After the Removal of Multiple Teeth

BLEEDING:

It is normal to have some bleeding from the mouth for about 12 hours after oral surgery. The bleeding can be slowed and eventually stopped by placing some folded gauze on top of the bleeding area and biting your teeth or gums together to keep the gauze firmly in place. Replace with fresh gauze every 30 to 40 minutes as needed until the bleeding stops. You will know when the bleeding is starting to slow down by the color of the gauze when you change it. If you want to eat, drink or sleep and are still in need of the gauze, remove it entirely and replace when finished. Please do not change the gauze more frequently than every 20 to 25 minutes, as this will only prolong the bleeding. If large jelly-like clots develop, rinse the mouth with water to remove these clots, replace the gauze, and bite down. For persistent bleeding (gauze becoming soaked with blood within a few minutes) dip a fresh tea bag in warm water, squeeze the liquid from the tea bag on to the gauze, place in the area, and bite down. The tea will act as an astringent, which helps to stop the bleeding. Please avoid rinsing, spitting, smoking, or drinking through a straw for 3 days after the surgery.

DISCOMFORT:

We recommend taking ibuprofen as soon as you get home, before the novocaine starts to wear off. Take one of the prescription strength ibuprofen pills (600mg) you have been given every 6 hours for the next couple of days, unless your doctor has instructed you otherwise. It contains an anti-inflammatory, which will keep the swelling down, which in turn will take the discomfort down. If the ibuprofen alone is not making the discomfort tolerable, you can start taking the prescribed narcotic pain reliever, if applicable, in between the doses of the ibuprofen. Taking alternating doses of the two different medications will help take away the discomfort. Do not stop taking the ibuprofen if you take the narcotic pain reliever, but take both medications in alternating doses. You can also follow a regimen of only ibuprofen or acetaminophen (Tylenol) if the discomfort you experience is mild.

SWELLING:

Swelling is common after most oral surgery procedures. Please do not become alarmed if the swelling becomes severe. When you get home after the oral surgery, apply ice packs to the outside of the surgery area for intervals of 10 minutes on and 10 minutes off for the first 24 hours to minimize the swelling and discomfort. You can use ice cubes in a bag, cold packs or bags of frozen veggies, just make sure all cold items are wrapped in a towel to protect the skin. The lips and/or cheeks may become extremely puffy and swollen. Stiffness of the jaw is common for about 5-10 days after the surgery.

NAUSEA:

Nausea is a common side effect of surgery or anesthesia. Swallowing of blood also causes nausea and possible vomiting, but this condition stops as the bleeding subsides. Narcotics are the most frequent cause of nausea.  Switching to a regimen of non-narcotic medications, such as ibuprofen or acetaminophen (Tylenol) can be helpful. If vomiting persists after 24 hours, please contact the oral surgeon.

NUMBNESS:

The local anesthetic (numbing medication) given during surgery may result in numbness of the mouth for 1 to 12 hours. Some procedures are occasionally associated with extended periods of numbness lasting days or weeks. Please contact the surgeon about any unexpected numbness. Minimize chewing on the affected side until the numbness has subsided.

STITCHES:

Stitches are dissolvable and start to disintegrate after a few days to a few weeks. Avoid manipulating the stitches with your lip or tongue.

DIET:

You may eat and drink as soon as you feel like doing so after the surgery. Avoid eating anything chewy until the local anesthetic (numbing medication) has worn off. It is best to limit the diet to soft, non-chewing choices until the mouth feels more comfortable. These choices can include soups, shakes, smoothies, puddings, soft cereals, pasta, mashed potatoes, scrambled eggs, and pureed foods. If you chose a shake or a smoothie, remember no straw for 3 days after the surgery.

INFECTION:

Infection after oral surgery can occur. Infections generally take 3-5 days to develop, but can also occur 3-6 weeks after surgery. If we have prescribed antibiotics, be sure to take them as directed. Contact the surgeon if new swelling or redness appears several days after the surgery.

SMOKING:

Smoking can delay healing and interferes with healthy tissue formation. Avoid smoking after oral surgery until the swelling subsides, at least 3 days.

RINSING:

For the first 48 hours, do not rinse your mouth as this may stimulate bleeding. After the first 24 hours, you may rinse gently with warm salt water (1/2 tsp. salt to 8 oz. water) after eating. After 24 hours, you may brush your teeth, but avoid using any commercial mouthwash (i.e. Scope, Listerine) for the first week.

ACTIVITY:

Stay off your feet as much as possible the first day. Do not engage in any vigorous activity until the swelling subsides. Showering is okay the day after surgery.

IMPORTANT:

If you are using birth control while using an antibiotic, you could become pregnant. You should use a second method of contraception during this time, as well as the birth control pills. Take any other prescribed medications on schedule, as normal.

If you have followed our instructions and are having a severe problem, contact the surgeon at 216-464-1200 (office). For after hours emergencies, page the surgeon at 216-245-2280. You will be instructed to leave a voice message and input your phone number. Alternative number if paging fails is 216-469-3199

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