Multiple Extractions

After the Removal of Multiple Teeth Instructions

The removal of impacted teeth is a serious surgical procedure. Post-operative care is very important. Unnecessary pain and the complications of infection and swelling can be minimized if the instructions are followed carefully.

Immediately Following Surgery

The gauze pad placed over the surgical area should be kept in place for one hour. After this time, the gauze pad should be removed and discarded. Replace a gauze pad as needed approximately every hour until the bleeding/oozing has slowed or stopped.

Vigorous mouth rinsing or touching the wound area following surgery should be avoided. This may dislodge the blood clot that helps the socket heal. 

Bleeding

A mild to moderate amount of bleeding or oozing is expected following any tooth extraction. Bite down gently on any gauze packs that have been placed over the surgical site, making sure they remain in place. Do not change them for the first hour, unless the bleeding is not controlled. If active bleeding persists, place enough gauze to obtain firm pressure over the site for an additional hour. The gauze then may be changed as necessary. If bleeding has not slowed down after 4-5 hours, place a moist tea bag over the surgical site and bite down firmly for 1 hour. If bleeding persists, please call the office.

Swelling

Some mild swelling in the gums, cheek, and jaw is a normal occurrence after teeth removal. To minimize swelling, apply an ice pack or cold compress on the cheek adjacent to the area of surgery. Apply the ice 20 minutes on and 20 minutes off during the first 48 hours following your surgery. After 48 hours, begin applying moist heat packs to decrease swelling and stiffness.

Diet

Drink plenty of non-caffeinated and non-alcoholic fluids. Avoid really hot liquids or food. Following your surgery, your diet should be limited to liquids and soft foods only. You may return to a normal diet as soon as you are no longer numb. Make every attempt to chew on the opposite side of your mouth until you are fully healed. 

Pain

Having multiple teeth removed will likely cause some degree of discomfort. If you were prescribed any medication for pain, you take it only for severe pain and do not abuse it, some medications may be addicting. It is advisable to take your pill(s) with a light meal to reduce the chance of nausea. The effects of pain medication vary widely among individuals. If you do not achieve adequate relief at first, you may supplement with an analgesic such as ibuprofen (Advil or Motrin). 

Oral Hygiene

Maintaining good oral hygiene is essential to good healing. Begin your normal oral hygiene routine as soon as possible after surgery. Soreness and swelling may not permit vigorous brushing, but please make every effort to clean your teeth within the bounds of comfort. Warm salt water rinses (teaspoon of salt in a cup of warm water) can be used at least 4-5 times a day, especially after meals. Be gentle initially with brushing the surgical areas.

Other Complications

Do not be alarmed if there is numbness of the lip, chin, or tongue after your surgery. It is usually temporary but important you take care not to bite your tongue or lip while numb. Chewing solids is not recommended while you still feel numb because of this. 

A slightly elevated temperature immediately following surgery is not uncommon. If a fever develops and persists, notify our office. Tylenol or ibuprofen may be taken to reduce the fever.

Be careful going from the lying down position to standing you may be lightheaded from the sedation and limited intake of food and liquids. Taking pain medications may also make you dizzy. You may feel light-headed when you stand up suddenly. Before standing up, you should sit for one minute and then get up slowly.

Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will likely subside within 2-3 days.

Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.

Sutures

Sutures are placed in the area of surgery to minimize bleeding and aid in healing. Do not be alarmed if you feel a suture come loose. If it is loose and bothers you, you may pull it out gently and discard it. The sutures will most likely dissolve within 2-10 days after surgery.

Pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling significantly worsens or unusual symptoms occur call the office for instructions.

What is a Dry Socket?

There will be a cavity (a.k.a. socket) where the tooth once was. Soon after the procedure a blood clot will form in the socket and help with healing. The cavity will then gradually fill in over the next month with new tissue. In the meantime, the area should be kept clean, especially after meals with salt water rinses or a toothbrush. You will be given a syringe at your follow-up visit to assist in cleaning your socket(s).

A dry socket is when the blood clot gets dislodged too early from the tooth socket. Symptoms of pain at the surgical site and even pain to the ear may occur a week following surgery. Call the office if your discomfort cannot be managed with the prescribed pain medications.

1 Week Post Surgery

One week after your surgery you can begin irrigating lower sockets with the syringe and warm salt water.

• You only need to irrigate the lower teeth sockets
• Fill the syringe with warm salt water
• Gently flush the socket
• Repeat this 2-4 times or until the water comes out clear like it is going in
• You will have to irrigate with the syringe until the sockets are completely closed (sometimes 2-4 weeks depending on your healing process).