Emergencies & Post-Operative Instructions

Emergencies                                      >> Jump to Post-Op Instructions

If your child has an accident, please call our office as soon as possible. If it is an after-hours emergency, a pager number will be given on the answering machine.

The first 30 minutes after an accident are the most critical to treatment of dental trauma. If a permanent tooth is knocked out, gently rinse, but do not scrub the tooth under water. Replace the tooth in the socket if possible. If this is impossible, place the tooth in a glass of milk or a clean wet cloth and come to the office immediately. If the tooth is fractured, please bring in any pieces you can find.

Our schedule may be delayed in order to accommodate an injured child. Please accept our apologies in advance should an emergency occur during your child's appointment. We will provide you the same care should your child ever need emergency treatment.

Care of the Mouth after Trauma
Please keep the traumatized area as-clean-as possible.  A soft wash cloth often works well during healing to aid the process. 

Watch for darkening of traumatized teeth.  This is a common result following trauma and could be an indication of a dying nerve (pulp). If the swelling should re-occur, our office needs to see the patient as-soon-as possible.  Ice should be administered during the first 24 hours to keep the swelling to a minimum.

Watch for infection (gum boils) in the area of trauma.  If infection is noticed - call the office so the patient can be seen as-soon-as possible.

Maintain a soft diet for two to three days, or until the child feels comfortable eating normally again.

Avoid sweets or foods that are extremely hot or cold.

If antibiotics or pain medicines are prescribed, be sure to follow the prescription as directed.

Please do not hesitate to call the office at (919) 845-8212 if there are any questions.

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Post-op Instructions

Care of the Mouth after Local Anesthetic
Your child has had local anesthetic for their
dental procedure:

• If the procedure was in the lower jaw... the tongue, teeth, lip and surrounding tissue will be numb or asleep.
• If the procedure was in the upper jaw... the teeth, lip and surrounding tissue will be numb or asleep.

Often, children do not understand the effects of local anesthesia, and may chew, scratch, suck, or play with the numb lip, tongue, or cheek.  These actions can cause minor irritations or they can be severe enough to cause swelling and abrasions to the tissue.  Please monitor your child closely for approximately two hours following the appointment.   It is often wise to keep your child on a liquid or soft diet until the anesthetic has worn off.

Please do not hesitate to call the office at (919) 845-8212 if there are any questions.

Extraction Post-op Instructions
1. Your child has had 1 or more teeth "wiggled" out.

2. The gauze needs to stay in place with biting pressure for 30 minutes. This will reduce the amount of bleeding.

3. Give your child the appropriate dose of children's Tylenol, Motrin or Advil when you take the gauze out (NO aspirin). Your child should only need this for approximately 12 to 24 hours. If pain persists beyond 48 hours, please call our office.

4. Your child should eat only soft, bland food for the first couple days- nothing sharp, crunchy or too hot or cold because the area may be a sensitive. Encourage plenty of liquids (water, soups, juices, etc.). Let your child determine when a regular diet can be reintroduced.

5. NO spitting or drinking through a straw or "sippy" cup. The force can start the bleeding again.

6. A clean mouth heals faster. Gentle brushing around the extraction site can be started immediately along with warm salt water rinses (1/4 teaspoon to a glass of water) to aid with any discomfort.

7. Activity may need to be limited. Sometimes a nap is a good idea.

8. Swelling after an extraction is not uncommon and should not cause alarm. If this occurs, apply an ice pack for 15 minutes on and 15 minutes off as needed in the 24 hours following tooth removal.

9. Your child's cheek, lip and tongue will be numb for approximately 1-2 hours. Please be very careful that your child does not bite at his/her cheek or pick at this area. As this area "wakes up" it may feel funny. A self-inflicted bite injury is the most common post-op complication. Please keep on eye on your child!

If you have any questions or should any complications arise,
please call the office at (919) 845-8212.

Care of Sealants
By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay.  Since, the covering is only over the biting surface of the tooth, areas on the side and between teeth cannot be coated with the sealant.  Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

Your child should refrain from eating ice or hard candy.  This tends to fracture the sealant.  Normal retention of a sealant is up to four years.  Sealants that become displaced in the first twelve months will be replaced at no charge.  After twelve months, sealants will be replaced at 50% charge for the next 3 years.

The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay.  When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth.  A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten.  If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!
 

Oral Discomfort after a Cleaning
A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort.  This is not due to a "rough cleaning", but to tender and inflamed gums from insufficient oral hygiene.  We recommend the following for 2-3 days after cleaning was performed:

1)  A warm salt water rinse 2 - 3 times per day 
    ( 1 teaspoon of salt in 1 cup of warm water)

2)  For discomfort use Children's Tylenol, Advil, or Motrin as
     directed for the age of the child.

Please do not hesitate to contact the office at (919) 845-8212 if the discomfort persists for more than 7 days or if there are any questions.

Post-Sedation Instructions
It is important for your child's safety that you follow these instructions carefully! Failure to follow these instructions could result in unnecessary complications.

• ACTIVITIES: Do NOT plan or permit activities for your child after treatment. Allow your child to rest. Closely supervise any activity for the remainder of the day. When sleeping, encourage your child to lie on his/her side or stomach.
• GETTING HOME: Two responsible adults must accompany your child. One adult should drive your child home and a second responsible adult must be available to take care of your child while driving home. Your child should be closely watched for signs of breathing difficulty and carefully secured in a car seat or seat belt during transportation.
• DRINKING or EATING after TREATMENT: After treatment, the first drink should be plain water. Clear liquids can be given next (fruit juice, sugar-free Kool-Aid, Gatorade, ginger ale, soup broth, etc). Small drinks taken repeatedly are preferable to taking large amounts. Soft, luke-warm, bland food may be taken when desired (mashed potatoes, yogurt, soup, pudding, ice cream, popsicles, etc.).
• TEMPERATURE ELEVATION: Your child's temperature may be elevated to 101 F (38 C) for the first 24 hours after treatment. Tylenol every 3-4 hours and fluids will help alleviate this condition. Temperature above 101° F (38° C) is cause to notify Dr. Dave and your pediatrician.
• EXTRACTIONS: If your child had teeth removed, a small amount of bleeding is normal. Do NOT let your child spit, as this will cause more bleeding. In order to not disturb the blood clot, do NOT use a straw to drink for the first 24 hours. Also, remember that a small amount of blood mixed in with a lot of spit in the mouth looks like a lot of blood.
• BRUSHING: Since your child has had a cleaning and fluoride treatment today, it is not necessary to resume tooth brushing and flossing until tomorrow morning. However, it is very important for you to brush and floss your child's teeth beginning tomorrow morning and on a daily basis thereafter, to prevent infection and future dental problems.
• SEEK ADVICE: If any of the following problems arise, call Raleigh Pediatric Dentistry, or if the office cannot be reached, call the Emergency Department at your local hospital:

  · If vomiting persists beyond four (4) hours

  · If the temperature remains elevated beyond 24 hours or goes above 101° F (38° C).

  · If there is any difficulty breathing or coloration of the skin is poor.

  · If any other matter causes you concern.

PLEASE CONTACT THE OFFICE (919) 845-8212 IF YOU HAVE ANY PROBLEMS RELATING TO YOUR CHILD'S TREATMENT

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