A full mouth extraction (FME) involves the surgical removal of all teeth from both the upper and lower jaws. While the idea of removing all teeth at once is significant, the procedure is possible and can be performed in a single session. This major surgery is typically considered only when widespread dental failure has occurred, usually due to advanced gum disease or extensive decay, and less invasive treatments are no longer an option. The decision to proceed with FME marks a transition toward prosthetic dental solutions.
Determining the Necessity of Full Mouth Extraction
A general dentist can recommend a full mouth extraction, but the complex procedure is typically performed by an oral and maxillofacial surgeon. The decision to remove all teeth is usually considered a measure of last resort to protect the patient’s overall health. This action becomes necessary when the teeth are compromised beyond repair by conditions like severe, chronic periodontal disease.
Advanced periodontal disease causes the gums to pull away and leads to significant loss of the bone structure supporting the teeth, making them unsalvageable. Extensive decay or widespread dental abscesses that pose a risk of spreading infection are other common justifications for FME. In some instances, the procedure may be required to prepare the mouth for radiation therapy for oral cancer or to alleviate chronic oral pain. A thorough evaluation, including X-rays and a review of the patient’s medical history, is conducted by the surgical specialist to determine if FME is the appropriate path forward.
The Surgical Environment and Anesthesia Options
A full mouth extraction is a lengthy surgical procedure that requires a controlled setting to ensure patient comfort and safety. Because of the number of extractions and the duration of the surgery, FME is generally performed in a specialized surgical center or a hospital operating room, rather than a standard dental treatment room. The time commitment for a single-session FME can be several hours, depending on the complexity of the extractions.
The management of pain and anxiety relies on advanced anesthesia options beyond simple local injections. While local anesthesia is always administered to numb the surgical sites, a deeper level of sedation is typically used for patient comfort. This often involves intravenous (IV) sedation, which puts the patient into a deeply relaxed state with little to no memory of the surgery. For the most extensive procedures, general anesthesia may be used, rendering the patient completely unconscious.
Immediate Post-Operative Care and Healing
Bleeding Control
The first 24 to 72 hours following FME are the most critical period for managing discomfort and promoting blood clot formation in the sockets. Immediately after the surgery, the patient must maintain firm, gentle pressure on gauze pads over the extraction sites to control bleeding. The gauze should be changed every 20 to 30 minutes until the bleeding is minimal, which is typically within three to four hours.
Swelling Management
Swelling is a common reaction, often peaking around two to three days after the procedure. To minimize this, cold compresses or ice packs should be applied to the outside of the face. Use a cycle of 20 minutes on and 20 minutes off for the first 48 hours. The patient should also keep their head elevated with pillows when resting to further reduce swelling.
Pain and Diet
Pain management is achieved with prescription medications, which should be taken as directed, often before the local anesthesia fully wears off. During the initial 24 hours, the patient must avoid vigorous rinsing, spitting, or using a straw, as the suction can dislodge the protective blood clot and lead to dry socket. The diet must be restricted to cold, soft foods, such as yogurt, ice cream, and smooth soups, for the first day, with a gradual progression to warmer, soft foods over the next week.
The Process of Receiving Replacement Dentures
After a full mouth extraction, the next step involves receiving replacement dentures, which is often divided into two phases.
Immediate Dentures
Many patients receive a set of “Immediate Dentures” on the same day as the surgical extractions. These pre-fabricated prosthetics act as a protective bandage over the surgical sites, helping to control bleeding and allowing the patient to function aesthetically and speak. Immediate dentures are temporary because the gums and the underlying jawbone begin to remodel and shrink significantly after the teeth are removed. This natural process means the initial fit will quickly become loose and require multiple adjustments, or “relines,” over the healing period.
Conventional Dentures
The soft tissue typically heals within six to twelve weeks, but the bone changes can continue for a total of six to twelve months. Once the mouth has fully healed and the bone has stabilized, the patient can proceed with the creation of “Conventional” or “Permanent Dentures.” These are custom-made to conform precisely to the fully remodeled gum and bone contours, offering a much more stable and comfortable long-term fit than the immediate set. This two-stage prosthetic approach ensures the final restoration is built upon a stable foundation, providing the best possible function and fit.