Post-Operative Instructions: Multiple Extractions

After the Removal of Multiple Teeth

Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

• The gauze pad placed over the surgical area should be kept in place for 1 hour. After this time, the gauze pad should be removed and discarded. If bleeding continues, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. Avoid hot liquids and exercise, and elevate the head while lying down. If bleeding persists, call our office immediately. 
• If you have an immediate denture, do not remove it unless the bleeding is severe. Expect some oozing around the side of the denture.
• Do not rinse your mouth for the first post-operative day, or while there is bleeding. Vigorous mouth rinsing or touching the wound area following surgery may initiate bleeding by causing the blood clot that has formed to become dislodged.
• 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.).
• For severe pain, use the prescription given to you. This will usually coincide with the local anesthetic becoming diminished. If the pain does not begin to subside in 2 days, or increases after 2 days, please call our office. If an antibiotic has been prescribed, finish your prescription regardless of your symptoms.
• For mild discomfort use aspirin, Tylenol^® (325mg) or any similar medication, two tablets every 6 hours; ibuprofen (Advil^®, Motrin^®) 200mg can be taken 2–4 tablets every 6 hours.
• Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
• Use ice packs (externally) on the same side of the face as the operated area. Apply ice for the first 24 hours only. Apply ice continuously while you are awake.
• Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least 6 glasses of liquid the first 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 from 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 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 dentures sores, which may prolong the healing process. After you have seen your dentist for denture adjustment, take out the denture and rinse 3–4 times a day with the warm salt water rinse.