After Multiple Tooth Extractions
After a surgery to remove multiple teeth, some bleeding or redness in the saliva is normal for 24 hours. It is important for a blood clot to form to stop the bleeding and begin the healing process. Bite on gauze for 30-60 minutes immediately after the appointment. If the bleeding or oozing still persists, place additional gauze and bite firmly for another 30-60 minutes. You may have to do this several times to stop the flow of blood. If bleeding continues profusely (your mouth fills rapidly with blood), please call our office at North Liberty Office Phone Number (319)-382-3113.
After the blood clot forms it is important to not disturb or dislodge the clot. Do not rinse vigorously, suck on straws, or smoke for 7 days. These activities may dislodge or dissolve the clot and hinder the healing process.
Sometimes bruising may occur and if it does, will gradually resolve with time.
Swelling is a normal occurrence after surgery. To minimize swelling, apply an ice bag (wrapped in a thin towel) to the cheek in the area of surgery. Apply the ice for 20 minutes on the area and 20 minutes off the area for the first 24 hours. Swelling normally peaks 2-3 days after surgery.
- Avoid hot liquids or food until the local anesthesia/numbness has worn off.
- Avoid the use of straws for 7 days after surgery.
- Start with cold, soft foods in the area of surgery.
- Resume a normal diet as soon as tolerated.
- Drink plenty of fluids.
- Keep physical activities to a minimum immediately following surgery.
- Resume normal activities as soon as tolerated.
- Brush all of your teeth with toothpaste, taking care to be gentle around the surgical site(s).
- Resume normal oral hygiene as soon as tolerated.
- Warm salt water rinses (one teaspoon of salt in a cup of warm water) should be used at least 2-3 times a day as well, especially after meals.
- If Chlorhexidine mouth rinse was prescribed, use as directed.
- If sutures (stitches) were placed, they will fall out on their own in the time frame discussed at surgery.
WEARING YOUR PROSTHESIS
- If you use a provisional (flipper or Essix retainer), it is meant for esthetics and speech only, NOT for chewing.
- If you use a partial denture, it should be used as directed.
- If immediate dentures have been inserted, they should be left in place until you see your dentist. This usually occurs within 24-48 hours after surgery and is important to make any necessary adjustments and relieve sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process. After you have seen your dentist for denture adjustment, take out the denture and rinse 3 to 4 times a day.
To aid in your post-operative pain control and recovery, over the counter or prescription pain medications will be recommended. These will vary significantly between patients based on age, allergies, medical history, other medications, etc. Particular differences will exist in regards to recommended medications, dosages, and frequencies. Doses indicated below are the maximum adult doses, which will vary for children and the elderly. The lowest dose and frequency able to obtain adequate pain control should be utilized.
Please consult your Post-Operative Pain Control Instructions for specific recommendations.
As a general rule, the following medications are typically recommended:
- Ibuprofen (Advil, Motrin, etc.) – Take 3-4 tablets (200 mg each) every 6 hours with a maximum of 3,200 mg per day. Ibuprofen or other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as naproxen (Aleve), aspirin, etc. should not be taken concurrently and should be avoided in patients with an allergy to ibuprofen, bleeding disorders, blood thinning medications, ulcers, etc.
If ibuprofen is ineffective in managing post-operative pain, acetaminophen can be added for additional pain control. This can be taken at the same time as ibuprofen or staggered in between doses of ibuprofen.
- Acetaminophen (Tylenol) – Take 1-2 tablets (500 mg each) every 6 hours with a maximum of 4,000 mg per day. Acetaminophen should be avoided in patients with an allergy to acetaminophen, liver problems, heavy alcohol use, etc.
If ibuprofen and/or acetaminophen are ineffective in obtaining adequate pain control, then an opioid pain medication may be necessary.
- Opioids (prescription pain medications such as hydrocodone/acetaminophen, oxycodone/acetaminophen, oxycodone, etc.) – Take as directed according to the prescription label. Keep in mind that if an opioid including acetaminophen (Tylenol) was prescribed, you should discontinue the plain acetaminophen.
Start pain medications prior to the local anesthetic/numbness wearing off or at the time directed on your Post-Operative Pain Control Instructions.