Extractions and other types of oral surgery can require special care and attention over the next few days. We have included the information you should have already received from our office here for your convenience. Contact our office in the event that other concerning symptoms appear. Your instructions may differ slightly from what is written here due to special circumstances. Follow instructions given by your pediatric dentist and use the following as a reference to that information.
The mouth will be numb approximately 2-4 hours. Watch to see that your child does not bite, scratch, or injure the cheek, lips, or tongue during this time.
Bleeding was controlled before your child left the office, but some occasional oozing (pink or blood-tinged saliva) may occur and is normal. Hold gauze with firm pressure (or, if able, have your child continue to bite on the piece of gauze placed by your dentist) against the surgical site until oozing has stopped. This pressure will help form a blood clot that will stop the oozing and is important for proper healing. You may need to change the gauze or repeat this step. If bleeding is not controlled try using a slightly moistened tea bag pressed against the area. One of the elements in regular black tea is tannic acid which helps with the formation of a blood clot. If bleeding continues, despite these efforts, for more than 2 hours, contact us.
SURGICAL SITE CARE
Today, do not disturb the surgical site. Do not stretch the lips or cheeks to look at the area. Do not rinse vigorously, use mouthwash, probe the area with fingers/other objects, or drink with a straw. This can cause the blood clot to dislodge. Beginning tomorrow (after 24 hours), you may rinse with warm salt water (1/2 teaspoon salt with 1 cup warm water) after meals. Improper care can cause bleeding to re-occur or delay proper healing.
Sutures (stitches) may have been placed to help control bleeding and promote healing. If you were told these sutures are dissolvable, they do not need to be removed. Otherwise, they will be removed at your follow-up visit. If the stitches come out during the first 48 hours, call our office.
Today, avoid physical exercise and exertion. Return to normal activities as tolerated. Your child may be tired and sore from today’s procedure, depending on severity of treatment.
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, pudding, yogurt) are ideal the first day. By the second day, consistency of foods can progress as tolerated. Until healing is more established, avoid foods such as nuts, sunflower seeds, rice, and popcorn that may get lodged in the surgical area.
Keeping the mouth clean is essential. Today, teeth may be brushed and flossed gently, but avoid stimulating the surgical site with vigorous brushing/rinsing. Soreness and swelling may not permit proper brushing of all areas, but please make every effort to clean the teeth within the bounds of comfort.
Because some discomfort is expected, you may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®) before the numbness wears off. Keep in mind that brand names Tylenol and Motrin may not be found on shelves due to a recall, use of generics are acceptable. Do NOT give aspirin to your child. Follow the instructions on the bottle for dosing based upon your child’s age/weight. If pain is not relieved by one of these medications, a prescription may be needed. Take prescription pain medication with a small amount of food to avoid nausea.
Your dentist may or may not have given you antibiotics. Each situation is different and will be discussed with you by your dentist on the day of the procedure. If antibiotics were given, it is important to follow the instructions carefully and to finish the course as instructed. Although it may appear that your child’s infection has subsided after a few days of antibiotic use, the course must be completed to fully eradicate the infection and avoid other associated problems, such as long term bacterial resistance to antibiotics.
Slight swelling and inflammation may occur for the next 2 days. If swelling occurs, ice packs may be used for the first 24 hours (10 minutes on then 10 minutes off) to decrease swelling and/or bruising. If swelling persists after 24 hours, warm/moist compresses (10 minutes on then 10 minutes off) may help. If swelling occurs after 48 hours, call our office.
A slight fever (temperature to 100.5°F) is not uncommon the first 48 hours after surgery. If a higher fever develops or the fever persists, call our office.
Premature dissolving or loss of a blood clot following removal of a permanent tooth may result in a “dry socket.” This typically occurs on the 3rd to 5th day after the extraction, with a persistent throbbing pain in the jaw. Call our office if this occurs. Oftentimes, following proper care as described above can help prevent “dry socket.”
The American Academy of Pediatric Dentistry contributed, in part, to the information set forth in these instructions.
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