After the Removal of Multiple Teeth
Bleeding is to be expected following the operation. If no denture or appliance is present, place a gauze pad directly over the bleeding socket and apply biting pressure. In most surgeries, the bleeding will be steady for 8-10 hours and then begin to slow down over the next 8 to 10 hours. The more you apply light constant pressure on the wound sites, the sooner the bleeding will subside. If the patient sleeps a lot after surgery, often the lack of light pressure on the gauze will allow the patient to bleed more. If excessive bleeding occurs it may be controlled by first rinsing or wiping any old clots from your mouth, then placing a gauze pad over the area and biting firmly for forty-five minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. If an immediate denture has been placed, leave the denture in the mouth and bite on the gauze packs. Expect some oozing around the side of the denture. If bleeding does not begin to slow down over the first 8-10 hours, remove the dentures and bite on the wounds with the gauze directly and follow the instructions above. If bleeding does not subside or you are concerned with the amount of bleeding, feel free to call the office. To minimize further bleeding, make sure that the patient is not feeling undo discomfort, does not become excited, sits upright, and avoids exercise.
Swelling may be minimized by the use of ice packs and elevation of the head. Ice packs can be made by placing a zip-loc bag within a second zip-loc bag and filling the inner bag with ice. Some patients prefer to use frozen vegetables or commercial gel packs. In any event, the ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be left on for 45-50 minutes every hour. It is important to allow the skin to warm to room temperature every hour to avoid the risk of a thermal burn. After 36 hours, ice has no beneficial effect. If swelling persists on the fourth post-operative day, heat (either moist or dry) may be applied to the face to help resolve the swelling. The heat is applied in a similar method as the ice packs. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery.
Do not remove immediate denture unless the bleeding is severe. On the morning after surgery, remove the dentures from your mouth and clean them with a toothbrush and tooth paste. If a soft liner has been placed in your denture, do not remove it. Your mouth can then be rinsed with water or salt water to clean off any dried blood. Replace the dentures into your mouth and wear them during the day only. At night, remove your dentures from your mouth and place them in a cup of water to keep the plastic moist.
Your doctor and surgery staff will review your post-operative pain treatment with you and/or your family members after your surgery. If you have any questions about how to take the medications prescribed, please call the office for clarification.
The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Avoid alcoholic beverages. Since pain medication, especially in the post anesthetic patient, can make you more susceptible to light headedness and fainting with positional movement, we recommend you are assisted with all ambulation the first day of surgery. Pain or discomfort following surgery should subside more and more every day. If pain persists and you do not see improvement of your symptoms, it may require attention and you should call the office.
Drink plenty of fluids. Do not use straws as they cause the bleeding to persist longer. Drink from a glass. We recommend that you stay on clear liquids until the heavy bleeding subsides. It is important that you keep hydrated and drink fluids at least every hour. Once the bleeding has slowed down you may resume drinking full liquids (fluids with cream and milk) or begin a soft diet. If you do not have dentures or an appliance, make sure that all chewing is away from the surgical sites. If you have an immediate denture, you should consider these an esthetic appliance only, for the first 2 to 3 weeks. This means that eating hard or chewy foods may not be possible as the area is healing. With time, however, the use of your dentures will become easier and more comfortable. Please refer to the section on suggested diet instructions at the end of the brochure. A normal dietary intake can be resumed as the patient tolerates a more substantial diet.
Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse (One half teaspoon of salt in a glass of lukewarm water) periodically and following meals to flush out particles of food and debris that may lodge in the operated area. After you have seen your dentist for denture adjustment, take out the denture and rinse 3 to 4 times a day.
The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be re-shaped and smoothed (alveoloplasty) 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 two days. If upper teeth were removed, it is common for swelling and discoloration to extend to the eyes.
- A sore throat may develop. The muscles of the throat and the floor of the mouth are near the extraction sites. Swelling of these muscles can cause pain. This is normal and should subside within a few days.
- If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline. There may be a slight elevation of temperature for 24-48 hours. If temperature continues or exceeds 101.5 F, 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 and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.