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After Surgery Instructions following Multiple Tooth Extractions & Immediate Denture(s)

DISCOMFORT: Adults should take 400 to 600mg (2 to 3 pills of 200mg each) of Ibuprofen (Advil or Motrin) as soon as possible (before the numbness wears off), and continue taking them every 6 hours for at least 5 days.  However, do NOT take Ibuprofen if your medical doctor has instructed you to avoid NSAIDs.  If pain persists in spite of taking the Ibuprofen, take your prescription pain medication as directed on the bottle. Please note: it is O.K. to take the Ibuprofen & the prescription drug at the same time.  Patients who have undergone removal of impacted teeth should expect at least 2 to 3 days of significant pain, facial swelling & stiffness when opening the mouth. A dry socket occurs in about 10% of patients & starts as a persistent ache in one or both sides of the jaws or ear. It begins 3 to 7 days after surgery and is relieved in the office by placement of a medicated dressing.

SWELLING & BRUISING: This may develop within the first 24 hours, peaks at 48 to 72 hours, rapidly resolves, and is negligible by the 7th day.  You may apply an ice pack during the first 36 hours (20 minutes on then 20 minutes off) for comfort & to reduce swelling. Keep your head elevated for the first 48 to 72 hours.  Discoloration of the face sometimes normally occurs as a result of bleeding into the tissues (bruise or hematoma) and will resolve in 5 to 7 days.

BLEEDING: If gauze were left in your mouth, bite firmly on them for at least 60 minutes after surgery, then remove (gauze will be colored red-- this is normal).  Expect to see persistent oozing from the sockets for the first 24 hours; it will color your saliva pink-red and is normal.  If needed, moisten & then twice-fold 1 or 2 of the gauze from your Postop Bag into a square and place over the surgical site in your mouth, maintaining constant (not chewing!) pressure for 30 minutes.  If the oozing is bothersome, you may place a dry, caffeinated tea bag (NOT herbal tea) over the wound, elevate your head (extra pillow) and bite firmly on the bag for one hour. Your upper teeth should not be touching your lower teeth while the packs are in place.  If you notice that they are touching, either reposition the packs or replace them with a thicker pack.  In other words, ALL of your jaw pressure should be directed on the gauze! However, if your mouth fills with large clots of blood, please call the office promptly.  Before taking a nap, consider placing an old towel over a pillow, as pink-red (serous oozing) saliva may leak from the mouth.  Stains may be removed with 3% Hydrogen peroxide.

EATING & NUTRITION:  If you were asleep during surgery, begin with clear liquids like 7-UP to avoid nausea.  Then rapidly advance to milkshakes, soups, and then soft, solid food as tolerated.  Be careful not to chew until the numbness has worn off.  Let the severity of your discomfort guide you in the selection & placement of food. Take smaller bites & keep the food in an area remote from the wound(s) if possible. After 3 or 4 days you should be able to chew a soft or even regular consistency diet, depending on your level of discomfort.  If teeth were removed, a straw should not be used for drinking for 48 hours following your surgery so as to avoid dislodging the blood clots from the wounds. 

A normal (or supernormal) intake of calories and nutrients is important, as your body now has a higher than usual metabolic requirement in order to heal your wounds. High protein/high calorie nutritional supplementation is encouraged for the first week to encourage rapid & uneventful healing.

NAUSEA: This uncommonly occurs as a side effect of the prescribed medications or (rarely) from the anesthetic drugs. Try not to take your pills on an empty stomach. Antacids (Maalox, Pepto-Bismol, etc.) may help to alleviate nausea.  If vomiting occurs and is persistent, call the office. A prescription will be called in for a suppository medication.

ACTIVITY: Get plenty of rest & go to bed early!  Do not participate in any activity that will significantly raise your heart rate or blood pressure for 24 hours after your surgery.  Avoid contact sports for 1 to 2 weeks.  Depending on your occupation, you may return to work within 24 to 48 hours. Following minor surgery, you may be able to return to normal activity immediately.

WOUND & DENTURE CARE: Try and leave your dentures in place until the second evening following your surgery.  At that time, remove your dentures and soak them in a mixture of 50 % salt water (1/2 teaspoon per 6 oz. glass) and 50% hydrogen peroxide. Nowgently rinse your mouth with warm salty water and then immediately replace the dentures.  If you leave your dentures out for more than 5 or 10 minutes, it may be difficult to replace them due to the swelling that persists for several days. You should resume brushing any remaining teeth on the day after your surgery.  Beginning the fourth day after surgery you should begin leaving your denture out of your mouth at night while sleeping.  Stitches (sutures) are auto-digestible and will dissolve within 1 to 2 weeks.

IF QUESTIONS ARISE, PLEASE DO NOT HESITATE TO CALL US AT 770-218-9135