Care of the Mouth after Local Anesthetic

If the procedure was in the lower jaw: tongue, teeth, lip and surrounding tissue will be numb or "asleep"
If the procedure was in the upper jaw: teeth, lip and surrounding tissue will be numb or "asleep"
A self-inflicted bite injury is the most common after-treatment complication. Children do not always understand the effects of local anesthesia, and may chew, scratch, suck, or play with the numb area. These actions can cause minor irritations or they can be severe enough to cause swelling and abrasions to the tissue. Injured area may appear swollen, white/yellow and “infected”. However, this is not a result of infection and does not require antibiotic. You may apply Vaseline / petroleum jelly and the area will heal in 7 to 10 days without leaving any scar of the incident.
Please monitor your child closely for three hours following the appointment. It is best to keep your child on a liquid or soft diet until the anesthetic has worn off. The uncomfortable feeling of the numb area “waking up” can be relieved by giving an over the counter children’s pain medication.

Sealants

After sealants are placed, the bite may feel a little different due to the new coating on the chewing surface of the teeth. This is normal, and the feeling will go away in a few days. The integrity of sealants is affected by teeth grinding and activity such as eating ice or hard candy – these can fracture or chip the sealant. Our office routinely checks on the integrity of sealants and will “touch up” the sealants as needed.

Oral Discomfort after Teeth Cleaning

A thorough teeth cleaning may produce some gum bleeding and swelling and may cause discomfort of the teeth and gums. This is not due to a "rough cleaning", but due to tender and inflamed gums which results from substandard oral hygiene. If your child experiences gum bleeding or mouth discomfort after teeth cleaning, we recommend the following for 2 to 3 days:
· For gum bleeding and swelling rinse 2 times daily with warm salt water rinse (1/4 teaspoon of salt in 1 cup of warm water).
· For mouth discomfort use children’s Motrin, Advil or Tylenol as directed.
To prevent your child from feeling any discomfort at the next cleaning, maintain twice daily teeth brushing and good oral habits.

Extraction

When your child has had one or more teeth extracted:

· Gauze should stay in place with biting pressure for approximately 30 minutes. This will reduce the amount of bleeding.

· Give your child children’s Motrin, Advil or Tylenol when you take the gauze out. Do not give aspirin. Your child should only need the pain medicine for 24 hours to 48 hours. If pain persists beyond 48 hours, please call our office.

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

· NO spitting or drinking through a straw or "sippy" cup. This action can start the bleeding again.

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

· Activity may need to be limited. Sometimes a nap may help relieve discomfort.

· Swelling of tissue in the area of extraction is common and should not cause alarm. If this occurs, apply an ice pack to the face for 15 minutes on and 15 minutes off, as needed in the first 24 hours following tooth removal.

· Your child's cheek, lip and tongue will be numb for approximately 2 to 3 hours.

Please be very careful that your child does not bite or pick at this area. A self-inflicted bite injury is the most common after treatment complication. The uncomfortable feeling of the numb area “waking up” can be relieved by giving an over the counter children’s pain medication.

EMERGENCIES

If your child is involved in an accident resulting in injuries to the mouth or teeth, please call our office as soon as possible. If you are calling after business hours, you will be able to reach Dr. Banaji or a member of the team by calling the phone number given on the answering machine. The first 30 minutes after an accident are the most critical for treatment of dental trauma.

Fractured or broken tooth:
If your child experiences trauma to the mouth and a tooth becomes broken or fractured, please call the office for an evaluation of the injury. It is important to bring all pieces of the broken tooth when coming to the office. Until your appointment, place tooth pieces in a container with clean cold water or wrap it in clean wet cloth.

Swelling:
If there is swelling near an injured area, please call our office for an evaluation. An ice pack wrapped in a clean cloth may be applied during the first 24 hours after injury to keep the swelling to a minimum. Anti-inflammatory pain medications such as children’s motrin, advil or Ibuprofen may be given as per the directions.

Discoloration of Teeth:
Injured teeth may turn dark and this could be an indication of a dying nerve (pulp). Sometimes the discoloration lasts for a short period of time and the tooth may regain its normal or near normal color. More often, the discoloration lasts for a longer period of time until treated. If the discoloration lasts for several weeks, please call the office for an evaluation of the tooth.

Gum Boil, Abscess, Infection:
An abscess or gum boil in the area of trauma is an indication of a dead nerve in the tooth. This appears as a “pimple” on the gum near the injured tooth. Treatment should be administered to the area as soon as possible to reduce pain, swelling or discomfort. It is essential for the development of healthy permanent teeth, that an injured baby tooth be treated, rather than extracted. Generally, antibiotics are not required unless the child has extreme pain, facial swelling or high fever.

Knocked out Primary Tooth (Baby Tooth):
If you are certain that it is a baby tooth, do not put it back in the mouth. Save the tooth, by placing it in a container with clean cold water or wrap it in clean wet cloth. Please call the office for an evaluation of the injury.

Knocked out Permanent Tooth:
Gently rinse the tooth in clean water - do not scrub the tooth. If at all possible, put the tooth back in its place in the socket by holding the wide end and inserting the pointed end in to the socket. If this is not possible, save the tooth by placing it in a container with cold white milk, clean cold water, or wrap it in clean wet cloth. Please call the office immediately since time is critical for reinsertion of the permanent tooth.

Impact on Scheduled Appointments:
Our schedule may be delayed in order to accommodate an injured child. Please accept our apologies in advance if we are running behind due to treatment of a child with a dental emergency. We will provide the same care should your child ever need emergency treatment.

Care of the Mouth after Injury

Hygiene:
Please keep the injured area as clean as possible. If regular tooth brushing is not possible, a soft wash cloth or gauze may be used to clean the injured area during the healing process. Your child may use a gentle mouth wash such as ACT for Kids fluoride rinse, Fluorigard or PhosFlur.

Diet:
Maintain a diet of soft foods (pasta, eggs, soup, jell-o, pudding, etc.) for two to three days, or until the child feels comfortable eating normally again. Avoid foods that are extremely hot or cold, as well as foods with high sugar content. A diet supplement such as Pediasure may also be used during the healing period to ensure proper nutrition and fluid intake.