Post-Operative Instructions: Multiple Extractions

For the first 72 hours, do not:

• Disturb the site
• Use straws
• Drink anything with carbonation
• Vigorously rinse, swish or spit
• Smoke

BLEEDING

Some bleeding is expected after tooth extractions. It’s important for a blood clot to form to stop the bleeding and begin the healing process. That’s why we ask you to bite on a cold, damp gauze pad for 30 minutes after the appointment. If the bleeding or oozing persists, you will need to moisten the gauze with ice cold water, squeeze out the excess water, and bite down with firm pressure for 20-30 minutes. If bleeding continues, moisten a tea bag with ice-cold water and bite down for 20-30 minutes. The tannic acid in the tea bag helps to form a clot by contracting the blood vessels.

A small amount of bleeding can continue intermittently for a couple of days, especially if the area is stimulated by movement. After the blood clot forms, it is important not to disturb or dislodge the clot, as it aids in healing. If you have a denture or prosthesis in place, do not remove it until the morning after surgery unless the bleeding is severe. Expect some oozing around the side of the denture. Avoid hot liquids and exercise and elevate the head.

SWELLING

Swelling is also a normal part of post-operative healing and can increase for 2-3 days following any surgery, slowly resolving after this. You may apply an ice pack to the area for 20 minutes at a time for the first 24 hours; this will help minimize pain and swelling during this time. After 24 hours, you may switch to warm, moist heat.

MEDICATION

If you have been sedated for your procedure, you may not drive for 24 hours. If you have been prescribed a narcotic pain medication, you also cannot drive while taking this. If an antibiotic mouth rinse is prescribed, do not begin using until the day after your procedure to avoid stimulating further bleeding. If an antibiotic was prescribed, make sure to take as directed and until completely gone to help prevent infection.

PAIN

You should begin taking pain medicine as soon as you feel the local anesthetic start wearing off. For mild to moderate pain, ibuprofen (Advil® or Motrin®) may be taken. Ibuprofen bought over the counter comes in 200mg tablets: 3 tablets may be taken every 6 hours as needed for pain. You may alternate with 2 Extra Strength Tylenol® as needed (example: 12 PM—Ibuprofen, 3 PM—Tylenol, 6 PM—Ibuprofen, 9 PM—Tylenol). For severe pain, the prescribed pain medicine should be taken as directed with food. Tylenol may be in the prescribed pain medication; therefore, do not take Extra Strength Tylenol when taking prescribed pain medication. Do not take any of the above medications if you are allergic or have been instructed by your doctor not to do so.

DIET

Hydration and nutrition are important for healing following surgery. Drink plenty of fluids (5-6 glasses of liquid the first day). Restrict your diet to liquids and soft foods that are comfortable to eat. As the wounds heal, you will be able to advance your diet. Stick to cold and/or soft foods and liquids while you are numb. Remember to always eat prior to taking any pain medication to avoid nausea.

ORAL HYGIENE

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

ACTIVITY

Limit vigorous exercise for the next 24 hours, as this will increase blood pressure and may cause more bleeding from the extraction site(s). If you exercise, throbbing and/or bleeding may occur. If this occurs, you should discontinue exercising. Keep in mind that you are probably not taking in normal nourishment, which may weaken you and further limit your ability.

FINALLY

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:

• Swelling and discoloration around the eye may occur. The application of a moist, warm towel will help eliminate the discoloration quicker. The towel should be applied continuously for as long as tolerable beginning 24 hours after surgery (remember, ice packs are used for the first 24 hours only).
• A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling in the throat muscles can cause pain. 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 Aquaphor®.
• There may be slight elevation of temperature for 24-48 hours. If temperature continues, notify our office.
• If immediate dentures have been inserted, sore spots may develop. In most cases, your general dentist or prosthodontist will see you within 24-48 hours after surgery and make necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
• Call our office immediately for heavy or persistent bleeding, severe pain, continued swelling lasting over 3 days, or a reaction to the medication.