to see him this morning. The digital x-ray did not reveal any obvious infection and the implant did not appear to intrude into the maxillary sinus. The implant was stable. I was given Metronidazole 250mg qid in addition to the PCN and the abx rinse. I also have a “referred pain” to one of my lower teeth and the tooth directly behind the implant. I have pain where the implant is placed if pressed outside on my cheek just to the right of my nose. My dentist also recommended that I take a sinus decongestant and use a nasal saline spray. I do not have any other systemic signs of infection (lymph node swelling, fever, etc.). The pain is tolerable during the day but at night seems to increase to disrupt my sleep unless I take motrin 400-600 mg.
    Does this seem normal? Is there the possibility of implant failure? All looks well on the x-ray. I am in good dental health and this implant was necessary to to an injury during labor. I am very concerned.

    Thank you for any advice.

  88. I am sorry that I forgot to mention that I am a teeth-clencher and when I used the decongestant the pain went away. I feel as if I am on the verge of getting a cold. Could this be the reason for the pain?

    Thanks!
    Tracy

  89. It is now 2 months since I had a left side sinus lift, bovine bone grafting, and implants. I previously wrote that I was OK the first week, but after the 2nd week I had an infection and was in a terrific amount of pain. After two rounds of antibiotics I was feeling pretty good. Ever since week 3 it’s been downhill for me. I have left side face/sinus pain (where the lift was done) and horrible nerve/burning pain all over the sides of my face. I have had a CT Scan, been checked by my GP, neurologist, ENT, and a second opinion by a periodondist/implant specialist. The next step is another CT scan and then go see an immunologist.

    No one can see anything wrong. The only concern I have is could I be having a foreign body reaction to bovine bone grafting or a reaction to the titanium implants.

    Does anyone have any suggestions for me?

  90. I had two implants (11 & 12) in 1/08 – as soon as abutments were installed I developed gum pain – told it would be away from perm. crowns. The pain began in 10/08 – radiating up above my nose. Throbbing all the time. I was referred to dental pain specialist. I’ve had 3 nerve blocks w/relief.. He put me on amatryptoline – made me sick now he wants to put me on Trileptal – I already take 600 mg neurotin for fibromyalia. I’m in horrible pain during the day – after I take 10 mg ambien at night the pain is relieved some – I have gum pain around 11 &!2. Any suggestions. Thanks.

  91. Had my 2nd implant+sinus lift yesterday, both times I had intense pain starting 6 hours after the surgery, lasting 1~1.5 wall climbing hours, and then the pain was completely gone never to come back ( thanks god…). It felt like explosive bone crushing far to sharp to be affected by the general pain killers I pre dosed on. What could be the mechanism behind that sort of effect ?

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