After the Removal of Multiple Teeth

Home Instructions After the Removal of Multiple Teeth

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 green or 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.

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. 

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 three 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 3 days after surgery. (Remember: ice packs are used for the first 48 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.

PAIN

You should begin taking pain medication prior to the local anesthetic wearing off.

• NSAIDs:
  • NSAIDs (Ibuprofen, Aleve, Motrin, Aspirin, Naproxen, Advil, Lodine, Etodolac, etc) are additive. We recommend using only one type of these medications such as Lodine (Etodolac) OR  Ibuprofen (Motrin).
    • Ibuprofen:
      • Over the counter comes in 200 mg tablets. Taking three or four 200 mg over-the-counter tablets has equivalent pain and inflammation control as a prescription 600 mg or 800 mg tablets.
      • Do not exceed 3200 mg daily for an adult
      • Take two tablets (400 mg) every 4 hours OR three tablets (600 mg) every 6 hours OR four tablets (800 mg) every 8 hours. 
    • Lodine
      • Typically prescribed at 400 mg
      • Take 1 tab every 8 hours
  • Ask you doctor prior to taking these medications if you are on a blood thinner other than 81 mg Aspirin.
• Tylenol (acetaminophen)
  • This is a different medication class than NSAIDs. It is completely safe and much more effective to take in addition to NSAIDs.
  • Comes in strengths of 325 mg, 500 mg, or 650 mg.
  • Max dose of 3000 mg daily for an adult. Be aware than many other medications such as Dayquil, decongestants, antihistamines, and some narcotics also have Tylenol (acetaminophen) added to them.
  • You may take three 325 mg tablets (975 mg) OR two 500 mg tablets (1000 mg) every 8 hours. Or one 650 mg tablet every 6 hours.
  • Discuss with your physician prior to taking Tylenol if you have a history of hepatitis, cirrhosis, or other liver disease

It is safe and advisable to take both Tylenol and NSAIDs. Maximum pain relief and fewer side effects occur when the medications are staggered. Consult our practice for individuals under 18. 

For procedures that  cause more severe pain, a narcotic may be prescribed. This narcotic should be taken in addition to an NSAID (such as Ibuprofen or Lodine) and Tylenol (acetaminophen). If you are taking a narcotic, do not drive an automobile, work around machinery, or drink alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office.