Removal of Multiple Teeth

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully. If you have had any form of sedation, please refrain from driving for at least 24 hours.

 

DAY OF SURGERY:

  • Bite firmly on gauze for 15-20 min at a time. Limit any talking to keep pressure. When you get home you can take the gauze out & check the bleeding. If the gauze has light spotting/light bleeding, it is okay to leave the gauze out, as long as the bleeding has slowed down. You may need to repeat this process several times through out the first day.

  • If an immediate denture was placed; Do not removed denture unless the bleeding is severe. Bite your teeth together so that the denture is putting pressure on extraction sites. This will help stop bleeding just as gauze would. Do expect some oozing around the sides of the denture. 

  • If bleeding is uncontrolled by evening, you may try biting on a moisten black tea bag, wrapped in moist gauze keeping pressure for 15-20. Intermittent bleeding overnight is normal.

  • DO NOT SLEEP WITH GAUZE IN YOUR MOUTH.

  • Limit vigorous exercise for 1 week after surgery.
  • Sutures are placed the area of surgery to minimize post-operative bleeding and to help healing. 

  • A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur 2-3 days following surgery. Call the office if this occurs.

  • If immediate dentures have been placed, sore spots may 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.

PAIN CONTROL:

  • Long-acting numbing medicine is given for multiple extractions; you should be numb into this evening. It is important start pain medication before numbness has worn off.

  • The main medication used in our office for post-operative pain is a high strength Ibuprofen. You can take prescribed 600mg of Ibuprofen every 6 hours.

  • For additional pain control; it is safe to take 2 Extra Strength Tylenol, (Two 500mg tablets to equal 1000mg) in the middle of the ibuprofen (3hrs into the 6hrs). Alternating between the two medications every 3 hours. That equals 1000mg of Tylenol every 6 hours. (DO NOT exceed 4000mg of Tylenol in 24 hrs). 

  • If you do not have a prescription for Ibuprofen 600mg. Over the counter Advil/Motrin is ibuprofen and is usually supplied in 200mg. Therefore you can take three 200mg tabs to equal 600mg, every 6 hours. )

  • If a medical issue prevents you from taking ibuprofen, Tylenol is the only alternative.

DIET:

  • Nausea is common after anesthesia. Start by drinking clear fluids and advance to soft foods as long as your stomach has settled.  (Pudding, yogurt, applesauce, milk shakes, protein shakes, mash potatoes)

  • Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.

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

  • AVOID foods that can get stuck in extraction sites. (Chips, nuts, seeds, popcorn, rice).

  •  Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

  • NO STRAWS FOR THE FIRST 2 WEEKS AFTER SURGERY.

SWELLING:

  • Apply ice packs on the outside of face where the jaw makes the bend. Keep ice packs on the area for 20-30 min. each hour for the first 48 hours.  (Swelling may peak at days 3-4 after surgery, and then subside.) 

  • After about 48 hours, ice has no beneficial effect. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. forty-eight hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling. 

  • In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively.

HYGIENE:

  • You can resume brushing 24 hours after surgery. Tonight, you can gently rinse with the prescribed oral rinse by rolling your head side to side & gently letting it spill out of your mouth- NO vigorous swishing/rinsing.  

  • If you run out of or do not have prescription oral rinse, you can use 1tsp of salt mixed with 8oz of warm water.  

  • Use the prescription rinse or warm salt water mixture to rinse your mouth following meals to flush out particles of food/debris that may lodge in surgical sites.

  • DO NOT probe extraction sites.

OTHER COMPLICATIONS

  • If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated, before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. So be careful. Call if you have any questions.

  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. 

  • Sore throats and pain when swallowing is not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in 2-3 days.
  • You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get lightheaded when you stand up suddenly. Before standing up, you should sit for one minute then get up.

  • Occasionally, patients may feel hard protrusions in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These protrusions usually smooth out by themselves over time. If not, they can be removed by Drs. Pavlick & Reppas. If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.

  • Stiffness (Trimus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.

  • Smoking is NOT advised. Smoking creates pressure change within your mouth and can lead to dry socket, it is also quite detrimental to healing. Refrain from smoking until extraction sites have completely closed over

IF YOU HAVE ANY QUESTIONS, OR IF YOU’RE STILL EXPERIENCING PAIN, DO NOT HESITATE TO CALL THE OFFICE.