Post Procedure Care & Info

TRAUMA TO FRONT TEETH INFORMATION AND CARE

  • Avoid biting into food with these teeth for 2 weeks.  Instead cut up these foods before eating them.
  • If possible, avoid thumb-sucking, pacifier and sippy-cup use for 2 weeks.
  • Lift up the lip and look for a raised bubble or a “pimple” occasionally.  If you see this, please call the office immediately.  This is a sign of an infection and if not treated can cause pain and damage to the permanent tooth that may be developing beneath this tooth (if it is a primary tooth).
  • The tooth may become discolored.  It may turn gray, pink or yellow.  This is because the nerve tissue of the tooth has been injured.  The color may fade overtime or remain unchanged.  There is no treatment needed for this.
  • Sometimes when this occurs to primary (baby) teeth it causes the tooth to come out earlier than if no trauma had occurred. 
  • If your child begins to complain of pain in this area, please call the office immediately.  This is another possible sign of infection.
  • Keep regularly scheduled recare appointments so we may evaluate the status of the injured tooth or teeth.

COMPOSITE CROWN OR BUILD-UP CARE

  •   Avoid biting into crunchy or chewy foods.  The crown or build-up can fracture.  Instead cut up these foods before eating them.
  •   Avoid foods and drinks that stain teeth, such as coffee, tea and soda.
  •   Nail biting and sporting accidents can damage these types of restorations.  If your child is active in sports we strongly recommend the use of a mouth guard.
  •   Stringent oral hygiene measures must be followed – when brushing pay special attention to the gumline.  Be sure to floss daily.  Plaque left behind after brushing can lead to recurrent decay around the margin of the crown or build-up.  Any restoration will last longer with good oral hygiene.
  •   Keep regularly scheduled recare appointments.  At each check-up we will evaluate the integrity of the restorations.

 COMPOSITE FILLING CARE

  •   Avoid foods and drinks that stain teeth, such as coffee, tea and soda.
  •   We recommend your child avoids eating sticky, chewy foods, sodas and limits juices for overall dental health.
  •   If it was necessary to use Novocain to place the filling your child should avoid eating anything that he or she has to chew until the numbness has worn off.  This may take up to four hours.  In the meantime, you may offer your child soft foods such as soups, milkshakes, yogurt, pudding, applesauce, etc.  If you have a young child you may explain to them that their cheek, lips or tongue are “taking a nap and will wake up soon”.  Remind them not to touch or chew on these areas to prevent accidental injury to these soft tissues.
  •   Keep regularly scheduled recare appointments.  At each check-up we will evaluate the integrity of your child’s restorations.

SPACE MAINTAINER CARE AND INFORMATION

It may take your child a few days to get used to the space maintainer in his or her mouth.  Remind your child not to play with the space maintainer with his or her fingers or tongue; over time this may cause the space maintainer to become loose and cause it to come out.

It is very important that your child NOT EAT ANYTHING STICKY or CHEWY.  These types of foods may loosen the appliance and cause it to come out. (Tootsie rolls, caramel, fruit snacks, Starburst, gum, taffy)

The space maintainer will remain in place until the permanent teeth begin to erupt in the space being saved.  It is important to keep regular dental check-ups so we may evaluate the space maintainer.

When tooth brushing, be sure to brush along the gumline where the space maintainer is attached.  If plaque begins to collect in this area the gums (gingiva) will become irritated and sore.

Please call us immediately should the space maintainer become loose or comes out.  We will schedule an appointment as soon as possible to recement the appliance so that valuable space is not lost.  If possible, please bring the space maintainer with you to your child’s appointment.

Keep regularly scheduled recare appointments.  At each check-up we will evaluate the status of the space maintainer.

STAINLESS STEEL CROWN CARE

It is very important your child NOT EAT ANYTHING STICKY OR CHEWY (Tootsie rolls, caramel, fruit snacks, Starburst, gum, taffy).  These types of foods may loosen or pull off the crown.  

When tooth brushing, be sure to brush along the gum line where the crown was placed.  If plaque begins to collect in this area the gums (gingiva) will become irritated and sore.

Please call us immediately should the crown come off.  If possible, please bring the crown with you to your child’s appointment.

Keep regularly scheduled recare appointments.  At each check-up we will evaluate the status of the crown.

The crown will come out when the tooth naturally falls out.

TOOTH EXTRACTION CARE

To stop bleeding, fold a piece of gauze, apply it directly over the extraction site and have your child bite down on it, holding steady pressure for AT LEAST 10 minutes.  Do NOT let your child chew on the piece of gauze.  This will disrupt the clot trying to form and increase bleeding.  If your child is very young and unable to follow these instructions you may hold the piece of gauze in place with your fingers.  If you are unable to do this, in most cases, the bleeding will stop on its own; it will simply take longer for a clot to form.  It is not uncommon for the extraction site to ooze a small amount of blood over the next 24 hours.

Most children have minimal discomfort after extractions.  Most children complain about the “numb feeling” more than any pain or discomfort associated with the extraction.  The best way to avoid any pain or discomfort is to give Motrin prior to the numbness wearing off.  This may be given every 4-6 hours for the next 24 hours if needed.

Until the “numb” feeling has worn off, usually within 3-4 hours, we recommend your child NOT eat anything that he or she has to chew.  This is to prevent your child from accidentally biting his or her tongue, cheek or lip.  Some suggestions for foods your child can eat are Jell-O, pudding, yogurt, applesauce, mashed potatoes, luke warm soup, popsicles, ice cream, etc.  In addition, we recommend your child not eat anything crunchy, hot, or spicy for the first few days. 

DO NOT ALLOW YOUR CHILD TO DRINK USING A STRAW FOR THE REMAINDER OF THE DAY.  FOR VERY YOUNG CHILDREN, WE ALSO RECOMMEND AVOIDING THUMB-SUCKING, PACIFIER AND SIPPY-CUP USE FOR THE REMAINDER OF THE DAY.  The sucking action will increase the pressure inside your child’s mouth and may interfere with a clot forming.

Be sure to gently clean the teeth next to the extraction site trying not to disturb the clot.  No vigorous rinsing or swishing for the remainder of the day.  To help promote healing, rinse GENTLY with warm salt water (1/2 tsp. salt added to 8oz. of water).  After the first day, it is very important to continue to brush and floss!

Your child should rest or play quietly for the remainder of the day.

If any of the following occurs, please call the office immediately at (518) 226-6010:

  • facial swelling
  • uncontrolled pain
  • prolonged bleeding

SEALANT CARE

Your child had sealants placed today.  Sealants do require maintenance. To increase the life of the sealant please adhere to the following guidelines:

Immediately following sealant placement, your child may complain that his or her bite does not feel right.  This is normal.  Over the next few days the sealants will wear slightly (this is expected) and your child’s bite should begin to feel normal.  If your child continues to complain of this after 3 days please call the office so we may reevaluate your child’s bite.

  • Avoid biting into hard objects or food, this includes chewing on ice cubes.
  • We recommend your child avoids eating sticky, chewy foods, sodas and limits juices for overall dental health. 
  • Keep regularly scheduled recare appointments.  At each check-up we will evaluate the integrity of your child’s sealants.
  • Sealants are only one step in the plan to keep your child cavity-free for a lifetime.  Brushing, flossing, a healthy diet and regular dental visits are still essential to a healthy, happy smile!

SEDATION INFORMATION

PRE-OP INSTRUCTIONS FOR CONSCIOUS SEDATION

Conscious Sedation is used by pediatric dental specialists in the treatment of very young, apprehensive, or uncooperative children and for children with extensive treatment needs.  During sedation your child will be conscious, i.e., vital signs remain normal, protective airway reflexes remain intact, and he/she remains responsive to conversation.  In the desired state your child becomes consciously unaware and will have no unpleasant memory of treatment, although he/she may subconsciously react to noises, vibrations, etc. by crying.  Please do not be upset should this occur- remember, your child is not consciously aware and will likely have no lasting memory of his/her dental treatment.

General Policies

Your child must be free of colds, nasal and chest congestion the day of treatment.  PLEASE CALL THE OFFICE SO WE MAY EVALUATE YOUR CHILD IF AN ILLNESS DEVELOPS PRIOR TO YOUR SCHEDULED APPOINTMENT.  As we have reserved at least one hour of office time for you and your child, your cancellation of a sedation appointment without 48 hours of notice or your failure to follow these instructions may result in an office charge even if treatment is not rendered.

Conscious Sedation Procedure Guidelines

  • DO NOT FEED YOUR CHILD ANYTHING TO EAT OR DRINK AFTER MIDNIGHT THE NIGHT PRIOR TO THE SEDATION APPOINTMENT.
  • Maintain your child's normal daily routine, usual activities and bedtime, prior to the sedation appointment.
  • Try to avoid discussing the sedation appointment around your child.  If your child should ask you questions regarding the sedation appointment, please keep the discussion positive (i.e. "Dr. Nikki is going to take great care of you.  I know you're going to do a great job.")
  • Dress your child in a short-sleeve shirt to allow us to apply the vital signs monitor.
  • Upon arriving to the office, your child will be given the oral sedation medication(s) that Dr. Byrne has recommended. 
  • While the medication is taking effect, your child may remain you.  Your child may experience only minor relaxation, may have difficulty walking or sitting, or may fall quietly asleep.  PLEASE WATCH YOUR CHILD CAREFULLY.
  • After 15-30 minutes, depending on the type of medication administered, an assistant will accompany your child into a treatment room while you remain in the reception area. 
  • During treatment, we will constantly monitor your child’s vital signs and level of awareness with sophisticated electronic equipment. Your child may receive local anesthesia (Lidocaine), nitrous oxide and, for your child’s safety, be treated with passive protective equipment (papoose board and mouth prop).  The soft papoose board assures us your child will not roll or slide in the chair while he/she is sedated. Treatment usually is completed within 30-60 minutes and every attempt will be made to complete all necessary dental work during this time. Plan on spending up to three hours in the office for a conscious sedation appointment.

SEDATION POST-OP INSTRUCTIONS

The effects of the sedatives will begin to weaken and disappear from the body with 3-4 hours after administration.
Please watch your child closely for the next several hours.

Your child may experience any of the following: 

  • Alert one minute, then drowsy or sleepy the next minute. 
  • Sleepiness may last 4-8 hours. 
  • Dizziness and/or lack of coordination. 
  • Occasional irritability throughout the day. 
  • Poor appetite for a few hours. 
  • Nausea and/or vomiting.

Traveling home:

  • *Keep your child awake during the car ride home.*
  • Rest and activity
  • Be sure that someone is with your child at all times. 
  • Keep your child awake for at least one hour after leaving the office.  Do not allow your child to sleep in the car.
  • Your child may take a nap one hour after leaving the office but avoid pillows or extra blankets.
  • Pay special attention to those of physically active ages (rolling off furniture, falling when walking or standing).
  • Avoid vigorous activity for the remainder of the day.
  • Your child should be able to return to his/her normal routine and activities tomorrow.

Drinking and eating:

  • Begin with clear, pulp free liquids such as water, apple juice, jello, popsicles or Gatorade.  If tolerated well, you may advance his/her diet slowly.
  • Avoid feeding your child anything he/she has to chew until the numbness has worn off (usually within 2-4 hours).
  • If your child vomits, stop feeding for 30-60 minutes then gradually resume clear fluids in sips.
  • Start solid foods again when the child is tolerating liquids well.

Treating pain:

Your child’s face may be numb if local anesthesia (Lidocaine) was used.  Please watch your child closely during this time.  Do not allow your child to bite, pick, or pinch his/her tongue, cheek or lips.  Your child may say that “it hurts” but NO PAIN OF ANY KIND IS POSSIBLE AT THIS TIME.  Children are unfamiliar with this numb sensation and are sometimes frightened by it.  We advise you to explain to your child in terms he/she can understand, like telling them “Your cheek is taking a nap.  It will wake up soon and feel normal again.”

The majority of the children we treat do not experience pain post-operatively, however if your child does complain of discomfort please follow the guidelines below:

  • Use Children’s Motrin or Children’s Advil.  Follow the dosage instructions on the bottle.
  • Occasionally, with tooth extractions swelling may occur.  Apply a COLD cloth to the swollen area for about 20 minutes.  If swelling increases after 48 hours contact the office.
  • We will call you at the end of the day to check on your child.  Please be sure to leave us a phone number where you can be reached.

When to call the doctor:

  • Breathing problems                             
  • Frequent nausea or vomiting
  • Prolonged weakness or sleepiness       
  • Prolonged bleeding, severe pain or swelling

If you feel you have a true emergency, call 911 immediately.

 

NITROUS OXIDE AND VISTARIL

NITROUS OXIDE

As specialists in pediatric dentistry, we have found that many of the children we treat benefit from the use of nitrous oxide (laughing gas).  “Laughing gas” is used to calm and distract your child during difficult portions of dental treatment.  It produces a calming feeling and a sense of well-being.  We combine a very low level of nitrous oxide with a high level of oxygen.  These children remain fully awake during the dental procedures.  At the end of treatment the child breathes 100% oxygen to cleanse the lungs of the nitrous oxide.  Nitrous oxide is quickly eliminated from the body with normal breathing.  We recommend your child eat a light breakfast prior to his or her appointment since nausea occasionally occurs with the use of nitrous oxide.

HYDROXYZINE

Dr. Nikki occasionally prescribes Hydroxyzine for children who require treatment.  Hydroxyzine is an antihistamine that calms the stomach, reduces the gag reflex and helps to decrease the saliva in the mouth.  Keeping the tooth in need of treatment free of saliva is very important in dentistry since this is one reason for dental work failing.  Hydroxyzine is often used in combination with nitrous oxide.  The Hydroxyzine helps the nitrous oxide work more effectively and counteracts its potential side effect of nausea.   Hydroxyzineis usually given to the child in one dose, 30 minutes to 1 hour prior to the appointment.  Occasionally, a child may develop abdominal gas, sleepiness or irritability due to Hydroxyzine.  However, the majority of the children we treat are able to return to their normal daily routine after their appointment.  We use Hydroxyzine because it works very well and is very safe. 

We want your child to have the best dental experience possible!