After the Removal of Multiple Teeth

Home Instructions After the Removal of Multiple Teeth

Bleeding is to be expected following the operation to remove multiple teeth. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 45 minutes. You can change that gauze every 45 minutes until bleeding stops, which typically takes 2-8 hours. 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 persists, call our office immediately.

If an immediate denture/prosthesis was placed after extractions, 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.

You should begin taking pain medication BEFORE you feel the local anesthetic wearing off.

For moderate pain:
3 tablets of 200mg Ibuprofen (over the counter) every 6 hours. You can alternate with 2 tablets of 500mg Extra Strength Tylenol every 6 hours if needed. Take the Ibuprofen first, then 3 hours later take the Tylenol. 3 hours after the Tylenol, take the next dose of Ibuprofen, and then continue the alternation schedule every 3 hours while awake.

For severe pain:
Narcotic pain medications can be prescribed and the medication should be taken as directed.
Narcotic pain medications do not help with swelling so they should still be alternated with Ibuprofen.
3 tablets of 200mg Ibuprofen (over the counter) or 600mg prescription strength Ibuprofen every 6 hours. You can alternate with 1 table of Norco or similar narcotic pain medication every 6 hours if needed. Take the Ibuprofen first, then 3 hours later take the narcotic. 3 hours after the narcotic, take the next dose of Ibuprofen, and then continue the alternation schedule every 3 hours while awake.

Do not take any of the above medication if you are allergic to them, or have been instructed by your doctor not to take it. Do not drive an automobile or work around machinery. Avoid 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.

Sample schedule:
8-9am: Surgery
10:00am: Ibuprofen 600mg
1:00pm: Tylenol 100mg if mild to moderate pain, Norco 5/325mg if severe pain 
4:00pm: Ibuprofen 600mg
7:00pm: Tylenol 100mg if mild to moderate pain, Norco 5/325mg if severe pain 
10:00pm: Ibuprofen 600mg
* Overnight dosing depends on pain control. If pain has been difficult to control, set an alarm for every 3 hours and stay on the schedule as above. If pain has been easy to control, set the next dose of pain medication by the bed with water and plan to take if you wake up in pain during the night. 

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 or a prescribed antibiotic rinse 3-4 times daily or 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 3-4 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 48 hours. Swelling and discoloration around the eyes or under the jaw may occur. The application of a moist warm towel will help eliminate the discoloration but you should wait until 3 days after surgery to begin. The towel should be applied continuously for as long as is tolerable, beginning 3 days after surgery. (Remember: ice packs only within the first 2 days).
  • 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.