After the Removal of Multiple Teeth

The removal of many teeth at one time is quite different than the extraction of one or two teeth. Sometimes it is necessary to smooth down the bone in order for the denture to fit properly.

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. Make sure you have this appointment made prior to your extraction date. Failure to do so may result in severe denture sores, which may prolong the healing process.

Immediately Following Surgery

  • You will leave the office with your dentures in place and will be biting on gauze. It is normal for blood to ooze out from under the denture.
  • Vigorous mouth rinsing or touching the surgical areas following surgery should be avoided. This may initiate bleeding by causing the blood clot that has formed to become dislodged.
  • Take the prescribed pain medications four hours after your surgical procedure.
  • Because local anesthetic was used for your procedure you must be on a LIQUID diet—but NOTHING through a straw. Patients can be “numb” up to 12 hours after the surgery.
  • Restrict your activities the day of surgery. You may resume normal activity 5-7 days after surgery.
  • Place ice packs to the sides of your face where surgery was performed. Refer to the section on “Swelling” for an explanation.

Bleeding

A certain amount of bleeding is to be expected following surgery. Slight bleeding, oozing, or redness in the saliva is not uncommon. It is normal to experience blood-tinged saliva a few days after surgery, as well as slight oozing after eating or brushing your teeth. To resolve this, we recommend warm salt water rinses. If bleeding does not subside, call for further instructions.

Swelling

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 two to three days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two plastic bags filled with ice, frozen peas/corn, or gel packs should be applied to the sides of the face where surgery was performed. The ice packs should be used at 20 minute intervals, (20 minutes on and 20 minutes off). 48 hours following surgery, the application of moist heat to the sides of the face is beneficial in reducing the stiffness of the jaw.

Pain

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. Pain or discomfort following surgery should subside more and more every day. We also recommend taking ibuprofen (Motrin or Advil) two 200 mg. tablets every 4-6 hours. If pain persists, it may require attention and you should call the office.

Diet

Drink liquids after IV sedation. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. High calorie, high protein intake is very important. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

The first day consume a liquid diet: Yogurt, pudding, ice cream, applesauce, mashed potatoes, Ensure/ Boost liquid meals. The next day, start chewing foods to help prevent jaw stiffness (Foods the consistency of scrambled eggs).

Oral Hygiene/Care of Dentures

If you left our office with dentures:

  • Make sure you have a follow up appointment with your dentist who made your denture. They will need to check its fit and make any adjustments. They usually want to see you 1-3 days after your extractions.
  • You may start rinsing with warm salt water the next morning. LEAVE YOUR DENTURES IN. If you remove them, they will be difficult to put back in due to swelling.
  • The day after surgery you should begin rinsing at least five to six times a day with a cup of warm water mixed with a half teaspoon of salt.

Remember: a clean mouth heals better and faster.

Activity

Keep physical activities to a minimum immediately following surgery. We usually recommend limiting physical activity five to seven days after surgery. If you are considering exercise, throbbing or bleeding may occur. If this occurs, you should discontinue exercising.

Sutures

Our surgeons usually use the dissolvable type of sutures/stitches that fall out between 5-7 days after surgery. Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm–just remove the suture from your mouth and discard it. If we used a type that needs to be removed, we will schedule you an appointment.

Sockets

There will be a cavities/holes where the teeth were removed. These sockets will gradually fill in with new tissue over the next month. In the meantime, the area should be kept clean especially after meals with salt-water rinses.

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 to the ear may occur two to three days following surgery. Call the office if this occurs.

Discoloration

In some cases, discoloration 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 postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

If we prescribed antibiotics, please finish the whole course as directed. Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea & 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. Try sipping slowly over a 15 minute period on some ginger ale or another clear soda. When the nausea subsides, you can begin taking solid foods and the prescribed medicine.

Other Complications

  • 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 sensation. So be careful. Call Dr. Reinbold if you have any questions.
  • A slight elevation of temperature immediately following surgery is not uncommon. If the temperature persists, notify the office.
  • You should be careful going from the lying down position to standing. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. 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 spontaneously.
  • 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 get swollen. The normal act of swallowing can then become painful. This will subside in two to three 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 that will resolve in time. Use warm moist heat packs to alleviate this.

Your case is individual. No two mouths are alike. Do not accept well-intended advice from friends. Please discuss your post-operative surgical problems with our office.