After the Removal of Multiple Teeth
Some bleeding is expected following the surgical removal of several teeth. You will likely leave the office biting on gauze that has been placed over the extraction sites to hold pressure an assist with clot formation. You should bite on this gauze for 20-30 minutes at a time holding firm pressure and swallowing your saliva (allowing your saliva to pool will only prolong bleeding). When changing the gauze at 20-30 minute intervals, it is normal to note blood on the gauze and once you reach the point where there is more white then red on the gauze, you may likely discontinue use. If this persists beyond a reasonable time period (2-3 hours) you may consider biting on a moistened tea bag for thirty minutes. If you should have questions or concerns regarding the amount of bleeding, please feel free to call the office. If you have just had an immediate denture placed, it is normal to expect some oozing around the side of the denture.
Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.
It is normal for post-operative pain to increase in the first 1-2 days along with swelling which usually peaks at about 48 hours. It is also normal in the case where four third molars have been removed for some sites to hurt more than others. It is important to stay ahead of this pain and swelling by following the pain medication recommendations provided by your treating surgeon. In general, healthy teenagers or adults with no medical contraindications can manage pain by taking 600mg of ibuprofen every six hours and either one extra strength or two regular strength Tylenol every six hours. This will diminish the need to take narcotic pain prescription medication. If you pain is not managed with the above regimen, the prescription narcotic may be substituted in for the Tylenol – at no time should the prescription narcotic be taken with Tylenol. If you are taking the narcotic medication, it is important that you do not drive or operate heavy machinery. If pain or swelling persist without improvement, it may be necessary to call the office and be seen for evaluation.
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.
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. (One half 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, 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 two 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 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. There may be a 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 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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