Dr. Melba Mayes, Pediatric Dentist

Care Prior To and After Treatment or Sedation

These instructions are provided for your convenience as you care for a child recovering from oral treatment with or without sedation. If anything is ever unclear or you have questions not answered in these instructions, please call our office to speak directly to Dr. Mayes

Post-Treatment Instructions

All Dental Treatments Requiring Local Anesthetic

• Children should be observed until the numbness wears off. Due to the strange feeling of the anesthetic, children sometimes chew the inside of their lips, cheeks or tongue which may result in pain, tissue damage, and/or swelling in the area.
• Children should not eat for at least 2-3 hours after the anesthetic. If your child is hungry, encourage liquids, milkshakes or smoothies.
• The lips may be dry. For dryness, Vaseline or a lip balm may be applied to the lips.
• Sensitivity, especially to cold, is common for a few days following a dental restoration. Usually, the deeper the cavity, the more sensitive a tooth may be. Patients usually will not experience pain, however, discomfort may be treated with Tylenol elixir if your child is not allergic to Tylenol.
• The gum tissue and/or the anesthetic injection site may be sore for a few days.
• The finished restoration may be contoured slightly different and have a different texture than the original tooth structure. The tongue usually magnifies this small difference which may not be noticed by the naked eye, but the tongue usually becomes accustomed in a few days.
• Brush the teeth gently and thoroughly every day as usual. This should be done by an adult, since young children lack the hand skills and motivation to clean the teeth properly.

Crowns

• After the local anesthesia wears off, the bite may feel different. It takes a few days to get accustomed.
• Avoid chewing on hard, sticky foods and candies.
• If crowns in the front were done, cut carrots, apples etc. in pieces and encourage your child to chew them with their back teeth.

Extractions

• Encourage child to bite on the gauze for the first 30 minutes after the extraction. The child should not chew on the gauze.
• Children usually will not experience severe pain, unlike adults. If your child is not allergic to Tylenol, it almost always takes care of any extraction discomfort. You can give it every 4-6 hours if needed. Sometimes, children may experience mild swelling.
• Limit the child's intake to clear liquids for the first several hours. Do Not use straws (Sucking through a straw may increase bleeding.) Drinking from a cup or glass is fine. Clear liquids include: ice chips, popsicles, clear fruit juices and water.
• The first meal should be soft requiring little chewing. Suggestions include: applesauce, scrambled eggs, jello, ice cream, mashed potatoes, macaraoni & cheese, soup and yogurt.
• A minimal amount of bleeding will be expected to occur for the first 24 hours after a tooth is extracted. Often there is a slight oozing of blood, when mixed with saliva, may appear to be excessive bleeding. In case of persistent bleeding, fold two or three sterile gauze pads and place orver the bleeding area. Encourage the child to bite on the pads for 45 minutes.
• For your convenience, put an old pillowcase on the pillow in case of oozing. There will be less to wash up and worry about later. However, hydrogen peroxide will take stains out.
• If a sponge was placed in the extraction site, it minimes bleeding and prevents the loss of the clot so it can heal faster.
• Have your chld rest and plan to watch him/her the rest of the day. Resting, reading, watching Tve, and being up and about as your child feels able, are all fine. Avoid strenuous play activities, especially if it is warm.
• Control of oral bacteria is always important, and particularly after extractions. Brush the teeth as usual, avoid the extraction site the first day or two.
• Starting the day after the extraction, have your child rinse with warm salt water rinses (1/2 teaspoon in 4 oz of water) after eating for 3-5 days.

Sealants, Spacer Maintainers and Groper Appliances

• The bite may feel different. It takes a few days to get use any new change in the mouth.
• Avoid chewing on hard, sticky foods and candies.
• Regular brushing and flossing should maintained and these in turn will increase the longevity of the treatment.

Instructions Prior to IV Sedation

For your child’s safety, all of the following instructions must be strictly adhered to before proceeding with IV sedation. Neglecting any of the following may compel the anesthesiologist to postpone treatment and a charge may be incurred.

Eating or Drinking

It is extremely important that patients have an empty stomach. No solids and/or non-clear liquids (milk, orange juice) up to 8 hours prior to anesthesia. Clear liquids (water, apple juice) may be taken until 4 hours before the start of anesthesia.

Medications

Patients should take their normal daily medications unless otherwise instructed by the Anesthesiologist.

Clothing

Short sleeves are advised and it is suggested that loose fitting pants be worn as well as comfortable shoes. For our older children do not wear makeup, nail polish, or false eyelashes. Contact lenses must be removed before anesthesia. For children it is suggested to bring a change of clothing and a blanket. Please feel free to bring a favorite toy, stuffed animal for comfort and security. If possible have your child wear a diaper or pull-up.

Change In Health

A change in health, such as cold or fever, is extremely important. Please notify Dr. Mayes or the Anesthesiologist if there is any change in your child’s health. Some illnesses may necessitate delaying your child’s treatment.

Designated Driver

A parent must accompany the patient and must remain in the office. State law requires a car seat for patients under the age of four or weighing less than forty pounds.

After Care

Please arrange to have a responsible adult care for the child after the sedation.

Questions

Prior to your appointment the Anesthesiologist will contact you to review your preoperative instructions and to answer any questions. If you have any questions, you may call Dr. Khalaf (323)982-0004.

Instructions After IV Sedation

Drinking

Slowly introduce liquids once you are home. The first drink should be plain water, then clear fruit juice, Popsicles or Gator-Aide. Small drinks should be taken repeatedly. If there is some bleeding in the mouth, cold liquids are best. Please avoid dairy products for the first 4-6 hours.

Eating

If local anesthesia was used during treatment, avoid chewing until the patient is no longer numb. Slowly introduce soft, bland food into the diet. Suggestions include applesauce, scrambled eggs, mashed potatoes, and soups. If you child is not hungry, do not force him/her to eat but encourage as much liquids as desired. It is not unusual for young children to have nausea and/or vomit after sedation.

Fever

In the first 12 hours following IV sedation, your child may experience an increase in temperature. This is usually due to a young child’s inability to sweat when given one of the anesthetic medications. Children’s Tylenol is usually effective and can be taken 4-6 hours after the procedure with plenty of liquids. If the temperature rises above 101º, please call the Anesthesiologist.

Discomfort

Muscle aches and a sore throat similar to a mild flu may occur. It is very common after IV sedation and will usually disappear within 24 to 36 hours. Your child’s mouth and tongue will probably be numb following the treatment, resulting in a sensation of a foreign body or “lump” in the throat. This perfectly normal, and will disappear in a few hours.

Activity

You can expect your child to be confused for a time after he/she awakens. Be close to your child and comfort him/her as necessary. Often children are unsteady on their feet for several hours after sedation. Please carry your child to the car. Do not allow your child to walk or stand without your help.

Please Call

If vomiting persists beyond 4 hours, or if the temperature remains elevated beyond the first 12 hours, or you have any other anesthesia related concerns please contact Dr. Khalaf at 323-791-3889 or 323-982-0004. You may also call Dr. Mayes at 909-548-4044.