After the Removal of Multiple Teeth
Post-operative Instructions for Multiple Teeth Extractions:
- IF Dentures are delivered at the time of surgery, wear the Denture :almost constantly for the first 48 hours, taking it out after 24 hours.The morning after your surgery, remove and rinse mouth with warm salt water (1/2 tsp salt and 8oz of warm clean water). Rinse the inside of the denture with clean water. Immediately replace the dentures into the mouth and wear again until later that night. The dentures act as a pressure dressing and help prevent swelling. Before bed remove the dentures and repeat the process above. Sleep in them one more night and repeat the process the next morning. DO NOT MAKE IT A HABIT OF SLEEPING IN YOUR DENTURE. As prolonged sleeping in your denture can lead to denture sore mouth.If no dentures were delivered today, then you will rinse gently tonight with warm salt water( 8oz or warm clean water and 1/2 teaspoon of salt).
- Bleeding: expect to have bleeding until the end of the day of surgery. If you had dentures delivered, try to avoid removing the dentures unless the bleeding is significant. If you did not have dentures placed in your mouth today, then simply bite on gauze until the bleeding stops. You may have to change the gauze every 30 minutes until tonight. Biting on a moist regular tea bag for 30 min or so helps stop the bleeding. Slow oozing is expected until the end of the day; however, profuse large amounts of bleeding is not and please give us a call.
- Swelling: mostly will be limited to the first 48 hours. Remember, if you had dentures delivered, keep the dentures in your mouth the first 24 -48 hours, or else you may not be able to get them back in until the swelling goes down. However, we understand this can be a very painful recovery and you must do what you feel is best for you at the time. If you did not have dentures delivered, you may swell significantly, especially if we smoothed the bone in the area. You can ice your face for the first 36 hours. Expect some bruising which can cause some discoloration in the skin. Swelling is always worse in the morning when you wake up and you can even have swelling around your eyes. This should dissipate toward the neck throughout the day as you are more upright and gravity pulls the swelling downward.
- Pain: The first 2-3 days are the worst and things should begin to feel better after 2-3 days. Your pain is usually well controlled with 5-10 mg of hydrocodone and 400 mg of advil. You can take these together or alternate them. NSAIDS like ibuprofen, Advil, Aleve, Motrin should not be taken if you are on blood thinners, history of stomach ulcers, severe asthma, kidney disease, allergic, or directed by your physician otherwise. If you cannot take one these drugs please call your surgeon or primary care and ask for advice. He may have written for another alternative like Demerol (Meperidine) with Phenergan, Oxycodone (Percocet), Ultram (Tramadol), or just Advil or Motrin, or just Tylenol. Remember most pain medications have tylenol in them as well and do not exceed 3000 mg in 24 hours. If you had wisdom teeth or lower second molars removed and the sockets are open, make sure you irrigate or rinse the lower sockets with warm salt water to keep food out of them three times a day. You may not be able to do so if the sockets were stitched closed. DO NOT IRRIGATE BEFORE 24 HOURS. This is to avoid a dry socket. A sore throat may develop. The muscles of the throat are near the extraction sites. However, if you are having difficulty breathing or swallowing is progressively getting difficult, please seek medical attention. 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.
- Diet: will be soft (flaky fish, over cooked pasta, eggs, grits, creamed vegetables, soups, shakes, etc.) and it will be difficult to chew with the dentures for the first few weeks. Feel free to use a straw, but just wait until you or the patient is awake and keep the straw in the middle of the mouth and avoid food from going directly into the sockets. Straws do not cause dry sockets.
- Sore spots on gums: Many times your dentist will have to reline the dentures and/or relieve spots on the underside of the denture.
- Ill-fitting denture: Your dentist may also be able to fix the bite so that it will not rock as much when you chew. The inside of the denture may have a soft liner to help with suction and comfort.
- Stitches: if any were placed, they will likely fall out in 7-10 days on their own.
- Water getting into your nose when rinsing or drinking: This may be a sign of a sinus communication between the extraction socket of an upper tooth and the maxillary sinus. This is most commonly seen with the removal of upper wisdom teeth or upper molars. Please let your doctor know. These holes can close on their own but may require a surgical procedure to repair this.
- Small pieces of bone: may begin to surface due to the process of smoothing the bone during surgery. This is not a problem, however, if large pieces are present and are not coming out easily please let your surgeon know on your follow up visit. He may be able to remove these for you on your follow up visit or he may choose to watch them for now and allow them to work their way out on their own.
- Fever: sometimes a low grade temperature (<100.4) is present the day or so after surgery. However, you should not ever have a temp greater than 100.4 which is usually a sign of infection. Surgical infection is rare before the 2nd or 3rd day. However, this is not always the case and if you have any questions regarding your temperature please call the office.
- Antibiotics: Are not routinely given for tooth extractions and your surgeon may have decided that you did not need antibiotics. If you were given antibiotics, please complete the course. If you are having any side effects such as severe upset stomach, rashes, or hives, please call our office to discuss your symptoms.
- Follow up: You may or may not have been given a follow up appointment with your surgeon 1-2 weeks after your surgery. If you are having any problems, please call 984-0403 and schedule a follow up visit.
- Recovery/Going back to Work: Going back to work after this surgery is dependent upon your job and how you feel. There is very little that you can mess up with this surgery. If you feel good, are not needing narcotic pain medicine anymore, and swelling is minimal, there is no reason you cannot go back to work. If you need an excuse for missing work, please contact our office for this.
- Driving: No driving for at least 24 hours after surgery if you were sedated. If you are on pain medicine or have significant swelling your judgement/ability may be impaired.