After multiple dental extractions, following Pacific Oral Surgery’s Multiple Dental Extractions Postoperative Instructions can make the experience as pleasant as possible.
The extraction of multiple teeth at one time differs quite a bit from the extraction of a single tooth. You can avoid unnecessary pain, infection, and swelling if these instructions are followed carefully.
Immediately Following Surgery
- The gauze pads placed over the surgical area should be kept in place for 30 minutes. After this time, the gauze pads can be removed and discarded.
- Taking pain medication before the anesthesia completely wears off, can minimize the risk for increased pain .
- Restrict your activities the day of surgery and keep your head elevated if possible.
- Place ice packs to the side of your face where surgery was performed. This can have a significant effect on the reduction of swelling and help manage pain.
Some bleeding or redness in the saliva is normal for 24 hours. Bleeding should never be severe. If bleeding continues, it can be controlled by biting on a moistened gauze pad placed directly on the area for 30-45 minutes. This may be repeated as needed. Biting on a moistened tea bag for 30 minutes can also help control bleeding. The tannic acid in tea bag helps to form a clot by contracting bleeding vessels. If bleeding continues after 3-4 gauze changes, please contact the office for further instructions. It is best to sit upright and avoid excessive activity. Do not disturb the wound. After the blood clot forms, it is important not to dislodge the clot, as it aids healing. Do not spit, rinse vigorously, suck on straws, smoke, or drink alcohol for 72 hours. These activities can dislodge or dissolve the clot, which can restrict the healing process and promote bleeding.
Swelling is a normal development after surgery and is usually proportional to the surgery involved. Swelling can occur around the mouth, cheeks, eyes, and sides of the face. This is the body’s normal reaction to surgery and eventual healing. Swelling may not reach its maximum until the third day after surgery. However, the swelling may be minimized by the immediate use of ice packs and keeping your head in an elevated position. Baggies filled with crushed ice, or an unopened bag of frozen peas or corn should be applied to the side of the face where surgery was performed. The ice packs can be alternated between 20 minutes on, 10 minutes off, while you are awake. After 72 hours, ice has no beneficial effect. If possible, sleep with your head elevated at a 30 degree angle for several days following surgery. 72 hours after surgery, the application of a moist warm towel on the face can help eliminate skin bruising and discoloration. The towel should be applied continuously for as long as the patient is comfortable with the warmth. In general, patients who use ice and sleep with their heads elevated experience less swelling, have less post-operative pain, and recover more quickly from surgery.
Unfortunately, most oral surgery is accompanied by some degree of discomfort. To optimize your comfort, you should take the first pain pill before the numbing medication has worn off. For mild discomfort, use aspirin or Tylenol; two tablets every 3-4 hours. Ibuprofen (Advil, Motrin) 200mg can be taken 2 tablets every 3-4 hours.
You will usually have a prescription for pain medication. If you experience pain that becomes more substantial, it is best to take pain medication with a small snack and glass of water to avoid stomach upset. First, take the narcotic pain medication, then a couple of hours later, take ibuprofen if needed. Alternate prescription medications and ibuprofen (Advil or Motrin) as prescribed. Do not take ibuprofen if you are intolerant of this medication. Do not drink alcoholic beverages. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not operate a motor vehicle or machinery (lawn mower, etc.) while taking the narcotic pain medication. Notify the clinic if you are experiencing pain that is not improving 3-5 days after surgery.
Nausea and Vomiting
Nausea is not uncommon after surgery. Sometimes pain medications are the cause. Nausea can be reduced by preceding each pain pill with a small amount of soft food and taking the pill with 8 ounces of water. 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 slowly on coke, tea, or ginger ale. When the nausea subsides, you can begin taking soft foods and the prescribed medicine.
Do not smoke for a minimum of 4 weeks following surgery. The heat and toxic chemicals in cigarette smoke are harmful to the healing process and increase the likelihood of infection and dry socket.
Wearing your Prosthesis
Partial dentures or flippers should only be worn in social settings. When at home, remove your partial prosthesis to allow the healing surgery sites a chance to breath. If you had all of your remaining teeth removed and received a complete denture, please leave the denture in place for 24 hours following surgery. If you remove the complete denture prematurely, you will not be able to get it back in your mouth due to soft tissue swelling. Sore spots may develop if immediate dentures have been inserted. In most cases, your dentist can relieve those sore spots and make the necessary adjustments within 24 -48 hours after surgery. Call to make the necessary appointment. Failure to do so may result in severe denture sores, which may prolong the healing process. After the first 24 hours, you should remove and clean your denture every night, and do not sleep with your denture in your mouth after the first day. This will cause pain and inflammation to your gum tissue.
Because of the close relationship between upper back teeth and the sinus, an interaction between the sinus and mouth sometimes results from surgery. Slight bleeding from the nose is not uncommon for several days after surgery. When sneezing during the first two weeks after surgery, sneeze with the mouth open to avoid applying pressure to the sinuses. Please keep our office advised of any changes in your condition, especially if drainage or pain increases. Sinus exposures often heal slowly and with difficulty. It is important that you keep all future appointments until this complication has resolved itself.
- Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to change back to a more normal diet. Avoid hot foods and hot liquids for the first 48 hours.
- Keeping your mouth clean while you heal from surgery is important to help prevent infections. Begin brushing any remaining teeth the night of surgery- just be gentle when brushing around the surgical sites.
- You should be careful going from lying down to a standing position. You could get light-headed if you stand up suddenly. You were not able to eat or drink prior to surgery and you may be dehydrated. Taking pain medications can make you dizzy. Before standing up, you should sit for one minute, then get up.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
- Sore throats and pain when swallowing are not uncommon. The normal act of swallowing can become painful. This will subside in 2-3 days.
- Stiffness (Trismus) 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 3-4 days.
- Be sure to take any prescribed antibiotics as directed to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction and notify our office. Otherwise, please finish the entire course of your antibiotic.
Following these Instructions for Patients after the Removal of Multiple Teeth will assist you in making your recovery as smooth and pleasant as possible. If you have any questions or concerns about your progress, please call our Pacific Oral Surgery office.