After the Removal of Multiple Teeth

If Immediate Denture is Placed

If a denture has been placed immediately after your extractions, do not remove.  You will need to keep pressure on the extraction sites by biting together with the denture in place.  It may be easier to keep pressure on the extraction sites if you bite on gauze packs (one on each side) with the denture in place. Apply pressure for 30-60 minutes.  Do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the edges of the denture.  Leave the denture in, even at night, for the first 48 hours as it will aid in managing swelling.  You may take the denture out after 24 hours to rinse your mouth and the denture, but replace it immediately.  The denture should not be left out for more than five minutes as swelling may increase and the denture will not fit properly.  You may need to see your dentist for adjustments. 

If No Denture is Placed

The gauze packs that have been placed over the extraction sites should be kept in place for an hour. After this time, they should be removed and discarded. They will need to be replaced only if you see a flow of blood coming from the extraction sites.  To replace the gauze packs, take three or four pieces of gauze, fold in half and moisten with water so they are just damp. Place the gauze packs directly over the extraction sites and apply pressure for 30-60 minutes. Use enough gauze to  give you the bulk that you need to feel the pressure when biting down.  Pressure on the gauze packs will help stop the bleeding.

Ice and Swelling

Swelling will be minimized by the immediate use of ice packs on the outside of your face for the first 48 hours.  The ice packs should be left on for a minimum of 20 minutes on, 20 minutes off. On the third day, or after 48 hours, discontinue the ice and switch to warm, moist compresses to help resolve any remaining swelling.  Elevate your head with a couple of pillows when lying down.  This will help control swelling and also bleeding.

Pain Medication

You will want to take your pain medication before the local anesthesia wears off, usually within a couple of hours.  Always try to eat or drink something before taking any medication.  Please try an over-the-counter pain reliever first.  If additional pain control is needed, you may supplement with a narcotic pain medication if prescribed.  Wait three hours after taking the over-the-counter medication before taking the narcotic.  It is important to stagger the doses so you are not taking them both at the same time.  Narcotic pain medications will make you sleepy and slow down your reflexes.  Avoid alcoholic beverages and do not drive or operate machinery if you are taking a narcotic. As pain subsides during recovery, you may discontinue the prescribed pain medication and take an over-the-counter pain medication as needed. 

Antibiotic 

If an antibiotic is prescribed, you may begin taking it at dinner or in the evening.  Take as directed until gone.  Do not take all medications at the same time as this could cause and upset stomach.

Rinses

Do not rinse or spit vigorously or drink through a straw for 24 hours.  These things could prevent proper clotting and healing.  The day after surgery, begin rinsing 5-6 times a day for the next week especially after eating and before bed.  Mix one cup of warm water with one teaspoon of salt and one-half cup of hydrogen peroxide in a cup.  Swish your mouth with this solution or fill the plastic syringe (if given) with the solution and gently squirt it in the areas where the teeth were.  It’s important to rinse out any food particles that could get caught in the sockets.  After the first week, continue to rinse your mouth with plain tap water for two more weeks or until food no longer gets caught in the extraction sites.  Keeping the area clean will help to prevent infection.

If you have an immediate denture in place, do not take it out until 24 hours after surgery to rinse it.  Rinse your mouth with the salt water solution and replace the denture immediately, leaving it in for another 24 hours before taking it out to rinse again.   Leave the denture in for any other rinsing until swelling subsides.

Diet

After IV sedation, we recommend starting your post-operative diet  with clear liquids (water, fruit juice, 7-Up, Jell-O, broth).  Drink from a glass and avoid using a straw for 24 hours.  The sucking action can cause more bleeding by dislodging the blood clots and can prevent proper healing.  You may gradually introduce soft foods (applesauce, soup, mashed potatoes, scrambled eggs, pasta) if tolerating liquids well and feeling has returned to your lip and tongue. We do not recommend dairy products such as yogurt, ice cream or milkshakes on the day of surgery, as nausea and vomiting may develop in conjunction with the anesthetic and pain medication.  A high calorie, high protein intake is very important. Nourishment should be taken regularly. You will prevent dehydration by taking fluids regularly. Drink at least 5-6 glasses of liquid daily. Try not to miss any meals. You will feel better, have more strength, less discomfort and heal faster if you continue to eat.

Sutures

Stitches are dissolvable and will come loose and fall out on their own within the next week.  If there are any long pieces that are bothersome as they become loose, it is okay to trim them with a small scissors.

Smoking

Do not smoke for five to seven days.  Smoking greatly increases the risk of infection and slows healing.

Finally

If you sit up or stand quickly from a lying position, you may become dizzy.  If you are lying down following surgery, make sure you sit up for a few minutes before standing.

The removal of many teeth at one time is quite different from the extraction of just one or two teeth. Because the bone must be shaped and smoothed 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 to three days. Swelling and discoloration around the eyes may occur. The application of a moist warm towel will help eliminate the discoloration. The towel should be applied continuously for as long as is tolerable, beginning 48 hours after surgery. (Remember: ice packs are used for the first 48 hours only).
  • A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause discomfort. This is normal and should subside in 2-3 days.
  • If the corners of the mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment like Vaseline. There may be a slight elevation of temperature for 24-48 hours. If your temperature continues to rise, notify our office.

If immediate dentures have been placed, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery to make the necessary adjustments and relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.