FLUORIDE / SEALANTS / LOCAL ANESTHESIA / FILLINGS / EXTRACTIONS / PRIMARY TOOTH CROWNS / SWELLING & PAIN / SPACE MAINTAINERS / SEDATION / CONTACT US 24/7
FLUORIDE
Professional fluoride treatments are placed on the teeth usually at the end of an exam and cleaning. The high fluoride concentration about twice a year helps to prevent cavities. The minerals are absorbed by the teeth and make them more resistant to tooth decay.
Recommendations:
- No eating hot or crunchy foods for three hours after your child’s appointment.
SEALANTS
Sealants are effective in preventing tooth decay, but ONLY if the sealant stays in place. If the sealant falls out, the tooth is again susceptible to food and bacteria filling the grooves of the teeth, which results in cavities.
Recommendations:
- Avoid tacky candies like Milk Duds, Laffy Taffy, Tootsie Rolls, Jolly Ranchers, etc. These kinds of candies, when bitten into, require excessive force to separate the teeth, which can result in sealant loss.
LOCAL ANESTHESIA
Local anesthesia allows us to complete dental work painlessly. Local anesthetics vary in their duration of action. Duration of action depends on a number of factors: the amount of anesthetic used, the child’s metabolism, the injection type/site, etc.
In general, you can expect local anesthetic to last two to four hours after your child’s appointment. Depending on the tooth worked on, the anesthetic may affect/numb the lips, cheeks, tongue, or nose of your child.
Recommendations:
- Monitor your child: They should not be left unattended. Many children find the sensation puzzling and will bite, pick, rub, or suck on the numb area. Any one of these actions can result in self-inflicted trauma such as abrasion, laceration, swelling, bleeding, and pain. If you notice your child playing with the area, take action.
- No chewing: A child should defer chewing until the numbness goes away. If your child is hungry, he or she can have applesauce, yogurt, or a smoothie. (Note: if your youngster had an extraction, he or she should not drink through a straw.)
- Pain control: Local pain at the injection site is normal. We recommend administration of over-the-counter children’s ibuprofen BEFORE the numbness wears off. It’s easier to prevent pain from starting than to stop it once it has started.
Trauma care:
If your child traumatized the lip, cheek, or tongue while numb, administer pain medication every 4-6 hours. Ibuprofen is preferred over Tylenol due to the anti-inflammatory effect. Place a cold compress or ice on the area; this will help to reduce inflammation and pain as well. If the trauma is severe, your son or daughter may need stitches. Call our office if this is suspected.
FILLINGS
Fillings are the most common treatment rendered in the dental office.
Pain is not typically expected. Sometimes if a cavity was particularly deep, the tooth may be sensitive to cold or hot for a couple of weeks.
Recommendations:
- Avoid tacky candies like Milk Duds, Laffy Taffy, Tootsie Rolls, Jolly Ranchers, etc. These kinds of candies, when bitten into, require excessive force to separate the teeth, which can result in filling failure
- Composite: Tooth colored fillings are as hard, the day they are placed, as they’re ever going to be. Therefore, a child may proceed with a normal diet after the numbness goes away.
- Amalgam: Silver fillings require 24 hours to fully harden. It is recommended to eat a soft diet for 24 hours.
EXTRACTIONS
Extractions are performed for a number of reasons, and recovery depends on an array of factors, such as the extraction site, tooth extracted (front tooth vs. back tooth, baby tooth vs. adult tooth), and means of extraction (surgical vs simple). In general, children do far better than adults with tooth extractions and are unlikely to have much pain or complication.
Recommendations:
- Bleeding: Bleeding is controlled before we discharge your child, but some occasional oozing (pink or blood-tinged saliva) may occur. Hold gauze with firm pressure against the surgical site until oozing has stopped. You may need to change the gauze. If bleeding continues for more than two hours, contact us. (Note: We recommend sleeping with an old t-shirt on your child’s pillow-case just in case your child drools and there is some oozing from the extraction site.)
- Surgical site care: On the day of the procedure, do not disturb the surgical site. Do not stretch the lips or cheeks to look at the area. Do not rinse vigorously, use mouthwash, or probe the area with fingers or other objects. Beginning the next day, you may rinse with warm salt water (½ teaspoon salt with one cup water) after meals.
- Diet: We recommend a soft diet for 5-10 days. After all bleeding has stopped, the patient may drink cool, non-carbonated liquids but should NOT use a straw. Encourage fluids to help avoid dehydration. Cold soft foods (e.g., ice cream, gelatin, instant breakfast shakes, pudding, yogurt) are ideal the first day. By the second day, consistency of foods can advance as tolerated. Until healing is more established, avoid crunchy foods such as nuts, chips, and popcorn that may get lodged in the extraction site.
- Daily activities: Avoid physical exercise and exertion. Return to normal activities as tolerated.
- Pain: Because some discomfort is expected, you may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®) before the numbness wears off. Do NOT give aspirin to your child. Follow the instructions on the bottle for dosing based upon your child’s age/weight.
- Oral hygiene: Keeping the mouth clean is essential. Teeth may be brushed and flossed gently, but avoid stimulating the surgical site. Soreness and swelling may not permit vigorous brushing of all areas, but please make every effort to clean the teeth within the bounds of comfort.
- Sutures: If stitches were placed to help control bleeding and promote healing they will dissolve and do not need to be removed. If the stitches come out during the first 48 hours, call our office.
CROWNS
Crowns are common in pediatric dentistry to restore grossly decayed teeth to proper form and function. Crowns are very strong. In essence they are glued onto your child’s tooth with a cement that requires 24 hours to fully harden.
Recommendations:
- Diet: Soft foods for 24 hours. Avoid hard or tacky foods/candies that require excessive force to chew. After 24 hours the crown cement is an appropriate hardness to withstand normal chewing forces.
- Gums: Crowns sit just below the gum line. Because of this, gingival irritation is expected after treatment. Expect bleeding associated with brushing. Do not allow bleeding to deter proper oral hygiene techniques; just like any wound, the better the area is kept clean the faster and more predictable the healing process.
- Pain: Gingival trauma is unavoidable during placement of a crown. We recommend over the counter Tylenol or ibuprofen BEFORE numbness wears off to prevent the onset of pain.
Your child’s crown will naturally fall out when the underlying baby tooth falls out. Many times parents are concerned that a crown is loose when in actuality the baby tooth is naturally exfoliating.
SWELLING & PAIN
Mild swelling and discomfort are to be expected after many dental procedures. In most cases the swelling and discomfort are limited to the gums. Often the gums are traumatized in the process of restoration.
In pediatric dentistry, swelling is usually very mild and children typically do not require special post-operative care for swelling and pain beyond over-the-counter pain medicine.
Self-inflicted trauma to their lip or cheek while being numb is the most common cause of excessive post-operative swelling and pain. If your child bit, picked at, or sucked on their lip with enough force the lip or cheek could swell and be very painful.
Recommendations:
- Cold: Swelling can be reduced/prevented using a cold compress or ice pack. Application to the cheek or lip for 10 minutes three times a day is recommended. Always keep a cloth between the skin and the ice pack and do NOT apply for longer than 15-20 minutes.
- Ibuprofen: Ibuprofen is preferred to Tylenol because of its anti-inflammatory action.
- Alternating medications: Narcotics are to be avoided in childhood. In most cases over-the-counter pain relievers are adequate. If ibuprofen is not sufficient, we recommend alternating doses of ibuprofen and Tylenol. Studies show that alternating these two medications works as well as many narcotics.
SPACE MAINTENANCE
Space maintainers are ‘glued’ to the teeth and are intended to remain in place until the underlying permanent tooth erupts into the mouth. If the spacer comes out it should be replaced IMMEDIATELY. Do not delay in contacting the dental clinic if a spacer has fallen out because space loss and tooth tipping can occur rapidly in the growing child.
In order to avoid spacer displacement, we recommend:
- Avoid tacky candies like Milk Duds, Laffy Taffy, Tootsie Rolls, Jolly Ranchers, etc. These kinds of candies, when bitten into, require excessive force to separate the teeth, which can result in spacer failure.
- Hard Foods: Hard foods can bend, distort, or break space maintainers. If your child has a space maintainer they should avoid eating hard things like nuts, uncooked carrots, pretzels, ice, and hard pizza crust.
If a space maintainer comes loose, call us immediately and we’ll work out a time to see your child. If it is a weekend or in the evening, have your child try to push it back into place (If it’s still attached on the other side) or remove the device (if it’s independently loose). A soft diet that requires minimal chewing is appropriate until you can make it in to recement the appliance.
NOTE: DO NOT ATTEMPT TO REMOVE A SPACE MAINTAINER BY YOURSELF IF IT’S CONNECTED TO MULTIPLE TEETH. This will result in appliance breakage.
SEDATION DENTISTRY
Sedation is an excellent way to manage your young or fearful child in the dental setting. It’s important that your child be monitored closely after a sedation appointment to avoid any complications.
Recommendations:
- Hydration: Some sedative medications can make children nauseous. Clear liquids should be encouraged. Treat your child as though they have a stomach flu, giving them easy to digest foods such as chicken broth, saltines, and water. Avoid dairy products or greasy foods until your child tolerates the milder diet.
- Clumsiness: Your child might be clumsy for the rest of the day. This is because traces of the medications can remain in their system throughout the day. We recommend a quiet day at home watching cartoons or reading books. Avoid climbing on things or playing on hard surfaces. Most children are fine going to school the next day.
- Sleeping: If your child wants to sleep, position your child on his/her side with the head supported and the chin up. During this period, check your child’s breathing and airway every three to five minutes. If your child is snoring, reposition the head until the snoring disappears and your child breathes normally. If breathing becomes abnormal or you are unable to arouse your child, contact 911 immediately
- Temperature: A slight fever (temperature to 100.5°F) is not uncommon after sedation. You may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®). Follow the instructions on the bottle for dosing based upon your child’s age/ weight. Because dehydration may cause a slight increase in temperature, clear fluids may help correct this condition. If a higher fever develops or the fever persists, call our office.
