After the Removal of Multiple Teeth
A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, bite on a moistened black tea bag for thirty minutes. The tannic acid in the black tea helps to form a clot by contracting blood vessels. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove the immediate denture unless the bleeding is severe. Expect some oozing around the side of the denture.
Use ice packs (externally) on the cheek near the surgical site. Apply ice for the first 36 hours only. Apply ice continuously while you are awake.
Pain Management Suggestions:
NSAIDs (IBUPROFEN, NAPROXEN, ASPIRIN):
- NSAIDs are by far the most effective medications for pain after oral surgery, however some patients cannot take them (due to ulcers/reflux, blood thinners, asthma, etc.).
1) Take 3 ibuprofen (Advil, Motrin) tablets (200mg each) every 6 hours as needed. Try to get the first dose taken before the local anesthetic/numbness wears off. If needed, a maximum of 4 tablets can be taken every 6 hours – up to 3,200mg per day.
2) Take 1-2 naproxen sodium (Aleve; 220mg) every 12 hours as needed. Do not exceed 4 tablets (880mg) per day.
- If you need better pain control after taking the NSAIDs (or if you cannot take NSAIDs), you should take Tylenol (acetaminophen):
3) Take acetaminophen (Tylenol) 325-1000mg every 4-6 hours as needed. DO NOT take more than 4,000mg of acetaminophen per day.
PRESCRIPTION OPIOID PAIN MEDICATIONS:
If you’ve taken adequate doses of an NSAID and/or Tylenol and feel that your pain is not tolerable, then it is appropriate to add the prescription opioid:
4) If you received a prescription for codeine (Tylenol #3) or hydrocodone (Vicodin, Norco, Lortab, etc.) – you can take that if you need better pain control.
*Be aware that these have Tylenol/acetaminophen in them, so you must be careful to be mindful of the maximum daily dose of Tylenol, which is 4,000mg.
5) If you received a prescription for oxycodone or hydromorphone/Dilaudid: these do not contain Tylenol/acetaminophen. You should be sure to try an NSAID and Tylenol before adding these medications.
- Pain from a tooth extraction usually resolves within 1-2 days, although infections can prolong pain for another day or two. If you are not seeing progress in your pain after 2 days, you should call our office.
Oral Surgery Nurse’s Line – (319) 337-8384
After Hours /Weekends – Mercy Hospital of Iowa City – (319) 339-0300, ask for the oral surgeon on call.
Drink plenty of fluids. If many teeth have been extracted, the blood lost at this time needs to be replaced. Drink at least six glasses of liquid the first day.
Do not rinse your mouth for the first post-operative day, or while there is bleeding. After the first day, use a warm salt water rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area. (One teaspoon of salt in one cup of warm water). After you have seen your dentist for denture adjustment, take out the denture and rinse 3 to 4 times a day.
Restrict your diet to liquids and soft foods that are comfortable for you to eat. As the wounds heal, you will be able to resume your normal diet.
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 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 36 hours after surgery. (Remember: ice packs are used for the first 36 hours only).
- A sore throat may develop. The muscles of the throat are near the extraction sites. Swelling into the throat muscles can cause pain. 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 inserted, 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.