ORAL CARE ASSOCIATES: DALE H. MINKIN, DDS

surgical instructions

after multiple extractions

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after the removal of multiple teeth

A certain amount of bleeding is to be expected following surgery.
Slight bleeding, oozing, or redness in the saliva is not uncommon, even for a few days after surgery. Excessive bleeding may be controlled by first gently rinsing or wiping any old clots from your mouth, then placing a gauze pad directly over the site of surgery and biting firmly with constant pressure for thirty minutes. The gauze can be folded or two can be combined if needed. Repeat this if it doesn’t work the first thirty minutes. If bleeding continues, bite on a moistened tea bag for thirty minutes, again, being sure to place it directly over the surgery site (typically, the tooth socket) with firm, constant pressure. The tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. Avoid hot liquids and foods. It is also important to sit upright, remain calm and limit your physical activity. If bleeding does not subside, call us (510-797-9100) for further instructions.
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The normal swelling that is expected is usually proportional to the surgery involved. 
​A certain amount is almost always to be expected. Swelling around the mouth, cheeks, eyes and sides of the face is not uncommon. This is the body’s normal reaction to surgery and eventual repair. The swelling may not become apparent until the day following surgery and will not reach its maximum until 2-3 days post-operatively. However, the swelling may be minimized by the immediate use of ice packs, before it occurs. Two small, plastic bags filled with ice, or ice packs should be applied to the sides of the face where surgery was performed. The ice packs should be used on a schedule of 20 minutes on and 5 minutes off, continuously, as long as the patient is not sleeping or eating. After 24 hours, ice generally has no beneficial effect on the swelling, but many patients find it to be a helpful adjunct in reducing pain. If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. Thirty-six hours following surgery, the application of moist heat to the sides of the face can be beneficial in reducing the size of the swelling. Once the normal post-operative swelling has resolved, it should not re-occur; if swelling does return, or, is progressively worsening, please contact the office (510-797-9100 or 408-916-9100).
You should begin taking pain medication as soon as you feel the local anesthetic wearing off. 
​For moderate pain, one or two tablets of ibuprofen (Motrin or Advil) two-four 200 mg tablets may be taken every three to four hours, not to exceed the manufacturer’s recommended daily dose. Do not take any medications if you’ve had prior allergic reactions to them.

​For severe pain, take the tablets prescribed as directed. The prescribed pain medicine will make you groggy and will slow down your reflexes. Do not drive an automobile, do not work around machinery, and do not consume alcoholic beverages while under the influence of these or any other medications which make you feel tired, sleepy or dizzy. Pain or discomfort following surgery should subside gradually each day. If pain persists or worsens, it may require attention and you should call the office (510-797-9100).
If antibiotics were prescribed, finish your prescription unless you experience adverse reactions or develop an allergy, in which case you should call the office. Not all patients and not all procedures require antibiotics. If you have been placed on antibiotics, take the tablets or liquid as directed. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions (510-797-9100).
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Drink plenty of fluids. 
​If many teeth have been extracted, the fluid volume lost needs to be replaced. Drink at least 5-6 glasses of liquid the first day. This is especially true if fasting was required before surgery, as in the case of general anesthesia or I.V. sedation. Do not use straws. Drink from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft by chewing away form the surgical sites. High calorie, high protein intake is very important. Nourishment should be taken regularly. Your food intake will be a challenge for the first few days. You should compensate for this by increasing your fluid intake. Fluid replacement and maintenance is very important and should not be ignored. Try not to miss a single meal; commonly available nutritional supplement drinks can be very helpful. You will feel better, have more strength, less discomfort and heal faster if you continue to eat. Avoid any fluids or foods that are hot; your lips and mouth will be numb so test with your hand. Caution: If you suddenly sit up or stand from a lying position you may become dizzy. This is often a sign of poor fluid/food intake. If you have been lying down following surgery, make sure you sit upright for a few minutes before standing.
Do not rinse your mouth for the first post-operative day, or while there is bleeding.
After the first day, use a cup of lukewarm water mixed with a teaspoon of salt to rinse every 4 hours and following meals to flush out particles of food and debris that may lodge in the operated area, using a cup of lukewarm water mixed with a teaspoon of salt. Continue this procedure until healing is complete. REMEMBER: A clean wound heals better and faster. If the doctors prescribed a mouth rinse for you, follow the instructions on the bottle. After you have seen your dentist for denture adjustment, take out denture and rinse 3 to 4 times a day. You can brush your teeth as best you can the night of surgery but spit and rinse gently when doing so.
Restrict your diet to liquids and those soft foods, which are comfortable for you to eat. As the wounds heal, you will be able to advance your diet.
The removal of many teeth at one time is quite different than the extraction of one or two teeth. Because the bone often times must be shaped prior to the insertion of a denture, the following conditions may occur, all of which are considered normal:
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  • The area operated on will swell reaching a maximum in about two days. Swelling and discoloration around the eye may occur. The application of a moist warm towel will help eliminate the discoloration quicker. The towel should be applied continuously beginning 36 hours after surgery (remember that ice packs are used for the first 24 hours for the purpose of reducing swelling; thereafter, cold can be helpful in reducing pain).
  • 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.
  • It is not uncommon for the lips and corners of the mouth to be dry and to crack. It is helpful to keep these areas moist with an ointment such as Vaseline or other products intended for the lips.
  • Slight elevation of temperature immediately following surgery is not uncommon. If the temperature elevation persists, notify the office (510-797-9100). Tylenol or ibuprofen should be taken to reduce the fever. Be aware that following surgery in the mouth, the oral temperature will be elevated. Post-operative temperature should be taken ideally under the arm or in the ear canal.
  • If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-72 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to have these sore spots adjusted may result in severe denture sores, which may prolong the healing process.
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Oral Care Associates: Dale H Minkin, DDS

39350 Civic Center Dr, Suite 320
Fremont, CA 94538
(510) 797-9100
info@oralcareassociates.com
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  • Home
  • Patient Information
    • Consultation
    • Scheduling
    • Financial Policy
    • About Insurance
    • Surgical Instructions >
      • Before IV Anesthesia
      • After Dental Implants
      • After Wisdom Teeth
      • Tooth Exposure
      • After Multiple Extractions
  • Procedures
    • Dental Implants
    • Bone Grafting
    • Wisdom Teeth
    • Impacted Canines
    • Oral Pathology
    • TMJ Disoders
  • Meet the Team
  • StemSave
  • Resources
    • Referral Form
  • Patient Feedback
  • Patient Registration
  • Contact