After Pre-Prosthetic Surgery & Multiple Teeth Extractions
The removal of multiple 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 pads placed over the surgical areas should be kept in place for 30 minutes. After this time, the gauze pads should be removed and discarded.
- Vigorous mouth rinsing or touching the wound areas following surgery should be avoided. Do not drink anything with a straw. This may initiate bleeding by causing the blood clots that have formed to become dislodged.
- Take pain medication as soon as you begin to feel discomfort. This will usually coincide with the local anesthetic wearing off.
- Keep your head elevated as much as possible for several days after your procedure.
- Do not smoke for at least 36 hours after surgery.
- Restrict your activities the day of surgery and resume normal activity when you feel comfortable.
- Place ice packs on the side(s) of your face where surgery was performed. Refer to the section on swelling for explanation.
A certain amount of bleeding is normal following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. Excessive bleeding 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 thirty minutes. Repeat if necessary. If bleeding continues, bite on a moistened tea bag for thirty minutes. The tannic acid in the tea leaves helps to form a clot by contracting bleeding vessels. Place an ice pack over the face in the area of bleeding. To minimize further bleeding, do not become excited or sit upright, and avoid exercise. If bleeding continues, please call our office at Walter J. James, DDS, MD, APC Phone Number 318-865-0249 for further instructions.
The swelling that is normally expected is usually proportional to the surgery involved. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling will not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Ice packs, or bags/towels filled with ice should be applied to the side(s) of the face where surgery was performed. The ice packs should be placed on and off every 30 minutes while you are awake. After 36 hours, ice has no beneficial effect. Thirty-six hours following surgery, the application of moist heat to the sides of the face may be beneficial in reducing the size of the swelling. If swelling or jaw stiffness persists for several days, there is no cause for alarm. This is a normal reaction to surgery.
For moderate pain, one or two tablets of Tylenol or Extra Strength Tylenol may be taken every three to four hours or Ibuprofen (Motrin or Advil) two-four 200 mg tablets may be taken every 3-4 hours.
For severe pain, take the tablets prescribed as directed. Any prescribed pain medicine will probably make you groggy and will slow down your reflexes. Do not drive an automobile or work around machinery. Do not drink alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists, it may require attention and you should call the office. Do not take any of the above medication if you are allergic, or have been instructed by your doctor not to take it.
If you have been placed on antibiotics, take them as directed. Antibiotics will be given to help prevent infection. You should finish your antibiotics even if you are feeling better. Discontinue antibiotic use in the event of a rash, hives or other unfavorable reaction.
Call the office at Walter J. James, DDS, MD, APC Phone Number 318-865-0249 if you have any questions.
After IV sedation, liquids should be initially taken. Do not drink from a straw. The sucking motion can cause more bleeding by dislodging the blood clots. You may eat soft foods by chewing away from the surgical sites. High calorie, high protein intake is very important for healing. Nutritional shakes such as Ensure are appropriate. You should prevent dehydration by drinking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least 5-6 glasses of liquid should be taken daily.
Try not to miss a single meal. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.
Keep your mouth clean
No rinsing of any kind should be performed until the day following surgery. You can brush your teeth the night of surgery but rinse very gently if you must. The day after surgery you should begin rinsing at least 5-6 times a day, especially after eating, with a cup of warm water mixed with a teaspoon of salt. Gently brush your teeth twice daily.
REMEMBER: A clean wound heals better and more quickly.
In some cases, bruising of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal post-operative occurrence, which may occur 2-3 days after your procedure. Moist heat applied to the area may speed up the removal of the discoloration.
Nausea and Vomiting
In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on fruit juice, tea or soda. You should sip slowly over a fifteen-minute period. When the nausea subsides you can begin taking other foods and the prescribed medicine.
- If numbness of the lip, chin, or tongue occurs there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the pain sensation, so be careful. Call the office at Walter J. James, DDS, MD, APC Phone Number 318-865-0249 if you have any questions.
- Slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office. Tylenol or ibuprofen should be taken to reduce the fever.
- You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. Taking pain medications can make you dizzy. You could get light headed when you stand up suddenly, so before standing up, you should sit for one minute and then get up.
- Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots, they are the bony walls which supported the tooth. These projections usually smooth out quickly. If not, they can be removed by Dr. James.
- If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as vaseline.
- Sore throats and pain when swallowing are not uncommon. The muscles can swell after surgery, so the normal act of swallowing can then become painful. This will subside in 2-3 days.
- Stiffness (Trismus) of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event which will resolve in time.
Sometimes, sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. They can become dislodged – this is no cause for alarm. Just remove the suture from your mouth and discard it. The sutures will dissolve on their own within one week after surgery. An appointment to remove the sutures is not necessary.
The pain and swelling should subside more and more each day following surgery. If your post-operative pain or swelling worsens or unusual symptoms occur call the office at Walter J. James, DDS, MD, APC Phone Number 318-865-0249 for instructions.
A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of pain at the surgical site and even pain in the ear may occur 2-3 days following surgery, which can indicate a dry socket. Call the office at Walter J. James, DDS, MD, APC Phone Number 318-865-0249 if this occurs.
There will be cavities where the teeth were removed. The cavities will gradually, over the next month, fill in with the new tissue. In the mean time, the areas should be kept clean, especially after meals, with salt water rinses or a damp washcloth.
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.
Your case is individual; no two mouths are alike. Do not accept well-intended advice from friends or family. Discuss your problem with Dr. James or your family dentist. Call our office at Walter J. James, DDS, MD, APC Phone Number 318-865-0249 with any questions.
Brushing your teeth is ok. Be gentle at the surgical sites.
If you are involved in regular exercise, be aware that your normal nutritional intake is reduced. Exercise may weaken you. If you get light headed, stop exercising.