After the Removal of Multiple Teeth

The proper care of surgical sites by the patient will hasten recovery and possibly prevent complications.

Please review the following recommendations.

 

Diet:    Fluids are encouraged as soon as tolerated, but avoid hot liquids, such as coffee, until the numbness has resolved. Soft and solid foods are permitted as tolerated.

 

Hygiene:     Avoid rinsing the mouth the first day. On day two brush unaffected areas as usual and rinse the surgical site with either prescribed mouthwash (Peridex twice daily) or warm water every 4 hours. Your customary mouthwash is acceptable, but may cause pain if it contains alcohol. This can be diluted with water to reduce discomfort. Your dentist may ask you to return after 24-48 hours to check the denture.  After the first 24 hours your denture should be removed twice daily  and cleaned with liquid hand soap, a soft brush and water. The denture should be left out of the mouth at night and in water.  Your denture should never be left out to dry.

 

Pain:                Pain is expected after surgery and usually reaches its peak in the first 1-2 days after surgery. Pain can be quite severe following surgery. Take your first dose of pain medications before the local anesthetic wears off. It is recommended to take the prescribed pain medication on schedule at least for the first four days, even if you feel you may not need it. It is easier to control pain by treating it before it becomes severe, rather than trying to “catch up” with the medication after it becomes severe. Begin by taking Acetaminophen which is then repeated every six hours. Three hours after your dose of Acetominophen, take Ibuprofen which is repeated every six hours. With this routine, you should be taking a pain medication every three hours.   Use your opioid medication (Oxycodone, Vicodin) only if you absolutely must. Many pain medications will cause nausea or vomiting as side effect, especially if taken on an empty stomach, thus always take your medication with a meal. Post operative pain usually starts to improve on the 3rd or 4th day after surgery. If your pain persists at a severe level on the 4th or 5th day after surgery, then you may have a complication called “dry socket”. This is easy to treat, but you must make your doctor aware of the problem. Please call the office for assistance.

 

Antibiotics:     Antibiotics may have been prescribed by your doctor. If you are taking oral contraceptive (birth control) medication, then antibiotics may reduce the effectiveness of these medications. You should use other means of contraception until your next cycle to reduce the chance of an unplanned pregnancy. Do take your antibiotics as directed with a meal. Take your antibiotics for the full duration as prescribed. If you experience side effects from your antibiotics such as diarrhea, rash, itchiness, hives then call the office immediately for assistance.

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Swelling:     After surgery, swelling is normal and expected. Peak swelling normally occurs 48-72 hours after surgery and then gradually subsides. To minimize swelling, apply ice to the face, as much as possible during the first 48 hours, after which application of heat will enhance resolution of swelling. Staying upright also helps with swelling, so when lying in bed use an extra pillow under your head to elevate it.

 

Bleeding:     The surgical site may continue to bleed or ooze slightly for a day or two. This is generally no cause for alarm. If severe bleeding occurs, the place a folded gauze directly on the site and apply firm pressure for 30 minutes. If this is unsuccessful, then apply a moistened tea bag in the same manner for 30 minutes. If this fails then call the office for assistance. Avoid frequent gauze changes as this may actually encourage bleeding. Limit vigorous physical activity for the first 48 hours after surgery as this may encourage bleeding.

 

Nausea:     Occasionally patients will experience nausea. This is usually due to prescription pain medication. Taking your pain medication with meals can reduce the chance of this. If nausea persists, then eating a bland diet (toast, bananas, rice, and applesauce) can help. Drinking ginger ale is also helpful. If you are able to reduce the amount of pain medication you are taking this may also help. If your nausea persists in spite of these measures then you should call the office for assistance.

 

Activity:     Avoid vigorous physical activity during the first 48 hours as this will be uncomfortable and may cause bleeding. Rest is encouraged at first. After the first 48 hours activity may be pursued as tolerated.

 

Sutures:     Sutures may or may not be used for your surgery. Resorbable sutures which fall out in 5-7 days are normally employed for your procedure. They do not require removal. If they come loose early, it is usually not a problem as a redundant amount are usually placed. If a suture comes loose and is dangling in the mouth causing discomfort, then you may clip it if you feel comfortable doing so.

 

Medication Refills:

Opioid medication refills are rarely required and generally discouraged. Any refill requests for controlled substances must be made during office hours.

 

Smoking:         Smoking places patients at increased for healing delay and painful inflammation of the bone of the tooth sockets (dry socket).  Abstaining from smoking for two day prior to the procedure two after can lower your risk of this problem.  If you pain does not improve after four dasy or even becomes more severe then you may have dry socket.  Please call the office for assistance if this should occur.

 

Bone chips/spurs:        It is quite common for patients to notice small chips of bone exposed or protruding through the gums.  Most of these will fall out on their own without intervention.  If the bone spurs/chips persist or become painful then call the office for assistance.  In some cases another procedure may be necessary to remove the bone chips or recontour the bone.

 

Denture Sores:   It is common and expected that denture sores may form after denture delivery. These ulcers are painful and look like canker sores. They are caused by breakdown of the gum tissues due to uneven pressure under the denture. The treatment for denture sores is to have the denture adjusted to relieve pressure on the site.