After the Removal of Multiple Teeth

 Bleeding

A certain amount of bleeding is to be expected following surgery.  Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding may be controlled by first wiping any old clots from your mouth, then placing a moist gauze pad over the area and biting firmly for one hour. Repeat if necessary. If bleeding continues, bite on a moistened tea bag wrapped in gauze for one hour. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. Do not rinse or spit or gargle today.  Do not use straws for one week.  To minimize further bleeding, be seated in a reclined position and do not talk, rinse or spit.  Avoid strenuous exercise.  If possible, do not sleep with gauze.  If bleeding does not subside, call for further instructions.

Swelling

The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on 20 minutes, intermittently, while you are awake. After 36 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. Thirty-six hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the size of the swelling

Pain

Pain may persist for a week following surgery, and sometimes longer.  Pain may be reduced by taking medication regularly.  Preferably, start taking medication before the pain begins. Your lips, chin, gums, tongue and teeth will feel numb and pain free for many hours after surgery. When home remove the gauze, try clear fluids (water, Sprite, 7-Up, apple juice).  If okay with that, try some dairy products or soft food.  Once you can do that, start taking pain medication.  We find Ibuprofen 400 to 600mg range every six hours works well.  Give it one hour to work.  If not comfortable, then take one or two of your narcotic medications.  You must have soft food or dairy products when taking pain medication to minimize stomach upset.  Prescription concerns can be accommodated during regular office hours.  Narcotic pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more after the third day. If pain persists, it may require attention and you should call the office.

Diet

After general anesthetic or I.V. sedation, cool liquids should be initially taken. This is especially important while your mouth feels numb.  Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Refer to the section on suggested diet instructions at the end of the brochure. Nourishment should be taken regularly. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the mouth clean

Do not rinse, spit, gargle or brush today.  Tomorrow start gently soaking areas with warm salt water after meals and before bed.  (One half teaspoon salt in glass of warm water).  Let the salt water soak the areas.  Tomorrow you may brush your teeth but avoid areas near the surgery sites until comfortable.

Discoloration

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. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If you have been placed on antibiotics, take the tablets or liquid as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea and Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on coke, tea or ginger ale. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking solid foods and the prescribed medicine.

  • 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 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 36 hours after surgery (remember ice packs are used for the first 36 hours only)
    • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. This is normal and should begin to subside after 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. There may be a slight elevation of temperature for 24-48 hours.

If immediate dentures have been inserted, 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.

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