Getting dental implants can be a multi-step process. After the implant is placed in the jawbone, a healing cap is often put on top to protect the implant while the bone and gums heal. This cap seals off the implant and prevents anything from getting inside it. So what should you expect after your healing cap is placed? Here’s an overview of the healing timeline and what to watch out for during recovery.
Immediately After Surgery
Once the implant and healing cap are in place, you can expect:
- Bleeding – Some minor bleeding or oozing is normal right after surgery.
- Swelling – Your gums will likely be swollen and tender.
- Numbness – Your mouth will remain numb for several hours after the anesthetic wears off.
- Discomfort – Tenderness and soreness at the implant site is common.
Your dentist will provide post-op care instructions to follow for the first 24-48 hours, including what medicines to use for pain and how to care for the surgical site.
The First Week of Healing
During the first week after getting your healing cap, you can expect:
- Swelling – Swelling around the implant site may get worse for 2-3 days before it gets better.
- Bruising – Some discoloration around the implant area is normal.
- Pain – The most discomfort is often felt in the first 3 days.
- Bleeding – Small amounts are normal for the first few days.
- Difficulty eating – Chewing and biting on the implant side may be uncomfortable.
- Oral hygiene – Brushing and flossing around the site may be difficult.
Your dentist may recommend eating soft foods, avoiding hard/crunchy foods, and rinsing with warm salt water to help manage pain and swelling. Most patients need around 1 week off of work. Moderate activity is ok, but avoid strenuous exercise for a few days.
1-2 Weeks After Surgery
In the second week after the healing cap is placed, you should notice:
- Decreased pain – Discomfort and tenderness starts to improve.
- Reduced swelling – Swelling/inflammation continues to go down.
- Possible numbness – Numb areas shrink, but may persist in small spots.
- No complications – Watch for signs of infection like increased swelling, severe pain, pus.
You can begin transitioning back to a normal diet around this time. Brush and floss gently around the site. Use warm salt water or antimicrobial rinses if prescribed. Moderate physical activity is safe, but continue to avoid strenuous exercise that could displace the cap.
3-4 Weeks After Surgery
Within 3-4 weeks after getting the healing cap, you should expect:
- Minimal pain – Only mild soreness with chewing.
- No swelling – Swelling/bruising fully resolves.
- Improved oral hygiene – Brushing and flossing become easier.
- Healed gums – Gums close around the healing cap.
- Follow-up appointment – Your dentist will evaluate healing and may take an x-ray.
If gum healing looks good, a follow-up appointment is made to attach the abutment and crown. This is usually around 4-6 weeks after getting the healing cap, but timing varies. If more healing is needed, you may need to wait longer and continue wearing the cap.
6+ Weeks After Surgery
It takes several months for the bone to fully integrate with the implant, but after 6 weeks you should:
- Feel no pain/discomfort – The implant site feels normal.
- See complete healing – Tissues appear normal without swelling.
- Be cleared for impressions – If healing is complete, impressions can be taken for the crown.
- Finish any needed grafting – Any bone or tissue grafts should start to integrate.
- Have stable implant – The implant should start to firmly fuse with the jawbone.
At this point, an x-ray and clinical exam should show excellent healing progress. As long as everything looks stable, your restorative dentist can move forward with impressions and crown fabrication for your implant.
When to Call the Dentist
While initial soreness, swelling, and bruising are normal, contact your dentist immediately if you notice any of the following:
- Severe throbbing pain that pain medication does not relieve
- Pus or discharge coming from the implant site
- Excessive or worsening swelling after several days
- Bleeding that doesn’t stop with pressure after 24 hours
- Numbness or tingling that lasts more than a few weeks
- Feeling like the implant is loose or a piece broke off
- Redness, inflammation, or warmth around the site signaling infection
- Reactions to medications like rash, itching, or trouble breathing
These could be signs of a postoperative complication that needs prompt attention. Your dentist will evaluate the implant site, check for infections or damage, and provide any treatment needed.
What is a Healing Cap?
A healing cap is a small protective cover that is placed on top of a dental implant after it is surgically embedded into the jawbone. It serves several important purposes:
- Protects the top of the implant from damage or contamination while the bone and gums heal (osseointegration period)
- Prevents tissue from growing into the top of the implant
- Provides stability and acts as a placeholder for the permanent crown
- Shapes the gingiva (gums) to form a natural looking emergence profile for the final crown
There are a few different types of healing cap attachments:
| Healing Cap Type | Details |
|---|---|
| Cover screw | A simple cover screw that fits over the implant mount and gets screwed in place. It provides basic protection with minimal contouring. |
| Contour healing cap | Designed with more anatomical shape to help contour the surrounding gums for better crown esthetics. |
| Impression coping | A transfer coping that gets picked up with an impression material to record the implant’s position for lab fabrication of the crown. |
Healing caps are usually made of titanium or plastic. They are placed at the time of implant placement surgery but can also be placed later at uncovering if the implant was buried. The cap remains in place until the restoration process begins 4-6 weeks later.
What Does a Healing Cap Look Like?
A healing cap is a small abutment that covers the top of the dental implant. Here are some key features:
- Small rounded shape – Usually circular or oval shape with tapered sides.
- White/metal color – Made from titanium or plastic for visibility.
- Smooth dome top – Rounded or flat disc-shaped top protects the hex connection.
- Small screw access hole – Allows cap to be secured with abutment screw.
- Low profile – Sits closely against the gums without much height.
- snug fit – Does not wiggle or rotate when properly tightened.
The cap may be contoured for ideal shaping of the surrounding gums. It should fully cover the implant platform and protect the internal connection. The dentist will select a healing cap size and shape appropriate for the specific implant.
Healing Cap vs Cover Screw
There are two main options used to protect a dental implant after placement:
- Healing cap – More anatomical shape encourages natural tissue contouring. Remains in place for entire healing period.
- Cover screw – Very basic protective screw with no contour. Often replaced later with healing cap.
In many cases, a simple cover screw is placed at surgery to protect the implant temporarily. At the 2-week uncovering appointment, this is replaced with a healing cap to shape the gums leading up to crown placement. But some dentists place the healing cap directly at the initial surgery.
Healing caps encourage soft tissue healing in the shape of the final crown. Cover screws sit flush with the implant platform and don’t affect gingival contouring very much. But they adequately protect the implant in the first couple weeks while the gums close over.
Temporary vs Permanent Healing Caps
Dental implants may involve one or two healing caps:
- Temporary healing cap – Placed at initial surgery and worn during osseointegration period for 4-6 weeks.
- Impression coping – Transfers implant position to the dental lab for the permanent crown fabrication.
The temporary cap protects the implant through the initial healing phase until the permanent restoration is ready to be placed. An impression coping is often used as a second healing cap after impressions to maintain the implant access until crown delivery. This allows accurate impressions without removing the healing cap too early.
Healing Cap Replacement
There are a few reasons why your healing cap may need to be replaced or adjusted:
- Damaged or loose cap comes off – A loose or broken cap will need to be replaced.
- Peri-implantitis – An infection may require swapping to a sterile cap.
- Need different shape – A cover screw may be swapped for a contour healing cap.
- Impression coping – The cap gets replaced to take an impression.
- Final crown placement – The healing cap gets removed and replaced by the permanent crown.
It’s quite common to go through one or two healing caps from initial placement to final restoration. Your dentist will evaluate the current cap at follow-up visits and replace it if necessary. Leave the cap in place unless instructed otherwise to protect the implant integration.
Do You Remove the Healing Cap Before Impressions?
With a two-piece implant, removing the healing cap too early before impressions can lead to tissue collapse inside the implant. There are two approaches:
- Leave cap in place – Use an impression coping as the new cap when impressions are taken.
- Remove cap – Take impressions then immediately replace with an impression coping healing cap.
The best practice is usually to keep the initial cap undisturbed until the impressions are taken. An impression coping cap is then placed to maintain the tissue contour until the crown is delivered. But some dentists elect to remove the cap briefly and replace it just for the impression procedure.
Healing Cap Benefits
Compared to leaving an implant exposed with no cap, benefits include:
- Protects the hex or internal connection from damage
- Prevents tissue from collapsing into the implant
- Allows precise transfer of the implant position to the lab
- Shapes surrounding tissues into an emergence profile
- Provides an attachment site for the final crown
- Serves as a placeholder to allow bone healing
- Lowers risk of infections or complications
Healing caps play an important role in the implant integration process. When left undisturbed for 4-6 weeks, they help ensure optimal healing and shape the gums for a natural looking, well-integrated final restoration.
Healing Cap Problems
While usually complication-free, potential problems include:
- Cap comes loose or falls off – The cap needs to be promptly replaced.
- Infection under the cap – Requires antibiotics and cap replacement.
- Too much or too little contour – May need a different cap shape.
- Bone loss under the cap – Indicative of peri-implantitis and infection.
- Food/debris trapped under cap – Causes inflammation, swelling, and discharge.
- Pain or discomfort from the cap – Needs adjustment or replacement.
With proper oral hygiene and avoiding trauma to the site, healing caps usually do their job with no issues. But see your dentist promptly if you have any symptoms of complications.
Healing Cap Cost
The cost for a healing cap is relatively minimal compared to the implant itself. Expect to pay:
- Cover screw – $35 to $75 per cap
- Healing cap – $95 to $250 per cap
- Impression coping – $50 to $100 per cap
This fee covers the manufacturing and material costs of the cap attachments. Most dentists include a supply of healing caps and abutments in their implant placement fees. But if you need additional or replacement caps later, your insurance may not cover the full cost. Talk to your dentist about what healing cap expenses to anticipate with your treatment plan.
Frequently Asked Questions
How long does a healing cap stay on?
Healing caps typically stay on for 4-6 weeks while the bone fuses to the implant through osseointegration. Some implant systems have protocols to leave it for up to 12 weeks. Your dentist will determine the optimal healing cap timeframe.
Can you eat with a healing cap?
Yes, you can eat with a healing cap on the implant but initially stick to soft foods. Avoid very hot, crunchy, or chewy foods that could dislodge the cap while chewing. As healing progresses after several weeks, you can transition back to more solid foods.
Do healing caps fall off?
It’s rare for a healing cap to spontaneously fall off if it was securely fastened into place. But loose caps can detach with chewing forces. Severe infections under the cap can also cause it to become displaced. See your dentist promptly if the cap comes off.
What happens if healing cap comes off too soon?
It’s important for the healing cap to remain undisturbed for the initial 4-6 week period if possible. If it gets knocked off or detached too early, the implant may be at greater risk of developing an infection or having tissue collapse into the empty space.
Can I remove my own healing cap?
No, do not remove the healing cap on your own unless specifically instructed to do so by your dentist. It must stay in place during the critical osseointegration process so the implant properly integrates with the bone.
Conclusion
Healing caps play a useful role in the implant healing process. While initially sore, gums should heal well around the cap within several weeks. Be sure to follow all post-op care instructions from your dentist. And be vigilant for any signs of complications. With proper healing, your implant will soon be ready for the final crown restoration using the cap as a stable attachment site.
