Common Side Effects After Multiple Extractions

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, the following conditions may occur (all of which are considered normal):

Bleeding

A small amount of bleeding is to be expected following the operation. If bleeding occurs, place a gauze pad directly over the bleeding socket and apply biting pressure for 30 minutes. If bleeding continues, a moist tea bag can be used for 30 minutes. The tannic acid in the tea bag helps to form a clot by constricting small bleeding vessels. If bleeding occurs, avoid hot liquids, exercise, and elevate the head. If bleeding persists, call our office immediately. Do not remove the denture unless the bleeding is severe. Expect some oozing around the side of the denture.

Swelling

A certain amount of swelling is normal after surgery and usually is proportional to the surgery involved. Swelling around the mouth, cheeks and sides of the face is not uncommon. The swelling will not become apparent until the day following surgery and will not reach its maximum until two days post-operatively. However, the swelling may be minimized by the immediate use of ice packs. Two 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 left on continuously while you are awake. After 24 hours, ice has no beneficial effect. 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 is beneficial in reducing the size of the swelling.

Pain

For moderate pain, take one or two of the prescribed paracetamol and ibuprofen combination tablets (Nuromol® / Maxigesic®) every four to six hours.

For severe pain, take the prescribed Tramadol® tablets in addition to the tablets above. The prescribed pain medicine will make you groggy and slow down your reflexes. Do not drive a car or work around machinery. Avoid alcoholic beverages. Pain or discomfort following surgery should subside more and more every day. If pain persists beyond the third day after surgery, it may require attention and you should call our office.

Diet

Drink liquids after general anesthesia or IV sedation. Do not use straws when drinking from a glass. The sucking motion can cause more bleeding by dislodging the blood clot. You may eat anything soft (eg: scrambled eggs, pasta, mashed veges, soup, noodles, ice cream, yoghurt, custard, jellies and milk shakes) by chewing away from the surgical site(s). High calorie, high protein intake is very important. Try to maintain a normal diet. You should prevent dehydration by taking fluids regularly. Your food intake will be limited for the first few days. You should compensate for this by increasing your fluid intake. At least five to six glasses of liquid should be taken daily. Try not to miss a single meal. You will feel better, have more strength, less discomfort, and heal faster if you continue to eat.

CAUTION: If you suddenly sit up or stand from a lying position, you may become dizzy. If you are lying down following surgery, make sure you sit for one minute before standing.

Keep the Mouth Clean

No rinsing of any kind should be performed until the day following surgery. After you have seen your dentist for denture adjustment, take the denture out and rinse three to four times a day with a cup of warm water mixed with a teaspoon of salt (or an antiseptic mouthwash, if prescribed), especially after eating.

Discoloration

In some cases, discoloration of the skin follows swelling. The development of black, blue, green, or yellow discoloration is due to blood spreading beneath the tissues. This is a normal postoperative occurrence, which may occur two to three days post-operatively. Moist heat applied to the area may speed up the removal of the discoloration.

Antibiotics

Antibiotics will be given to help prevent infection. Discontinue antibiotic use in the event of a rash or other unfavorable reaction. Call the office if you have any questions.

Nausea & Vomiting

In the event of nausea and/or vomiting following surgery, do not take anything by mouth for at least an hour including the prescribed medicine. You should then sip on Coke, tea, or ginger ale. You should sip slowly over a 15-minute period. When the nausea subsides, you can begin taking solid foods and the prescribed medicine.

Sutures

Sutures are placed in the area of surgery to minimize post-operative bleeding and to help healing. Sometimes they become dislodged. This is no cause for alarm. Just remove the suture from your mouth and discard it.

The sutures used are dissolvable, but can take up to 3 weeks to do so. 

Open sockets

There are open sockets where the teeth were removed. The sockets will gradually fill in with new bone over the next month. In the meantime, the area should be kept clean, especially after meals, with salt-water rinses. Do not attempt to clear food particles from the socket with a toothpick or paperclip, as it may cause infection.

Other Complications

• If numbness of the lip, chin, or tongue occurs, there is no cause for alarm. As stated before surgery, this is usually temporary in nature. You should be aware that if your lip or tongue is numb, you could bite it and not feel the sensation.
• You should be careful going from the lying down position to standing. You were not able to eat or drink prior to surgery. It was also difficult to take fluids. Taking pain medications can make you dizzy. You could get light headed when you suddenly stand up. Before standing up, you should sit for one minute and then get up.
• Occasionally, patients may feel hard projections in the mouth with their tongue. They are not roots; they are the bony walls, which supported the tooth. These projections usually smooth out spontaneously. If not, Mr. Erasmus can remove them.
• If the corners of your mouth are stretched, they may dry out and crack. Your lips should be kept moist with an ointment such as Vaseline.
• Sore throats and pain when swallowing are not uncommon. The muscles get swollen. The normal act of swallowing can then become painful. This will subside in two to three days.
• Stiffness of the jaw muscles may cause difficulty in opening your mouth for a few days following surgery. This is a normal post-operative event that will resolve in time.
• A dry socket is when the blood clot gets dislodged prematurely from the tooth socket. Symptoms of severe pain at the surgical site and even pain to the ear may occur three days following surgery. Call the office if this occurs.

Finally

• If immediate dentures have been inserted, sore spots may develop. In most cases, your dentist will see you within 24-48 hours after surgery and make the necessary adjustments to relieve those sore spots. Failure to do so may result in severe denture sores, which may prolong the healing process.
• Restrict smoking for 3 weeks post-operatively
• No two mouths are alike. Do not accept well-intended advice from friends. Discuss your problem with the persons best able to effectively help you: your surgeon, his staff or your family dentist.