All-on-4®

View or Download Pre Operative Instructions for All-On-4


Post operative instructions for All-On-4 surgery

1.  Protection of the blood clot and surgical site

Bleeding after tooth extraction or implant placement is normal and may last for several hours.

Put gentle pressure on your cheeks, jaws & chin with cool packs.  

If you have a removable denture then place gauze in the molar region and bite down.  

If there is no active bleeding then leave the gauze out.  

Lay in a semi-reclined position.  Keep your head above your heart unless you feel faint.

Avoid spitting, bending over, sucking through a straw, and rinsing for 24 hours.  

No strenuous activity or smoking for 48 hours.  

The blood clot is important for healing.

2.  Rinsing

Rinsing may dislodge the blood clot and interrupt the normal process of healing.  Carefully follow these steps in order.

 Day 1 (Day of surgery – first 24 hours after surgery)

  • Do not rinse or brush your teeth.  Do not spit.

Day 2 and 3  

a. Brush your teeth, 2 times a day, be gentle around the surgical sites.  

b. If you have a non-fixed denture then remove it, rinse and clean the inside of the denture.

c. Begin rinsing gently using a glass of warm salt water (1/2 teaspoon per cup).  Repeat rinsing 2 times a day.  

d. Never brush the gums

e. Never brush an exposed membrane

f. Never brush the surgical site

Day 3

  • Same regiments as day 2, however begin rinsing more vigorously, and 3 times a day.

Day 4 until day 42 (6 weeks)

a. Same regiment as day 2, however now rinse with a little more force.  

b. Continue rinsing and cleaning in this manner for 6 weeks.

3.  Care of teeth  / Cleanliness and healing

Starting day two, brush your 2 three times a day.  Be careful of the incisions Do not start a Waterpik until 6 weeks after the surgery. 

4.  Swelling / Fever / Bruising

A cool pack placed on face will be beneficial to help control swelling & bruising.  This should be used for at least 48 hours. Keep the jaw bra/face bra on as much as possible for one week to avoid hematoma formation and bruising.  If extreme swelling occurs or a temperature above 101.5 contact my office.

5.  Pain

Some discomfort is normal following oral surgery.  If pain medication is prescribed, take only as directed.  Often it is beneficial to take the medication after eating to help prevent nausea.  Do not drive while using narcotic pain medications.

6.  No Smoking or Alcohol

Do not smoke or drink alcohol for 48 hours following oral surgery.  This may cause the disruption of healthy blood clot formation and increase in complications including dry sockets, prolonged healing, wound breakdown and post-operative infections.

7.  Diet

No hot liquids, acidic foods or drinks for the first 24 hours.  No carbonated beverages like beer or soda.  Eat something when you feel ready. Cool liquids are best to start but avoid sucking through straws. Then, when the numbness starts to wear off, progress to a soft diet but avoid chewing in the area of the surgery. A soft diet is food you could pinch through with your fingers. However, Cool pureed diet (smoothies) would be best for the first seven days.

8.  I.V. Injection site

After having intravenous anesthesia, the arm vein may become hardened and tender.  If so, then, apply moist heat over the area for one hour three times a day for three days. Contact us if there is no improvement 

9.  Sharp bony edges

You may feel hard, sharp areas on the surgical site.  Leave it alone never pick at it or scratch it.  Notify the office staff on the post-operative check-up.

10.  Nausea

Nausea is a normal side effect of narcotic pain medications.  If you have severe nausea or vomiting you may need to stop the pain medications or take an additional anti-nausea medication.

11.  Antibiotics and Contraception

Contraceptives may be ineffective while taking an antibiotic. Use extra protection if you have been prescribed an antibiotic.


View or Download Post Operative Instructions for All-On-4 Procedures (shown above)
Long Term Care: Long Term Denture Care for All-On-4 Patients