After the Removal of Multiple Teeth

 

A small amount of bleeding is to be expected following the operation.  Place  gauze over the wounds, and apply pressure for 30 minutes at a time.  You should not check the gauze to see how things are going, instead, apply the pressure and watch the clock.  You will need to repeat this for approximately two to three hours in most cases.  Occasionally, someone will have immediate dentures in place, if so, place the gauze between the teeth in the molar region and bite down.  If you still seem to be swallowing blood or becoming nauseaous after two hours, then remove the dentures, and apply the gauze directly to the wounds.  Occasionally, immediate dentures are just too loose to provide adequate pressure to the wounds, so removing them may be helpful.  Tea bags can occasionally be used as well.  Bite down on the bags for about 15-30 minutes and then repeat 3-4 times as needed.  In order to lessen the chance of bleeding, avoid over-activity, avoid hot liquids, don’t forget to take any blood pressure medicine that you may have been prescribed, and keep your head elevated.  If bleeding seems to be excessive after attempting all of the above measures, call our office for further directions. 

Use ice packs (externally) on the same side of the face as the operated area.  Apply ice for the first 48 hours only. Apply ice in one hour intervals while you are awake (likely that you will need to do this 5-6 times with multiple extractions.

Use of any narcotic that has been prescribed for you should be started as soon as you return home (Vicodin, Lortab, or Percocet).  In conjunction with this, we suggest the use of Aleve or Motrin (Ibuprofen or Advil).  Two Aleve twice per day or 800 mgs of Ibuprofen every six hours (Advil or Motrin) will most likely take care of the majority of discomfort that most of our patients will endure-as long as it is taken along with the normal regimen of narcotics. 

If the pain does not begin to subside in 3 days, or increases after that time, please call our office.  If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.

Drink plenty of fluids.  If many teeth have been extracted, the blood lost at this time needs to be replaced.  Drink at least 8-10 glasses of liquid the first day (your goal should be approximately 2-3 liters of fluid per day).

Do not rinse your mouth for the first post-operative day, or while there is bleeding.  After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area (1/2 teaspoon of salt in a glass of lukewarm water).  After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day.

Restrict your diet to liquids and soft foods for the first few days, which are comfortable for you to eat.  As the wounds heal, you will be able to advance your diet.

The removal of many teeth at one time is quite different than the extraction of one or two teeth.  Because the bone must be shaped and smoothed prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:

  • The area operated on will swell reaching a maximum in 2-3 days.  Swelling and discoloration around the eye and neck may occur.  The application of a moist warm towel after the first 3 days will help eliminate the discoloration quicker.  The towel should be applied continuously for as long as tolerable beginning 48 hours after surgery (remember ice packs are used for the first 48 hours only).
  • A sore throat may develop.  The muscles of the throat are near the extraction sites and most of the time the throat has been packed with a gauze during the surgery…both will lead to some discomfort when swallowing for the first few days.  This is normal and should subside in 2-3 days.
  • If the corners of the mouth are stretched, they may dry out and crack.  Your lips should be kept moist with an ointment like Vaseline or lip balm.  There may be a slight elevation of temperature for the first 48 hours. If the oral temperature spikes above 102 degrees Fahrenheit, notify our office.

If immediate dentures have been inserted, sore spots will develop.  In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots.  Failure to do so may result in severe denture sores, which may prolong the healing process.  Occasionally, non-healing sore spots may mean that an area of bone needs modification or a portion of the denture is too prominent.