There are a handful of reasons a tooth might need to be extracted.
Depending on your child's age, anxiety and dental needs, some form of sedation might be suggested for your child.
Unless the child is deeply sedated, they are going to feel some pressure as the tooth is extracted even if they are completely numb. There are many verbal and distraction techniques that your dentist can use to help guide your child’s behavior through the procedure.
One of them is called "tell, show, do." Just like it sounds, first I tell the patient what I will do. Then I show them and finally, I actually do the actions I discussed. This simple method can be very helpful to help the patient get used to what will happen before you jump into the procedure.
The best post-extraction instructions will vary depending on the difficulty and type of extraction as well as the patient’s medical history. Below, I want to review some of the most common situations and questions patients ask me.
Possibly, depending on the severity of the infection and your child's medical history, your dentist might prescribe an antibiotic.
The suction motion from a straw, sports bottle or sippy cup can lead to loss of the blood clot that is forming where the tooth used to be. This will cause the healing process to slow down, increase pain, and possibly cause a dry socket.
Your dentist will give you some little cotton squares called packing gauze. The goal of the packing gauze is to put some pressure on the extraction site to allow the blood clot to stabilize. They may call them "2 by 2s" or "4 by 4s" these nicknames tell you how large the squares are (2 cm or 4 cm). All you need to do is fold over the gauze and have the child bite onto it. You will check this gauze every 30 minutes. If it is still pink or red, replace it and recheck it in another 30 minutes. If the gauze just looks wet from their saliva then the blood clot is firm and stable. At this point, the packing gauze is no longer needed.
Depending on the location of the extraction, age of the child, and temperament of the child, this can be difficult. In this situation, I like to give the parent the larger "4 by 4s" discussed above. This allows for a portion of the gauze to hang outside the mouth while the child puts pressure on the extraction site. This allows the parent the hold the other end in place.
If your child is extremely defiant about keeping the gauze in place, please contact your dentist. They can discuss options with you based on your specific situation.
One thing many parents overlook is how to keep your child comfortable after being numb. Some children have a habit of trying to suck in their upper lip while it is numb. This constant pressure against the front teeth can cut into the back of the lip. This can cause severe swelling and pain after the patient is no longer numb.
It is vital to keep a close eye on the patient after treatment to make sure they are not chewing or picking at their lips.
Bonus tip: I always like to remind my patients that it is normal for it to feel fat and funny. For some kids, when you say it will feel this way for two hours, they cannot fully grasp what two hours feels like. I like to break things down into movies or show lengths. This could mean they will be numb for one movie or three TV shows.
The closer you follow your dentist post-extraction instructions the better your child will recover after treatment.
If the child was only minimally sedated or had no sedation during the extraction there should be no problem going to school the next day. For deeper levels of sedation, please discuss it with your dentist to determine how much activity will be appropriate for your child after treatment.
It is common to need a space maintainer after a baby tooth is extracted. This is a custom device your dentist or a dental lab will create to help prevent the other teeth from tipping or drifting into where the tooth used to be. This will stay in place until the child's adult tooth is ready to come in, and then the space maintainer can be removed.
There are two major types of space maintainers. Unilateral (one side) bilateral (both sides). The unilateral space maintainer is typically used when a single tooth is extracted. A bilateral space maintainer is used if a unilateral cannot be used.
If you would like to know more about We Care Dental Care, please give us a call at 540-427-7274.