What does nobody tell you about recovering from full-arch surgery?

Your face will be lopsided

One side swells more than the other. It's one of the most common calls we get, and it's almost always nothing.

There may have been more infection on that side to start with. You may have slept on that side, and fluid goes where gravity takes it. And people swell differently, sometimes even from one side of the face to the other.

What would worry us is a pattern, like several patients from the same day all calling about the same thing. One side of one face, three days after surgery, is normal.

Call anyway. Nobody here will think you're a nuisance.

About the bruising

People sometimes take bruising as a sign of rough treatment. It isn't.

During surgery the gum is moved aside and then stitched back. That traps a little blood underneath, and the blood travels to where your skin is thinnest. That's why the bruise shows up along your jaw or under your eyes instead of where the work was done.

Plenty of excellent surgery bruises. It depends far more on your body than on the surgeon.

Two things help, and both often get missed: ice, and taking your anti-inflammatory on time. They get missed because the instructions went to whoever brought you, while you were still drowsy.

One word on supplements. Some make you bleed more, including a few you'd never suspect, and that affects both the surgery and the bruising. Tell us everything you take. And please don't put homeopathic remedies on the surgical site. We've seen them damage the gums.

Sleeping is awkward for a few nights

Propped up. A few pillows is plenty. It helps with swelling and breathing.

On your back. Lying on your side or stomach lets fluid collect where you don't want it.

On an old towel, in a dark shirt. You'll ooze the first night, and while you're numb you won't feel it.

If you wake up choking on saliva, it's usually blood and saliva mixing because the gauze routine slipped. Most often someone fell asleep before finishing it.

The first pill is harder than the surgery

Nobody warns you about this, and it catches almost everyone.

Swallowing a pill with a numb mouth is hard. You can't feel where the water is going or whether the pill went down, and the harder you try, the worse it gets.

What helps:

• Something thicker than water, like yogurt, applesauce, a smoothie or a protein shake. Water is too thin and leaves the pill behind.
• Two or three sips in a row instead of one careful one.
• Splitting a plain tablet. Never crush a tablet or open a capsule. The coating controls how the medicine is released.
• Taking a ten-minute break if it isn't working. It doesn't have to happen this second, and the panic is most of the problem.

Good to know: prescription-strength ibuprofen isn't a different medicine. A 600mg tablet is three regular ones, and smaller ones may be easier to swallow.

Follow your own after-surgery sheet for what to take and when. This is only about getting it down.

If you feel a pop

Call us the same day.

Usually it's nothing serious. Early on you're wearing printed prototype teeth, and the plastic and metal parts can settle against each other in a way that feels alarming but isn't.

Once in a while a part has come loose, and it's better to find that now than in three months. If it's a fit problem, we can take the teeth off, check the implants and put everything back properly in one visit.

Most people who feel a pop later admit they bit into something they shouldn't have. You can tell us. It won't change how we help you, and it tells us what to look for.

Metallic taste

Right after surgery, it's almost certainly blood and the aftermath of a long procedure.

If it's lasted for weeks, the likely cause is a prescription antiseptic mouth rinse. Used for a long time, those can leave exactly that taste. Let us know and we'll look at what you're using.

Numbness in your lip

Numbing medicines wear off at different speeds, some in half an hour, some after several hours. Numbness four or five hours after surgery is normal.

If it's still there the next day, call us. Most of the time it's a nerve that got disturbed during surgery and recovers on its own. But this is one thing not to wait out.

We'll check it properly: map where the feeling stops and starts, take an X-ray, and have a surgeon look. Rarely, an implant sits too close to the nerve, and that needs dealing with quickly, sometimes with a referral. It's uncommon, and it's why we'd rather you call than sit at home wondering.

The pizza burn

This one is fairly common, and almost nobody hears about it in advance.

A nerve comes through the roof of your mouth just behind your front teeth. Depending on what your surgery needed, that spot sometimes has to be moved or trimmed. As it heals, it feels a lot like the roof of your mouth after hot pizza.

It doesn't mean anything went wrong. Nerves further back take over, and it settles down.

If it's bothering you, a compounded rinse helps a lot. It mixes a numbing agent with other soothing ingredients and has to be made by a compounding pharmacy, so ask us for it.

Who needs to be with you

At least 24 hours. We'd say 48.

You won't be yourself for the first day, and it isn't only the sedation. Oral sedation only; we do not offer IV sedation or general anesthesia. Adrenaline takes a while to wear off, and many people don't notice how they really feel until later than they expect.

If you have nobody, tell us at your consultation. It comes up more than you'd think: people who live alone, single parents, people traveling a long way. We've arranged overnight home nursing for patients before, usually a few hundred dollars a night. It's good to know the option is there.

Most of this is really for your escort

Everything above gets explained to you while you're sedated.

So the person collecting you is the one who'll hear the instructions, keep track of the ice, and be there when the pill won't go down. If someone is coming with you, have them read this page.

Day five, crying for no reason

This happens, and it doesn't mean anything is wrong.

Think about what has piled up. Something you've probably been embarrassed about for years. A lot of money. Surgery. Days of people asking how you feel. Pain medicine. Poor sleep. And a face in the mirror that isn't yet the one you're going to have.

The day after surgery is the emotional low point of the whole process. It gets better from there, and quickly.

It's a bit like taking a child on a rollercoaster. Near the top they realize they've made a terrible mistake, and all you can do is sit beside them and know what's coming. Then it's over, and they want to go again.

You're allowed to cry about your teeth. Nobody here will be surprised, and nobody will think less of you.

And one small request

When you call us in pain and frightened, we understand. That's what we're here for.

Just keep in mind that whoever answers probably isn't the person who did whatever you're calling about, and everyone on our end wants the same thing you do. Almost nothing in this period is serious, and all of it can be fixed.

Call us. We'll sort it out.