Postoperative Care

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Helping Your Child After Dental Treatment

Now that your child’s restorative or surgical visit is over, here are some tips to help them bounce back quickly.

Providing Emotional Support

This may have been your child’s first time getting a filling or extraction. Or maybe their first time having sedation. How you support your child and manage their post-op feelings and discomfort will go a long way to shaping their perception of future dental care. Framing their experience and helping them through the postoperative process are key. Here are some tips:

Stellar Kids' Post-operative care

Fillings and Extractions

  • Do your best to praise your child for showing resilience through a challenging visit.
  • If they had a large cavity restored or tooth pulled, remind them that their tooth won’t be bothering them anymore.
  • If they are in discomfort, offer the appropriate pain medication and reassure them that they will be feeling much better very soon.
  • Distract them with calming or fun activities.
  • Offer them apple sauce, popsicles, jello, and other soft and cool foods. Colder food and drink are more soothing than hot.

Sedations

  • Children will often be disoriented and confused as sedation wears off. They may be emotional, upset, angry, or distressed. Sometimes they may not be able to articulate their discomfort and may just say ‘it hurts.’
  • Offer calm reassurance knowing that the feeling is temporary and will eventually fade. When parents are nervous and anxious, children will feel more panicked and distressed.
  • Offer appropriate pain relief (see below).
  • One suggestion is to place your child on the carpet or floor in front of the TV or their favorite device. Surround them with pillows and blankets. Don’t leave them unattended for at least 2 hours. Try not to put them on the bed or sofa as they could tumble off.

Specific Instructions for Managing Postoperative Issues

Local Anesthesia/Numb Feeling

Children have many different reactions to the numb feeling in their lips, tongue, and cheeks. Some kids ignore it, some are very curious about it, and others can get very upset. These are all normal responses. Especially with their first restorative visit, it’s common for children to explore their numbness by chewing, sucking, or scratching their lip and cheeks as the local anesthetic slowly wears off. This numb feeling can last 2-3 hours.

Please watch your child carefully in the next few hours so that they don’t injure the numb area. If your child injures their tongue, cheek, or lips, the area can swell dramatically and look quite alarming. An ice pack or frozen vegetables wrapped in a towel may be used on the outside of the area to help limit swelling and is most helpful if used in the first 24 hours. Any swelling usually peaks after 48-72 hours. Also, Ibuprofen (Advil or Motrin) will help with swelling and any discomfort. Please refer to the product information for dosage directions.

Sealants

  • Your child’s bite may feel off or different. Nearly all children will gradually adjust to the new protective coating on their back teeth. No special care is necessary.
  • If there is a bad taste, chewing gum is helpful.

Fillings

Immediately after the appointment, the area around the teeth may be sore and achy. We typically use a dental dam to properly isolate the tooth and ensure your child does not swallow any materials used in the filling process. However, the dental dam clamp may irritate the gums. This will heal in a day or so.

Your child may feel that their bite is off for a few days. When the filling was on a baby tooth, kids invariably adjust to the new fillings. It’s extremely uncommon that a bite adjustment is needed. However, if the filling was on a permanent molar, sometimes teens need to return a week after the appointment to have their filling adjusted. This is uncommon but easily fixed. If needed please call our office to schedule a return visit.

It’s rare for baby teeth to have any postoperative sensitivities beyond a few days. However, permanent teeth may take longer. If your child’s tooth is sensitive for longer than a week, please call our office to schedule a follow-up.

Crowns (Porcelain or Stainless Steel Caps)

  • Please avoid sticky foods such as gum, caramel, and taffy for at least one hour after the appointment. The dental cement holding the crown on takes 1 hour to set fully.
  • The gums around the margin of the crown may have some soreness and bleeding. This will heal within a day or so.
  • Some kids indicate that the crowns feel ‘tight’ and hurting. We strive for a perfect, tight fit so that the caps will never fall off. This feeling resolves within 2-3 days. Also, their bite may feel ‘off’. Be assured, your growing child’s bite will adjust.
  • Some bleeding at the gum line is common. It will usually resolve itself in a couple of hours.
  • You can resume normal brushing and flossing the first night.
  • Like a filling, a crowned baby tooth will usually fall out naturally when the permanent tooth is ready to come in.

Pulpotomy/Pulpectomy

Some minor discomfort may be present after the procedure, but acetaminophen (Tylenol) and ibuprofen (Advil or Motrin) are usually sufficient for relief.

Extractions

  • After a tooth extraction, it is important for a blood clot to form to stop any bleeding and begin the healing process. Advise your child to bite on the provided gauze for 5-10 minutes after the appointment. You may have to replace the gauze a few times before the bleeding stops. If the bleeding persists after you get home, your child may bite on a moistened COOL tea bag wrapped in gauze in the area of the extraction. The tannic acid in the tea typically will stop the bleeding.
  • After the blood clot forms, it is important not to disturb or dislodge the clot as it aids in healing. Make sure your child does not rinse vigorously or drink with a straw for 3-4 days after the procedure. Also, avoid hard, crunchy, or sticky foods. These will dislodge the clot and delay the healing process. Please limit vigorous activity for the next 24 hours, since this will increase their blood pressure and may cause additional bleeding.
  • Your child may have some minor discomfort or swelling following an extraction. Ibuprofen (Advil or Motrin) is usually sufficient to relieve discomfort. Please refer to the product information for dosage directions. Any swelling usually subsides after 48-72 hours. An ice pack or frozen vegetables wrapped in a towel may be used on the outside of the cheek to help limit swelling, and is most useful if used in the first 24 hours.
  • Finish any antibiotic prescription as advised by your doctor.

Wisdom Teeth Extraction

  • Please follow the instructions for ‘Extractions.’
    Follow a soft food diet, avoid straws and spitting with force, and minimize strenuous activity for a minimum of 1 week.
  • Swishing warm salt water several times a day may help with swelling. Don’t spit out forcefully, but let the water drizzle out.
  • If we gave you a syringe, clean the extraction site gently with warm water or warm mouth rinse 1-2 times a day.
  • Call us if you have bleeding beyond 1-2 days, swelling beyond 4-5 days, pain beyond one week, prolonged numbness or tingling, trouble swallowing, or if you suspect dry socket.

Tongue and Lip Tie Release (frenectomy)

Now that the laser frenectomy is complete, it’s critically important to start stretching and strengthening exercises right away. Children heal so quickly! This is a great thing, but with wound healing, we have to ensure the tie does not reattach. All released ties tend to contract back towards the middle of the wound. So, stretch along the length of the tie so that the wound edges meet and there is increased length and mobility during healing. Our goal is vertical, not horizontal healing.

See Tongue and Lip Ties under Our Services tab for more details”

Space Maintainer

  • Keep your spacer clean by brushing and flossing it along with the rest of your teeth.
  • Avoid sticky foods such as gum, caramel, and taffy. These will cling to your spacer and pull it off.
  • Call us right away if the spacer feels loose or comes off, sometimes they need to be recemented. Please save your spacer and bring it back with you.

Nitrous Oxide (laughing gas)

  • Side effects are extremely rare.
  • If you child is feeling nauseous, offer only water, clear juices, and light easily digestible foods.

Oral Sedation

  • Offer your child clear juice and water to start.
  • When they are able to hold it down, offer them apple sauce, popsicles, jello, or other soft and cool foods. Colder food and drink are more soothing than hot.
  • If they are in discomfort, offer ibuprofen (Advil or Motrin) only. We likely mixed the sedative with acetaminophen (Tylenol) already (please call us to confirm).
  • We gave local anesthesia, so your child’s tooth, lips, and cheek are numb. (See local anesthesia instructions above.)

General Anesthesia

  • DIET: Offer your child clear juice and water to start. Then progress to apple sauce, popsicles, jello, smoothies, or other soft and cool foods. Colder food and drink are more soothing. Maintain a soft food diet for a few days per your child’s comfort.
  • NUMB FEELING: Check with your doctors if local anesthetic was given. If so, see precautions with the numb feeling.
  • PAIN: If they are in discomfort, offer acetaminophen (Tylenol) only. Our anesthesiologist gave the NSAID Toradol (ketorolac) which is in the ibuprofen family of analgesics. Wait 8 hours to give ibuprofen to prevent NSAID overdose.
  • CALM REASSURANCE: Soothe your child with confidence that they will be feeling much better very soon
  • NAUSEA AND VOMITING are uncommon. Call us if it persists beyond 10-12 hours.
  • FEVER: A slight fever is common. Since dehydration is the most common cause of mild fever, ensure that your child is well hydrated. OTC Tylenol (acetaminophen) can also help. Call us if fever persists beyond 8-10 hours.