Ann Le All-on-4 implant surgery is a comprehensive and effective solution for gum disease and tooth decay where entire upper or lower arches are missing or beyond repair. Post surgery, you can expect some side effects before the advantages of All-on-4 implant surgery take full effect. These symptoms may include: Minimal bleeding Swelling Stiff jaw and jaw muscles Sore throat or difficulty swallowing Site-specific pain The side effects, if you have them, are only temporary and usually dissipate after one week. Any pain or discomfort can be managed with over-the-counter medication, e.g., Motrin, Advil, or Ibuprofen. It is important to start brushing your new teeth the day after surgery with a soft bristle toothbrush. Keeping your mouth and teeth clean reduces the side effects and prevents infection. Stitches or sutures may remain for up to 3 weeks. Your activities should match your tolerance level. For the first 3 to 4 days, rest. After that time, and again as tolerated, you can begin normal activities and exercise. Diet restrictions, however, last longer. These restrictions can be categorized according to two time periods: 1-2 weeks post-surgery From 2 weeks to up to 3 months post-surgery Understanding what foods are safe post-surgery will help you: reduce the effects of any pain and/or swelling; ensure you are on the path to speedy recovery; and ensure that you can enjoy the full benefits of your All-on-4 implant surgery. If you already have some strict dietary requirements due to any health condition (e.g. diabetes), you should consult a doctor or registered dietitian. A blender will be your best friend post-surgery. 1-2 Weeks Post-Surgery: Eating on a Liquid Diet For a few days up to about two weeks after surgery, your mouth, your jaw, and your throat will most likely be sore, though any pain or swelling will gradually subside. As such, eating can be unpleasant or difficult. A liquid, non-chewing diet is necessary during this time. Here are some things to keep in mind during this time period. First, most discomfort is felt directly after surgery. It may be difficult to open your mouth or to swallow. If your jaw feels stiff, making it difficult to open your mouth, try applying moist heat and lightly massaging it. Second, you can begin drinking liquids immediately after surgery. Within the first 48 hours, try to drink only cool liquids. If you drink something hot, do so only after the numbness from anesthesia has subsided and any bleeding has stopped. It is preferable to refrain from hot or spicy liquids until the third or fourth day post-surgery. Third, you must hydrate. Drink plenty of fluids but in small amounts frequently throughout the day. Drink clear fluids immediately after the surgery and then heavier fluids after the anesthesia has worn off and you can tolerate it. Staying hydrated serves another important purpose: whether or not there is drainage from the surgery, fluids will help replenish and maintain the tissue’s moisture for optimal healing. Fourth, you will be hungry as a result of drinking only fluids and refraining from solid foods the first week or so after All-on-4 implant surgery. At the same time it is important to get maximum nutrition to prevent infection and speed up recovery. Make sure you are drinking fluids packed with nutrition and make sure you are drinking it frequently throughout the day. It is understandable that your intake will be less than normal given you just had oral surgery, but you must keep in mind that nutrition is vital to recovery, and without it you may delay that recovery. The following is a guide of what foods you can eat during the first one to two weeks after surgery. Fifth, refrain from using a straw. The sucking action can loosen blood clots that form and cause additional bleeding and delay healing. What Foods Can I Eat During this Period? There are many foods you can drink in liquid form during the first one to two weeks after All-on-4 implant surgery. The below liquids are examples of what you can drink: Water Coconut water Kefir drinks Fruit juices Tea Coffee Hot cocoa Creamer Half and half Broth (bouillon — beef, chicken, vegetable) Strained or pureed vegetable soup Strained meat or cream-based soups Milk — all types of cow milk from fat-free to whole milk Milk — nut- or pea-based Milkshakes Yogurt drinks Meal replacement shakes (e.g., Ensure, Boost, Special K, Carnation, Glucerna) Protein shakes Smoothies Sodas Gelatin (e.g., Jell-O) Pudding Custard Sherbet Ice cream Frozen fluids, like fruit ices or popsicles Frozen yogurt When having smoothies and protein shakes, make sure the consistency is light enough so that you can sip it with ease. As the days pass and you feel as though you can tolerate it, heavier shakes can be taken. When needing to add more calories to you diet, include food items like the following in your shakes: Powdered egg whites Powdered milk products Instant breakfast mixes (e.g., instant oatmeal) Butter, margarine, or oil Sugar, syrup, or honey Brewer’s yeast Example Day’s Menu for 1-2 Weeks Post-Surgery Below is a sample one-day menu for a fluid diet directly after All-on-4 surgery. It is important to note that you should include snacks to ensure you are getting the nutrition and calories you need for recovery. Breakfast ½ cup fruit juice Cup of tea, coffee Instant oatmeal thinned with milk Morning Snack ½ cup fruit juice ½ serving meal-replacement drink Lunch ½ fruit juice Cup of strained soup Jell-O Afternoon Snack ½ cup meal-replacement drink Dinner Cup of broth Protein shake Pudding Evening Snack Cup of tea Ice cream 2 Weeks – Up to 3 Months Post-Surgery: Eating on a Soft Food Diet After the soreness recedes, you will start feeling better able to transition from a fluid diet to a soft food diet. It is important to remember that during the weeks and months following surgery, your jaw is still healing and the implants are trying to integrate. The process is known as “osseointegration” where the jaw forms a biological bond with the implant screws. To ensure this occurs properly, you must continue to watch what you eat. During the first three months, you should never eat foods that are: Hard; Chewy; or Crunchy. You should choose foods that require minimal chewing, which means foods that can be spoon-fed. What Foods Can I Eat During this Period? During the first few weeks following your surgery, you can continue with the above-listed fluids for the two-week period. The smoothies, however, can be thicker. The oatmeal no longer requires thinning with milk or water. And you can move on to other foods that can be eaten with a spoon so long as they require minimal chewing and crunching. Examples of foods you can add to your diet after two weeks are listed below. Fruits and Vegetables Anything mashed, e.g., applesauce, avocado, cauliflower Anything soft, e.g., bananas, watermelon Anything canned and without skin or seeds Anything baked or cooked to a soft consistency Breads, Pasta, Grains Breads soaked in syrup, sauce, or gravy Soft breads Muffins Pancakes or crepes Cooked pasta Quinoa Oatmeal Cream of Wheat Mashed potatoes Protein Cheese Eggs Pureed stews Sloppy Joe Chili Polenta Hummus Soft tofu Yogurt Example Day’s Menu for 2 Weeks – 3 Months Period Below is a sample one-day menu for a soft food diet after surgery. It is important to note that you should include snacks to ensure you are getting the nutrition and calories you need for recovery. Breakfast Pancakes Fruit drink Coffee/tea Morning Snack ½ cup mashed fruit ½ serving meal-replacement drink Lunch Bowl of soup Cottage cheese and applesauce Afternoon Snack Hummus Dinner Cooked carrots and squash Soft tofu Quinoa Baked peaches Evening Snack Cup of tea Yogurt Some Important Tips to Help You Through the Recovery Period Here are a few tips to keep in mind while you recover from All-on-4 implant surgery. Use a blender or food processor. During the first weeks of recovery, you can enjoy the fluid/soft food diet restrictions better if you can blend some of your favorite food items. If you enjoy your food, then you can ensure you are getting enough calories and nutrition to facilitate the healing process. Be proactive. At the time you decide to undergo this surgery, start researching about what you can and cannot eat. This can include recipes for different types of shakes and smoothies. This will also help you stock up with food items before surgery so you are ready to begin once home and recovering. Listen to your body. If at any time you feel like you are not getting enough intake or maybe overdoing it, then re-adjust. Ask family members for assistance. And get rest. What about… What about things not mentioned? You have learned mostly what foods you can eat and some of what you should not eat. But there are some foods and drink we frequently get asked about: Do not eat nuts or similar foods — they are simply too hard for your jaw at this time. You can drink carbonated drinks, but like hot and spicy liquids, you should refrain from doing so until 24-48 hours after surgery. Excessive alcohol should be avoided during the recovery stage — consumption of alcohol can compromise your dental implants. If you have additional questions, you can always consult with your oral surgeon. At Bunker Hill Dentistry, we want our patients to make informed decisions. We are happy to speak with you and answer all your questions. Contact us at 832-834-5281 today. Ann LeAnn Le has been successfully managing dental practices since 1990. She is currently Practice Manager at Bunker Hill Dentistry in Houston, TX which she runs with her husband Dr. Tri M Le.