After the Removal of Multiple Teeth
The removal of multiple teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary complications such as severe post-op pain, infection, dry socket, and swelling can be minimized if these instructions are followed carefully.
Immediately Following Surgery
- Do Not Smoke or use tobacco products of any kind for 1 week following surgery.
- The gauze pad placed over the surgical area should be kept in place for 30 minutes. After this time, the gauze pad should be removed and discarded. If oozing persists, replace the moistened gauze pad at additional 30-minute intervals, until the oozing has subsided.
- Vigorous mouth rinsing and/or touching the wound area following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
- Take the prescribed pain medications as soon as directed. This is to establish pain control prior to the local anesthetic becoming diminished.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs to the sides of your face where surgery was performed for the first 24 hours only. Refer to the section on swelling for a more thorough explanation.
- Maintain a soft diet for several days and avoid chewing near the surgical area.
- Take all prescribed medication as directed. Should you experience any reactions to the medication, call the office and stop taking the medication.
Before we discharge you from our office, all active bleeding will have stopped. A certain amount of oozing is to be expected following surgery. Slight oozing or redness in the saliva is normal. Excessive oozing may be controlled by first lightly rinsing or wiping any old clots from your mouth, then placing a moistened gauze pad over the area and biting firmly for thirty minutes. Repeat if necessary. If oozing 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 oozing vessels. To minimize further oozing, do not become excited, sit upright, and avoid exercise or activities that will increase your blood pressure.. If oozing does not subside to your satisfaction, or you have any concerns, call our office for further instructions.
Swelling that is normally expected after surgery is usually proportional to the surgery performed. Swelling around the mouth, cheeks, eyes, and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. Swelling will generally not become apparent until the day following surgery and will reach its maximum 2-3 days postoperatively. However, swelling may be minimized by the immediate use of ice packs. Two baggies filled with ice, or ice packs, should be applied to the sides of the face where surgery was performed. The ice packs should be applied for 30-minute intervals while you are awake, for the first 24 hours after surgery. After 24 hours, ice has no beneficial effect and actually delays healing. While swelling is anticipated, you can diminish the extent of swelling and resolve it more quickly by applying moist warm compresses in the same manner as you applied the ice; 30-minute intervals while awake, for several days. After 24 hours, once warm compresses have started, do not use ice again. If you are at all concerned about the amount of swelling, feel free to call our office at any time.
If you have been placed on antibiotics, take the medication as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or any other unfavorable reaction and contact our office immediately. Call our office if you have any questions.
For mild pain, any non-narcotic, over the counter pain medication should be taken regularly to keep pain minimized. Tylenol or Extra Strength Tylenol, Ibuprofen (Motrin or Advil) or any medication you have taken in the past that works well for you can be taken.
For moderate to severe pain, take the prescribed medication as directed. Narcotic pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery and avoid any activity which your diminished reaction time could cause you physical harm. Avoid alcoholic beverages. Pain or discomfort following surgery should subside progressively every day. If pain persists or actually increases, it may require attention and you should call our office.
Immediately after general anesthetic or IV sedation, liquids should initially be consumed for the first six hours. Drink from a glass and do not use straws. The sucking motion can cause more bleeding by dislodging the blood clot. After six hours, as long as you are not experiencing any adverse effects from the anesthetic, you may eat anything soft, by chewing away from the surgical sites. High calorie, high protein intake is very beneficial. The following list is a guide for suggested foods to be eaten freely:
- Soft or Scrambled Eggs
- Soft Rolls
- Cream of Wheat
- Canned Fruit
- Cottage Cheese
- Hash Browns
- Deviled Eggs
- Soft Corned Beef Hash
- Slow cooker foods
- Mac & Cheese
- Sloppy Joes
- Ground Beef/Turkey
- Pulled Pork
- Soft Pasta
- Meat Loaf
- Crab Cakes
- Soft Fish
- Egg Salad
- Tuna Salad
- Chicken Salad
- Anything Blended
- Soft Vegetables
- Mashed Potatoes
- Mashed Sweet Potatoes
- Soft Beets
- Refried Beans
- Shakes (no straws)
- Cheese Cake
- Shaved Ice
- Lemon Meringue Pie
- Ice Cream
- Frozen Yogurt
- Cheese Spreads
- Cream Cheese
- Smooth Peanut Butter
- Jam without seeds
- Cheese Dips
Drinks- NO STRAWS OR SEEDS
- Protein Drinks
- Greasy foods
- Hard shell tacos
Nourishment and fluids should be taken regularly. You can prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days, therefore, you should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.
CAUTION: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit up for one minute before standing.
Keep your mouth clean – Rinse and Brush
No rinsing of any kind should be performed for the first 24 hours following surgery. The day after surgery, you should begin rinsing at least 3-4 times a day with a teaspoon of salt mixed into one cup of warm water, especially after eating. Moisten your toothbrush under warm water and gently brush over the surgical area, 3-4 times daily, starting the day after surgery.
In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days post-operatively and last for up to a week. Moist warm compresses applied to the area may speed up the removal of the discoloration.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour, including prescribed medicine, with the exception of any anti-nausea medication that may have been prescribed. You should then sip on coke, tea, or ginger ale, as well as slowly eat saltine crackers. You should sip slowly over a fifteen-minute period. When nausea subsides, you can begin taking solid foods and any other prescribed medicine. Please call our office if nausea persists for more than an hour.
Other Post Op Sequella
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As reviewed in your consultation, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation. Call our office if you have any concerns.
- Slight elevation of temperature immediately following surgery is not uncommon. If a high temperature persists or elevates above 101 F, notify the office. Tylenol or ibuprofen can be taken to reduce the fever.
- You should be careful going from the lying down position to standing. You could get light headed from low blood pressure or medications. Before standing up, you should sit for one minute before getting up.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls which supported the tooth. These projections usually smooth out spontaneously. If not, they can be removed if they become bothersome.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
- Stiffness (Trimus) 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 time. Use moist warm compresses, as often as possible, to speed recovery.
- If you have any other questions or concerns, please call our office.
Sutures may be placed in the area of surgery to minimize post-operative bleeding and to speed healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it. Any remaining sutures will be removed approximately one week after surgery. The removal of sutures requires no anesthesia or needles. It takes only a minute or so, and there is usually no discomfort associated with this procedure.
Pain and swelling should subside gradually each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur, call our office for instructions.
There will be a void where the tooth was removed. The void will fill in with new tissue gradually over the next month. In the meantime, the area should be kept clean, especially after meals, with salt water rinses and careful brushing.
Your case is unique, no two mouths are alike. Discuss any problems or concerns with our office.
Brushing your teeth is okay – just be gentle at the surgical sites.
A dry socket occurs when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain near the ear may occur 2-3 days following surgery. Call our office if this occurs.
If you are involved in regular exercise, be aware that your normal nourishment intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.
REMEMBER: A clean wound heals better and faster