After the Removal of Multiple Teeth

Home Instructions After the Removal of Multiple Teeth

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A small amount of bleeding is to be expected following the operation to remove multiple teeth. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.

Use ice packs (externally) on the cheek near the surgical site. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.

You should begin taking the ibuprofen (if prescribed) and the over the counter acetaminophen or Tylenol (not prescribed) before the numbing or local anesthesia wears off and you feel okay swallowing.  This typically will be within 2-4 hours after the surgery. We typically have patients take 600mg-800mg every 6-8 hours at the same time as 1-2 tabs of OTC (over the counter) extra strength acetaminophen (Tylenol).  Studies have shown taking ibuprofen (Advil or Motrin) concurrently with acetaminophen (Tylenol) works better than rotating them or staggering the doses.  We also recommend taking the Ultram or Tramadol (if prescribed) with the ibuprofen (Advil or Motrin) and Tylenol if needed.  If you elected to take OTC ibuprofen (Advil or Motrin) it comes in 200mg tablets.  You can take three to four OTC tablets of ibuprofen if you elected to not fill your prescription.

Do not exceed 3200mg daily for ibuprofen (Advil or Motrin) for an adult.  Do not exceed 3000 mg daily of acetaminophen (Tylenol) for an adult.

For our pediatric patients please follow the instructions on the bottle as prescribed or the over the counter instructions if not given a prescription.

For our patients that elected to have the Exparel (long acting local anesthesia) injections you will hopefully have great pain relief for 2-4 days at the surgical sites.  This does not mean no pain, as some discomfort is still normal.  Please take the ibuprofen and Tylenol as needed and as explained above.

Use pain medication as directed. Call our office if the medication doesn’t seem to be working. If antibiotics are prescribed, continue to take them for the indicated length of time even if signs and symptoms of infection are gone. Drink lots of fluids and eat nutritious, soft food on the day of the extractions. You can eat normally as soon as you are comfortable.

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 teaspoon of salt in one cup of warm water). After you have seen your dentist for denture adjustment, take out the denture and rinse 3 to 4 times a day.

Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to resume your normal diet.

The removal of many teeth at one time is quite different from the extraction of just 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 eyes may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as is 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 your temperature continues to rise, 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 to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.