Bone grafting

After a tooth is taken out, the bone and soft tissue shrink if nothing is done to preserve them. That can leave too little bone for an implant later, or a gap between the gum and a bridge.

Filling the socket with a bone substitute immediately after the extraction preserves the bone volume, and keeps a wider range of options open for the future. Where an implant is placed soon after a tooth comes out, bone substitute packed around it plays a major part in maintaining the bone volume the implant needs to stay stable.

Enough bone matters for the long-term stability of your teeth or implants, and for how your teeth and gums look. Bone is lost through trauma, and through inflammation caused by:

• Plaque bacteria that aren't removed, which inflame and damage the gums and the bone around the teeth.
• Losing a tooth. Without a tooth to load it, bone naturally resorbs, and the height and thickness of the ridge diminish over time.

We use Geistlich Biomaterials regenerative products — quality tested, and backed by scientific evidence and clinical results.

As with any surgery:

• Swelling or pain at the surgical site.
• Bleeding.
• Local inflammation.
• Bone loss — the graft may not take as fully as hoped, and there is no way to accurately predict how any individual heals.
• Infection at the site during healing.
• Allergic reaction to a medication used or prescribed.

Heavy smoking and poor oral hygiene significantly reduce the success of the graft.

• Some swelling is normal. A damp cold compress against that side of the face helps settle it.
• If you have pain afterwards, ring us.
• Only use pain medication your dentist has prescribed or recommended.
• For the first two weeks, avoid the surgical area when brushing, and use an antibacterial mouthwash if we've recommended one. After that, clean around the site with a soft-bristled brush.
• Avoid coffee, alcohol and smoking for two to three days. That reduces the risk of bleeding afterwards and helps the wound heal.
• Attend your follow-up appointments even if healing seems to be going perfectly well.

• Not grafting, and accepting that the ridge will shrink — which may rule out an implant later, or leave a visible gap under a bridge.
• A different replacement option that doesn't depend on bone volume, such as a denture.
• Referral to a specialist where the defect is large or complex.

Attending your follow-up appointments lets us monitor and assess healing. Beyond that, your mouth needs daily care at home and a check-up every 3 to 6 months, which isn't included in the cost of the graft.

• Follow all the instructions you're given, so healing goes as well as it can.
• Clean your teeth, gums and any denture, crown, bridge or implant components thoroughly, as instructed.
• Come in for examinations and cleans every 3 to 6 months as your dentist advises. There's a fee for these visits.
• Take care not to abuse the area or any future replacement tooth, and tell us straight away if you notice a problem.

If you don't attend your follow-ups or keep up the maintenance, problems can develop to the point of being difficult, costly, or impossible to treat — and you would be liable for the full cost of correcting them.

• I have been informed of the reasons for bone grafting, the risks, the alternatives and the maintenance needed, before treatment begins.
• I understand the graft material used is Geistlich Bio-Oss, which is of bovine origin — made from the mineral part of cow bone.
• I understand the risks include swelling, pain, bleeding, local inflammation, infection and bone loss, and that allergic reactions to medications are possible.
• I understand there is no way to accurately predict how any individual's gums and bone will heal after grafting.
• I understand heavy smoking and poor oral hygiene significantly reduce the success of the graft.
• I understand what may happen if the graft is not done — the ridge shrinks, which can rule out an implant later or leave a gap beneath a bridge.
• I agree to follow the aftercare instructions, including avoiding the area when brushing for the first two weeks, and avoiding coffee, alcohol and smoking for two to three days.
• I agree to attend my follow-up appointments even if healing seems uneventful, and to attend for regular examinations and cleans as instructed.
• I have given an accurate report of my physical and mental health and medical history, including any previous allergic or unusual reactions to drugs, foods, anaesthetics, or any abnormal bleeding.
• I understand that no guarantee or assurance has been given that treatment will be completely successful, and that dentistry is not an exact science.
• I have read the information above and had the chance to ask questions.
• The costs have been explained to me, and I can ask for a written quote before treatment starts.
• I understand I can change my mind at any time before treatment starts.
• I understand my dentist will go through this with me and confirm my consent in person on the day.

This form records that you have read and understood the information above. It is not consent to proceed — your dentist confirms consent with you in person before treatment begins, and you can withdraw at any time.