After Multiple Extractions

surgical instructions

A small amount of bleeding is to be expected following the operation. To control bleeding apply firm direct pressure  by biting on a moistened gauze pad placed directly over the bleeding sockets for 30 to 60 minutes. If bleeding continues, apply firm direct pressure with moistened tea bags for 30 to 60 minutes. Tea has tannic acid which is an astringent. The direct pressure and tannic acid help to form a clot by constricting the blood vessels. If you have an immediate denture, some oozing of blood around the edges of the denture will occur. If bleeding beneath the denture is severe, remove the denture, gently wipe away large blood clots with a gauze pad and apply firm direct pressure to the bleeding sites by biting on gauze and/or tea bags for 30 to 60 minutes. Slight blood tinged saliva or blotting blood on gauze may continue off and on for a day or two after surgery. In general this does not require management with gauze pressure. If active bleeding continues please call the office for further instructions.

Immediate application of ice packs to the face near the operated area will help to minimize swelling and bruising. Apply ice continuously, or as much as possible while awake, especially during the first 12-24 hours. Ice is helpful only during the first 72 hours after surgery. Swelling will peak 72 hours after surgery; then it will gradually begin to subside.

For mild to moderate discomfort use Tylenol; two 325 mg tablets every 4 hours. Ibuprofen (Advil, Motrin) 200mg tablets can be taken: 2 tablets every 4 hours, or 3 tablets every 6 hours, or 4 tablets every 8 hours. For severe pain use the prescription given to you. Pain should begin to improve by the third or fourth post-operative day. Please view our General Post-operative Care Instructions for more information regarding pain management. If an antibiotic has been prescribed, it is important to finish the medication as instructed.

Begin warm salt water rinses if there is no active bleeding on the evening of surgery or the first post-operative day. Rinse 5 to 6 times a day to flush out particles of food and debris that may lodge in the operated area. (mix one half teaspoon of salt in a glass of lukewarm water.). After you have seen your dentist for denture adjustment, remove the denture, rinse it out and rinse out your mouth at least 5 to 6 times a day.

If Peridex (chlorhexidine) oral rinse has been prescribed, follow instructions on the bottle. Start the Peridex (chlorhexidine) the night of surgery or the next day. Rinse one capful in the mouth, swish for one minute and spit out twice a day after brushing for 10 to 14 days. If you have any natural teeth remaining you may start brushing gently with tooth brush and tooth paste on the evening of surgery or the day after surgery if there is no active bleeding.

During the first few days restrict your diet to liquids and soft foods. As healing proceeds and you become more comfortable, you will gradually be able to advance your diet to more solid foods. It is important to drink 6 to 8 glasses of juice, soda or water each day to avoid dehydration. Please see our General Post-Operative Care Instructions for more detailed dietary information.

• The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone must be shaped and smoothed prior to the insertion of a denture or partial denture, the following conditions may occur, all of which are considered normal:
• Discoloration around the eye and/or under the jaw may occur. The discoloration may not become fully apparent until 2 or 3 days after surgery. The application of a moist warm towel may help eliminate the discoloration more rapidly. Do not apply heat during the first 72 hours after surgery, this can increase swelling and bruising.
• The corners of the mouth may become dry and crack. Your lips should be kept moist with an over the counter lip balm or Vaseline.
• There may be a slight elevation of temperature during the first 24 hours after surgery. If temperature persists or reaches 101 or higher, notify our office immediately.
• If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you 24-48 hours after surgery and make the necessary adjustments to relieve the sore spots. Since immediate dentures are fabricated before the teeth are extracted they may be loose and require an over the counter denture adhesive to help keep them in place. Once healing is complete the dentures may be relined by your dentist to improve the fit.
• Learning to eat and speak comfortably and confidently with dentures takes time and practice. Please do not get discouraged, the harder you work at developing eating and speaking skills with your new denture, the sooner you will get good at it.

Missing teeth should be replaced for the following reasons: improved esthetics, improved chewing efficiency, improved speech articulation, stabilization of occlusion (preventing shifting of teeth), comfort and self confidence. In most cases the best option to replace missing teeth is with dental implants. If implants are not placed immediately, the extraction sites should be evaluated for implants about 7 or 8 weeks after the teeth have been extracted. Waiting too long for implant placement after extractions can result in shifting of the teeth and bone loss due to bone resorption prohibiting future implant insertion.

It is reassuring to know that, today, there are better options for replacement of missing teeth than conventional old fashioned dentures, partial dentures and bridges. Dental implants have rendered conventional dentures, partial dentures and in most cases, bridges obsolete. Only two dental implants are required to convert a loose lower denture into a secure over-denture. This simple surgical procedure will significantly improve chewing efficiency, speech, esthetics, self image and self confidence. Implant dentistry is a simple way to significantly improve your quality of life. Please call our office if you would like more information about dental implants. Also, please view our dental implant video and section on dental implants for additional information on this subject.

Please review our General Post-Operative Care Instructions for additional helpful information.

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Jon D. Turesky, D.M.D., P.C. • 1 Walpole Street, Norwood MA 02062 (781) 762-7077 • 100 Copeland Drive, Mansfield MA 02048 (508) 543-3754

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