Post-Operative Instructions: Multiple ExtractionsBACK
After Your Surgery
If you have been scheduled to have multiple teeth removed, it will be important to follow these instructions. Usually, the after-effects of oral surgery are quite minimal, so not all of these instructions may apply. Similar procedures can result in varying outcomes between people. The removal of many teeth at one time is quite different from the extraction of one or two teeth. If a denture is being inserted, the bone must be shaped and smoothed.
Care of your mouth is very important for proper healing. The following instructions will speed the healing process and reduce pain, swelling, and bleeding.
It is very important that you avoid smoking for a minimum of 5 days. Smoking will increase your bleeding; the nicotine and tar in tobacco impair healing and may cause a dry socket.
Unless we have instructed you otherwise, do no vigorous physical activity for one week following your surgery. Physical activity increases your blood pressure, which will cause an increase in your swelling, pain, and bleeding. You may gradually increase your activity, such as jogging or tennis, after a week.
Swelling is normal after surgery and can be a cause of post-extraction discomfort. You should apply ice packs to your face over the surgical areas for 20 minutes on and 20 minutes off for the first 24 hours to help minimize swelling. It is imperative to maintain low physical activity, staying off your feet. Muscle stiffness may cause limited opening of your mouth.
You will go home with gauze packs in your mouth, but you will need to change them, once you get home, every 15–30 minutes until the bleeding decreases or subsides. You should place the provided gauze packs directly over the surgical sites. If bleeding continues or is excessive, place a non-herbal black tea bag over the surgical sites and bite firmly for 45 minutes to one hour with constant pressure. Repeat if necessary. Some oozing or pink saliva may occur over the next several days.
Plan to rest for the remainder of the surgery day. You should not drive, operate heavy or dangerous equipment, or sign any legal documents for at least 24 hours following general anesthesia.
Take the prescribed pain reliever before the numbness starts to subside, making sure that you have eaten beforehand. If you develop hives or a rash from any of the medications, discontinue them and call our office. Beginning the day before your surgery, you should take up to 2–3 tablets of 200 mg Advil® or ibuprofen, continuing after surgery between each dose of the prescribed pain medication for 4–5 days. Remember, narcotic pain medicine can impair your judgment and reflexes. Take your prescribed antibiotics and continue those until they are gone.
If you feel nauseated, drink small portions of a carbonated drink such as 7UP® or ginger ale every hour for 3 or 4 hours. This will usually terminate your nausea. Bland foods like soda crackers, tea, clear broth, Jell-O®, applesauce, or unbuttered toast can also help with nausea. Avoid all milk and dairy products as long as nausea is present. If you are taking a narcotic, you may also take half the dose or break the pill in half.
Starting the day after surgery, brush your teeth twice daily, being gentle initially around the surgical sites. You should also begin lukewarm saltwater rinses. Rinse 3–4 times a day for the next 7–10 days. Dissolve 1 teaspoon of salt with 8 ounces or warm water.
Start use of the irrigation syringe one week after surgery. Gently flush the lower sockets only, twice a day with warm water. This keeps the areas clean and promotes healthy healing of the surgical sites. Do not use the syringe during the first week because it can cause a dry socket.
Swelling, discomfort, and possibly bruising typically peak on the third or fourth day after surgery and will gradually improve. Muscle stiffness may cause limited opening of your mouth. It is important for you to continue chewing softer foods to exercise these muscles. You may also begin to use heat instead of ice – whichever feels best to you. You may start to experience a slight earache, sore throat, elevated temperature, or flu-like symptoms on the day after surgery, as well as throughout the first week.
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.
For the first 3 days after surgery, avoid spitting or drinking with a straw. It is very important not to smoke for 5–7 days after surgery. Smoking will increase your pain and delay healing. It is difficult to control pain caused by wound damage due to the use of tobacco products. Defined as the loss of a blood clot, a dry socket results in exposed bone and can be painful, usually in the fourth or fifth day after surgery. Call the office if you think you have a dry socket.
Protein is necessary for proper tissue production and healing; therefore, we suggest a high-protein soft diet including foods such as scrambled eggs. Increase your fluid intake to at least four 8-ounce glasses per day, but do not use a straw. It is sometimes advisable, but not required, to confine the first day’s intake to bland liquids or pureed foods like pudding, yogurt, applesauce, or milkshakes. Gradually increase your diet to solid foods. We also advise that you avoid spicy and acidic foods, such as citrus fruits, for several days following your surgery, as they may sting the surgical sites. Do not skip meals! This is not a time to diet! If you take nourishment regularly, you will feel better, gain strength, and have less discomfort, and this will promote healing.
During the healing process, you may feel sharp edges in the surgical areas with your tongue. It is probably the bony walls, which originally supported the teeth. Occasionally, small slivers of the bone will work themselves out during the first week or two after surgery. They are not pieces of tooth, and if necessary, we will remove them. Please call the office if you are concerned about this.
If you had an IV and notice redness, pain, a red streak, swelling, heat to the touch, or a hardened area where the IV was removed, you should apply a heating pad or a warm, moist towel to the area. If you do not notice improvement within 24 hours, please call our office.