Where do we go?
Please attend the Children’s Surgical Unit at Doncaster Royal Infirmary. The Children’s Surgical Unit is situated on the basement corridor between Renal Unit and Day Surgery Unit. The ward can be accessed via Gate 5 on Armthorpe Road, Doncaster.
Pre-operative instructions
Can my child eat or drink before the procedure?
It is important that your child DOES NOT have anything to eat or drink before their operation. Please follow the instructions below. Failure to do so may result in the surgery being cancelled.
Morning Operation:
• Give your child a meal with lots of carbohydrates such as pasta, potatoes or rice the night before the operation.
• No food is allowed after 12 midnight.
• For drinks after 12 midnight, please only give sips of clear fluids such as water or diluted juice up until 7 a.m. on the morning of your child’s operation.
• After 12 midnight, DO NOT HAVE:
a. Milk or milk products
b. Boiled sweets or chewing gum.
Afternoon Operation:
• Do not attend school in the morning.
• We would recommend giving your child non sugary cereals (such as Weetabix) or toast with butter for breakfast.
• No food is allowed after 7 a.m.
• For drinks after 7a.m., please only give sips of clear fluids such as water or diluted juice up until 11 a.m. on the morning of your child’s operation.
• After 7 a.m., DO NOT HAVE:
a. Milk or milk products
b. Boiled sweets or chewing gum.
How long can I be expected to stay?
This depends on the time your child goes to theatre and the length of procedure. An average stay is around 3 – 4 hours.
What should we bring?
1. Your child’s appointment letter.
2. Any medications. Your child should take any medications as normal on the day of your admission unless you have been given other specific instructions.
3. A copy of your child’s consent form.
What should my child wear?
We recommend wearing comfortable clothing, many choose to wear pyjamas. Also bring a spare change of clothes with you. We have activities and toys on our wards and waiting areas. Your child is welcome to bring their favourite toy or teddy too.
How can I help my child to prepare for their procedure and anaesthetic?
It is important that children know a little about what to expect when they come for their procedure. All children should be told:
1. That they are going into hospital
2. That they will be having an operation
3. Some basic information about what will happen to them when they are in hospital
It may be enough to explain that some of their teeth are poorly and need to be removed. You can explain that the doctor will give them some medicine which will make them go to sleep while their teeth are removed. The doctor will look after them while they are asleep and will
help them wake up at the end of the operation. Older children may want to know more. Do encourage your child to talk about the operation.
We have included different age appropriate leaflets explaining what they should expect during their hospital visit. These are also available in different translations on the website. We would recommend your child to read them to prepare for themselves for general anaesthetic. Should you require support explaining the procedure to your child, please let us know.
1. For children under the age of 7: Rees bear has anaesthetics https://www.rcoa.ac.uk/sites/default/files/documents/2019-08/ReesBear.pdf
2. For children aged 7 to 11: Dennis has an anaesthetic! https://www.rcoa.ac.uk/sites/default/files/documents/2023-07/RCoA_Beano2022web.pdf
3. For children 12 years old and above: https://rcoa.ac.uk/sites/default/files/documents/2024-12/TeenGuide2024web.pdf
Who should bring my child to the appointment?
It is essential that a parent or legal guardian accompanies your child. This is essential as children under 16 years of age must have the consent form for treatment signed by someone with Parental Responsibility. Parental Responsibility refers to the individual who has legal
rights, responsibilities, duties, power and authority to make decisions for a child. Siblings can also be brought as long as there is one adult per child. Please check with your dental team whether other members of the family are allowed to attend.
What should we do if we cannot attend?
It is important to let us know if your child cannot attend their appointment so we can offer it to someone else. Please call us as soon as possible on 01709 649067.
What if my child is unwell?
Please inform us if your child has any common infection such as chicken pox, hand, foot and mouth disease, respiratory infections including COVID-19 and influenza (flu), or any other infections. If your child has a cough or cold, please call for advice on 01709 649067.
What happens on the day?
Admission
When you get to the ward, you will be met by a member of the team. They will put a wristband on your child and apply numbing cream on the back of their hand.
You will be seen by the team looking after your child. This will include a member of the nursing team, the dentist and the anaesthetist. The dentist will explain the procedure and confirm consent. The anaesthetist will meet you and your child to discuss the process of them going to
sleep and answer any queries you have regarding general anaesthesia. The nursing team will also give your child paracetamol and ibuprofen on admission as pain relief.
Waiting for procedure
You and your child will be able to wait in the waiting area until your child goes to theatre. It is important that you do not leave the unit once admitted. Where possible the team will give you an estimated time. However, time can change if an earlier case takes longer than expected.
Can I go with my child to the operating theatre?
One parent or carer can accompany your child into theatre and stay with them until they are asleep. Your child may require an anaesthetic gas to breathe in or a medicine through a cannula (thin plastic tube). You will then be asked to leave promptly when your child has been
anaesthetised.
How long will my child be asleep for?
This will depend on the length of the operation. Simple removal of teeth may take up to fifteen minutes. Recovery from anaesthetic will occur quickly.
What happens after the operation?
Your child will wake up in our recovery area. Your child will be closely monitored by the nursing team until they are ready to return back to the ward/unit. You will be able to see your child once they are starting to wake up. Some children may wake up quickly, whereas others
take much longer. The cannula will be left in their hand. This lets the nurses and doctors give further medicine if needed. They will remove it as soon as they can.
After the operation, you will need to wait for around an hour before you can go home. Some children go home sooner once the nursing team is happy. You will be expected to be at the hospital for around 4 hours for the whole procedure.
What will my child feel like after the operation?
When your child first wakes up, they are likely to be a bit confused and may cry for a short time. In addition, if your child is in pain, pain relief medicine will be given. Most children settle quickly and can soon have a drink.
It is common for children to:
• Feel dizzy and a bit sick for a few hours
• Be sick occasionally, especially if they have swallowed a little blood
• Have some pain and discomfort for couple of days requiring regular analgesia
Why are the gums numb?
To stop the gums from hurting when your child wakes up, the dentist will put some local anaesthesia (numbing liquid) in their gums when they are asleep. This numb feeling may make your child upset, but it helps to stop the gums from being sore immediately after the operation. The numbing may last for a couple of hours. You will need to check your child is not biting or pulling their lip while being numb. The local anaesthetic given also helps to reduce bleeding.
Can I keep my child’s teeth after?
Unfortunately, we are unable to give the extracted teeth after surgery as per our Trust’s policy but children tell us tooth fairy still comes!
Going home
When your child is ready to be discharged home, final checks will be made by the nursing team.
Please make sure you have some pain relief such as paracetamol and ibuprofen (if not contraindicated) at home before your child is discharged. We do not routinely provide pain relief to take home. The nursing team will tell you when your child needs their next dose
of pain medication. You will need to make your own transport arrangements home. We recommend going home by car or taxi.
After surgery
Will it hurt afterwards?
After extractions, the gums are often sore. It can also feel strange to eat for a couple of days. Give your child regular pain medication (paracetamol and/or ibuprofen) and follow the instructions on the bottle or packet.
It is much better to give the medicines regularly to maintain a steady level of pain relief, rather than giving medicines only when they begin to feel discomfort.
What can my child eat?
It is important that your child gets plenty of drinks (water and milk) and nutritious food. For the first couple of days a soft diet is recommended, however, your child can eat anything as long as it does not cause them discomfort. Please make sure hot food and drinks have been cooled to reduce the risk of bleeding after removal of teeth.
Here are some ideas for a soft diet:
• Porridge or non-sugary cereals (such as Weetabix) softened with milk
• Scrambled eggs
• Pasta
• Rice with mild curry
• Mashed potato and mince
• Soft cooked vegetables such as carrots, broccoli and peas
• Plain yoghurt.
Will it bleed?
It is normal for some redness in the saliva (spit) for a couple of days. In most cases, bleeding stops after a few minutes, especially if your child is drinking fluids and swallowing their own saliva. We discourage spitting or rinsing out their mouth within the first 24 hours of surgery.
If the bleeding does not stop, roll a clean dry gauze or cotton handkerchief (not tissue or cotton wool) into a ‘sausage shape’ and place it over the bleeding socket. Ask your child to bite on it for 20 minutes. If your child cannot bite, you may need to press the rolled gauze/handkerchief on the bleeding socket for 20 minutes. You may have to do this a few times.
When can we start toothbrushing?
The teeth should be brushed as usual but take care when cleaning around the areas where the teeth have been extracted whilst the gums are healing. Your child should not rinse their mouth after toothbrushing at any time. You can return to normal toothbrushing within 48 hours.
Recommendations to maintain your child’s oral health:
1. Use fluoride toothpaste containing 1350 – 1500ppm fluoride.
a. From 3 years of age: use a small pea sized amount of toothpaste.
b. Before 3 years of age: use a smear of toothpaste.
2. Brush twice daily for at least 2 minutes.
3. Do not rinse mouth after brushing.
4. Parents are advised to help brush their child’s teeth up to the age of 7 years.
When can my child go back to school?
We recommend staying at home on the day of surgery and the following day after surgery. If your child is going to school the day after surgery, please ensure your child is not running or participating in any sports or physical activities.
What next?
First 24 hours
• Your child will need rest and close adult supervision. Regular painkillers as advised.
• Do not let your child do anything which may put them or others at risk.
• Your child should not ride a bicycle, climb, or take part in sports or physical activities.
• No spitting or rinsing within the first 24 hours as this may encourage bleeding after surgery.
When should I seek medical advice?
Please seek medical advice:
• If excessive bleeding occurs that does not stop with pressure.
• If your child has severe pain and pain relief is not working.
• If your child is being frequently sick and even water is causing sickness.
• If their breathing is noisy or different to normal.
Please contact the department 8am to 5pm Monday to Friday on 01709 649064. If you need advice out of hours, you can contact our Oral and Maxillofacial Surgery (OMFS) Team based in Rotherham General Hospital via switchboard 01709 428000.
Other information
What are the alternatives to general anaesthesia?
Local Anaesthesia:
This method commonly involves numbing cream before a needle is inserted into the gum with administration of local anaesthetic or ‘numbing liquid’ into the gum.
Once the gums are numbed, your child will feel wiggling and pressure. This involves a lot of cooperation of the child and may be traumatic for the child.
Inhalation Sedation:
Inhalation sedation is a technique using a gas called nitrous oxide or ‘happy air’ which is delivered with oxygen by a small mask placed on your child’s nose.
It is used when a child is cooperative but nervous about a procedure.
This is extremely safe and can be very effective if your child can breathe through their nose. Inhalation sedation is typically carried out in a community dental services and some hospital settings and the patient can be referred by your dentist for this.
Inhalation sedation is typically considered for children from 6 years old but can be used to
support younger children where they are especially compliant or cooperative.
General Anaesthesia:
General anaesthesia is a state of controlled unconsciousness (going to sleep) and freedom from pain. In modern anaesthesia, serious problems are uncommon.
Most children recover quickly and are soon back to normal after their operation and anaesthetic.
Some children may suffer side effects like sickness or a sore throat.
For a child in good health having minor surgery:
• 1 in 10 might experience a headache, sore throat, sickness or dizziness
• 1 in 100 might be mildly allergic to one of the drugs that has been given
• 1 in 20,000 might develop a serious reaction (allergy) to the anaesthetic
• Less than 1 in 100,000 might result in death as a direct result of anaesthesia.
For further information, you can access the common events and risk for children and young people having a general anaesthetic infographics on the link: https://www.rcoa.ac.uk/sites/default/files/documents/2024-12/ChildInfographics2022_0.pdf
We would also recommend you visit other resources about your child’s general anaesthesia on the link: https://www.rcoa.ac.uk/sites/default/files/documents/2024-12/ChildGA2023web.pdf
What will happen if I decide that my child will not have the procedure?
Unfortunately, without treatment, tooth decay may worsen leading to pain and infection.
The symptoms may get worse or return. There is a risk of your child getting a serious, life-threatening infection. There is also a risk that the underlying developing permanent tooth may be damaged if the decayed baby tooth is being left behind. If your child needs to have
their tooth removed before they can have other dental treatment, the treatment may not be possible or the chance of treatment being a success may be reduced.
What are the alternatives to having my child’s teeth taken out?
There are different ways of treating decayed teeth. The dental teams looking after your child will discuss the options so you can decide together on the best one to suit their individual needs.
Questions or Comments
Hearing about the experience you had at our department is very important because it enables us to improve our services. If you need advice or have concerns, please contact us on 01709 649067.
If you would prefer to speak with someone outside of the department you are concerned with, you can contact the Patient Experience Team on 01302 642764, 01302 642767 or email dbth.pals.dbh@nhs.net.
Written communications can also be sent to:
Patient Advice and Liaison Service
Doncaster Royal Infirmary
Armthorpe Road
Doncaster
DN2 5LT
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