If your child has had an in-office procedure, they undoubtedly will have something to say about it.  This may include lingering bad tastes, a numb lip/tongue/cheek, or a sore mouth and gums for a day or two. Rest assured that this is normal and they will be back to their old self in no time.

There are some things that you can do to alleviate their discomfort, as well as things to watch for as their mouth heals. Please check out the following list on post-operative care, for common clinical concerns. (If your child was treated under general anesthesia, please see  our GA Post-op instructions.)

If your child becomes ill after having a cleaning (including diarrhea and vomiting), please be aware that he/she may be feeling the effects of the fluoride treatment. Children often swallow a small amount of fluoride during the procedure causing mild stomach irritation. Please avoid heavy foods or excessive fluid intake. Sometimes a glass of milk can help neutralize the fluoride.

A thorough cleaning can produce 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.

All discomfort should resolve with improved daily home care within 1 week.

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, which tend to fracture the sealant. Regular dental appointments are recommended in order for your child’s dentist to be certain the sealants remain in place. Often they can be “touched up” if needed at recare appointments.

Along with the American Academy of Pediatric Dentistry, we recognize 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, and are a key part to a total prevention program. Prevention also includes a primary focus on proper diet and oral hygiene, with a secondary emphasis on fluoride.

Numbness Associated With Local Anesthetic
Local anesthetic is the most effective way of eliminating any discomfort that may accompany dental treatment. The only downside to a comfortable dental visit and anesthetized teeth is the associated numbness of the adjacent soft tissues, the lips, the cheeks and the tongue.

We try to use the local anesthetic that best suits the treatment type and normally the numbness wears off within an hour or so after your child has left the office. Some individuals may experience numbness for less than a half hour while other children have been numb four hours after the treatment visit. Your child will notice his lips and/or tongue beginning to tingle as the feeling returns.

Some children become very upset (even crying) and complain of pain when they realize their mouth feels “different.” Please do not be alarmed! Many children are unfamiliar with this numb sensation and associate this with pain. Reassure your child that the “funny feeling” will soon go away.
Watch your child carefully following dental treatment. It only takes a second for a child to damage soft tissues by chewing on them or by sucking on lips or cheeks.

Younger children will leave the operatory with a “tooth pillow,” which is a cotton roll or gauze. This is placed between the teeth to remind the child that his tissues are asleep. Your child should not chew on the pillow as he may injure the soft tissues. Extra cotton rolls with be given to you in order to replace the original pillow if need be.

Older and younger children will be warned to “not chew on their lips or tongue.”
The lip and cheek and tongue will be numb on the affected side if you child receives local anesthetic to numb the teeth on the mandible or lower jaw. Only the lip and cheek should be numb if the affected tooth or gum is on the maxilla or upper jaw.

It is often wise to keep your child on a liquid or soft diet until the anesthetic has worn off. If they do accidentally traumatize their lip/cheek/tongue, you will notice it within hours of their dental visit.

Numbness and Tissue Biting (Cheek, Lip or Tongue)
If your child bites his lip, cheek or tongue following the administration of local anesthetic, please review the following and call the office if you have questions.

If there is excessive bleeding from the mouth following dental treatment, please call the office and be prepared to return to the office for a no charge observation exam.

The signs of lip/cheek trauma from biting are:

  • A swollen lip (as much a three-times normal)
  • A raw lip surface
  • A raw and tattered looking inner mid-cheek area on affected side
  • The cheek may be swollen and “trapped” between the teeth on the affected side
  • The affected area will be tender and sensitive to acidic and hot or spicy foods
  • The following day the lip/cheek surface will be covered by a white membranous “scab”

What to do:

  • Keep your child well fed and hydrated
    • Popsicles and other frozen items will be comforting
    • Cold liquids are best and milkshakes are yummy
    • Avoid acidic and spicy juices or foods
  • Infection is extremely rare in cases of these self-inflicted wounds
    • Usually antibiotics are not necessary
    • Do not use Vaseline or petroleum jelly type products to coat the tissues
    • Use vitamin E oil if you desire to coat the surface
    • Normal healing will require a week
  • Feel free to return to the office for observation
    • If you are in any way not satisfied with the advice
    • If the dentist feels it is necessary to see your child
    • You will not be charged
    • We want you to be comfortable and understand the injury and care
  • Call the office and inform the dentist of the incident. 360-588-8238

The signs of tongue trauma from biting are:

  • A swollen and tattered looking area on the affected side of the tongue
  • A deep cut and bleeding in the area of a tongue laceration

What to do:

  • If there is bleeding:
    • Place pressure on both sides of the tongue for five minutes
    • Use finger pressure with gauze or Kleenex
    • If there is still bleeding, bring your child to the office
    • Call the office to inform them of the incident and to alert the dentist
  • If the tongue is not bleeding: Follow instructions regarding lip/cheek trauma

After placement of white fillings or crowns, teeth may be sensitive to hot, cold and pressure for a brief period of time. It is not uncommon for recently filled teeth to need several weeks to feel “normal” again. However, things should be getting better over time, and not worse. Please return to clinic if it hurts EVERY time the child bites down or the pain is increasing!

Gum Irritation/Discomfort after treatment
Although not all dental treatment is in close proximity to the gum tissue, it is not uncommon to have a minor irritation/soreness of the gum tissue adjacent to the treated teeth immediately after the treatment visit. Fortunately, our oral tissues are some of the most resilient tissues in our body and most irritations will heal within a few short days. Any discomfort should be improving within 24 hours and the affected area may appear like a white patch (similar to a scab).

It is uncommon for infection to occur in such a case, however, should the area become reddened, inflamed or swollen please call (360) 588-8238 or return to clinic.

Stainless Steel Crowns
Your child’s teeth have been covered with a stainless steel crown which has been shaped to fit the tooth, cover it completely and strengthen the tooth thereby allowing your child to maintain that tooth until it naturally falls out. The gum tissue surrounding the tooth may appear to be bleeding. This is normal! When preparing your child’s tooth for a crown, it is necessary to fit the crown closely to the gum tissue, resulting in some hemorrhaging and bruising of the tissue. Following placement of the crowns some parents will notice a purple or gray color around the gums; this is also normal and will subside over time. “The cleaner you keep it, the faster it will heal.”

When your child receives a nerve treatment it is usually not necessary to prescribe any pain medication. Children that do experience discomfort usually do fine with Tylenol or Ibuprofen (follow the directions on the bottle).

Nitrous Oxide
“Happy/Magic Air” used during your child’s dental appointment has a proven track record of being very safe, providing exceptional relief of anxiety and gagging. Children are awake and talking throughout the entire appointment. They may feel a bit dazed afterwards, and in very rare instances, may have an episode of nausea.

After dental extractions your child will have gauze pressure packs placed to control normal bleeding from the site of the extraction. Most dental extractions are routine and it is unlikely that your child will need any pain medication or any antibiotics. Avoid strenuous exercise for several hours after the extraction. Do not allow your child to suck from a straw or drink carbonated beverages for 48 hours – this may prolong bleeding due to disrupting the normal blood clotting process.

If the site continues to bleed for a prolonged period of time, putting pressure on the area using wet gauze or biting on a tea bag will help the bleeding to subside. To minimize pain, follow a soft foods diet and take an OTC pain reliever such as Ibuprofen or Tylenol, to alleviate discomfort.
Any significant swelling or moderate to severe pain needs the attention of the dental office so it can be properly managed.

After dental treatment, especially dental extractions, your child’s diet should initially consist of soft foods (jello, pudding, smoothies) and non-carbonated beverages. Avoid eating crunchy or sticky foods.

Space Maintainers
A certain amount of pain and discomfort is expected following placement of a space maintainer. Be sure to brush adequately around the area. Follow a soft foods diet and take an OTC pain reliever such as Ibuprofen or Tylenol, to alleviate discomfort. Avoid chewy or sticky candies!

If the appliance has come loose or is completely out of the mouth, please save it (if possible) and contact us at 360-588-8238 to schedule an appointment.