Local Anaesthetic
The dentist has put some local anaesthesia (numbing liquid) in your child’s gum when they were asleep. The numb feeling will last for a couple of hours.
Check your child is not biting or pulling their lip while they are numb.
Pain
After extractions (tooth removal), the gums are often sore. It can feel strange to eat for a couple of days.
Give your child regular pain medication (such as paracetamol and/or ibuprofen) for at least 24 hours 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 waiting for your child to become uncomfortable and then giving medicines to treat pain.
If they still need pain relief after that, please follow the instructions on the paracetamol packaging to find out the correct dose to give for their age. Leave at least 4-6 hours between doses. Do not give more than 4 doses of paracetamol in any 24 hour period.
If you have given your child paracetamol and they are still in pain after 1 hour, you could try giving ibuprofen (if not contraindicated) as well.
You can give ibuprofen every 8 hours with food, using the correct dose for their age as stated on the packaging.
If they are still in some pain after giving ibuprofen, you can alternate between doses of paracetamol and ibuprofen. Only give 1 medicine at a time. It may help to keep a diary of the time and dose of each medicine you give.
Please make sure you follow the instructions on the packaging carefully to avoid overdose on the medicines. If pain is not controlled with painkillers as listed above, please contact the department for advice.
Bleeding
It is normal for some redness in the 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 spit. Your child should not rinse their mouth round vigorously as this could disturb the wounds in the tooth sockets and cause bleeding. Avoid hot food or drinks for the first 24 hours as this may encourage bleeding. Please provide them with cooler softer food and drinks for the first couple of days. Encourage your child to rest and avoid strenuous exercise for 24 hours.
If bleeding does not stop:
1. Roll a clean dry gauze or cotton handkerchief into a ‘sausage shape’
2. Place it over the bleeding socket
3. Ask your child to bite on it for 20 minutes
4. Check after 20 minutes
It is normal to see blood clot (red jelly) over where the tooth has been removed. If the bleeding does not stop after 20 minutes, please contact the department by calling 01706 649064 between 8am to 5pm Monday to Friday. If the bleeding is happening outside of these hours, please contact our Oral and Maxillofacial Surgery (OMFS) Team based in Rotherham General Hospital via switchboard on 01709 428000.
Infection
It is very rare for children to have infection following the extraction of teeth. If your child is able to tolerate it, encourage them to gently rinse with lukewarm salt water, starting from 24 hours after the surgery.
To make up the lukewarm salt water: mix 1 teaspoon of table salt to half a glass of warm water. Encourage your child to rinse 2 to 3 times a day for 5 days.
Nausea and vomiting
Many children may feel sick or vomit after having general anaesthetic. Your child may have these problems due to the effects of the medicines used during their procedure. Another possible cause is because they have not had enough to drink. Any problems usually get better within a few hours once they are able to drink more.
Swelling and bruising
It is not uncommon for your child to have swelling and bruising a couple of days after the surgery. Most of the time the swelling and bruising will go away 5 to 7 days after the extraction. If the swelling or bruising is getting worse, please contact the department by calling 01706 649064 between 8am to 5pm Monday to Friday. If you need help outside of these hours, please contact our Oral and Maxillofacial Surgery (OMFS) Team based in Rotherham General Hospital via switchboard on 01709 428000.
Stitches
Your dentist will inform you if they have placed any stitches in your child’s mouth. The stitches used are dissolvable and do not require further removal.
When can my child go back to nursery/school?
You will need to monitor your child for 24 hours after surgery as they recover, so they shouldn’t go to nursery/school straight after their surgery or on the day after their surgery. Some children are happy to go back to nursery/school after that. Some may need a couple more days. Please ensure they do not take part in any sports or physical activities for 24 hours after the surgery.
What can my child eat?
Your child can eat immediately after the surgery as long as they do not feel sick. Avoid hot food or drinks for the first 24 hours as this may encourage bleeding. Provide them with cooler, softer foods and drinks for the first couple of days e.g. soft bread, yoghurts; and cooled down
mashed potatoes, pasta and minced meat.
Recommendations to prevent tooth decay:
• Encourage your child to ‘sugar swap’.
• To choose food and drinks which contain less sugar, please visit https://www.nhs.uk/healthier-families/food-facts/healthier-food-swaps/
• Reduce the amount of sugary foods and drinks and how often they are being given.
• Keep sugary foods and drinks to mealtimes and avoid them as snacks between meals.
• The safest drinks for your child’s teeth are unflavoured milk or water. Avoid fizzy drinks, soft drinks, juices and squashes as these often contain sugar.
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 removed whilst the gums are healing. Your child should not rinse their mouth after tooth brushing at any time.
Recommendations to maintain your child’s oral health:
1. Use fluoride toothpaste which contains 1350 – 1500ppm fluoride.
Check the ingredients on the packaging for this.
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. The most important time to brush is last thing at
night just before bedtime, and then choose another time to brush as well.
3. Encourage your child to spit the toothpaste out but they should not rinse their mouth
after brushing.
4. Parents are advised to help brush their child’s teeth up to the age of 7 years.
What are the common side effects of general anaesthesia?
After waking from their operation, your child may have a sore throat, feel sick or vomit, feel dizzy, feel confused or even agitated. These side effects are common, affecting between 10 and 20 of 100 children. The side effects usually resolve within 24 hours.
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 01706 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 on 01709 428000.
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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