Oral surgery - Removal of Teeth under General Anaesthetic (GA) for Children

Introduction

The Dental team have discussed and recommended your child be admitted to hospital to have teeth removed under General Anaesthetic (GA).

It is essential that you follow the advice in this leaflet to ensure that the procedure goes ahead.

Instructions for parents/guardians of children attending for dental treatment under a GA.

Your child must have nothing to eat for 6 hours before the appointment this includes chewing gum; sucking sweets (or smoking) are not advised.

You may give your child, small sips of still tap water, pulp free juice, clear carbonated drinks tea or coffee without milk, but this should be limited and allow them to brush their teeth before their appointment time.

The hospital site, entrance and time to attend will be sent with your appointment letter in due course.

• If your child has dental pain or swelling whilst awaiting a GA – please contact your own dentist in the interim
• Your child MUST be accompanied by a parent or guardian who can legally sign the consent form on the day
• If possible, only one person should accompany the child as accommodation in the Unit is limited. Additional persons may be asked to remain in the waiting area if the Unit is busy
• Only children having an operation will be allowed in the Day Case Unit, so please make arrangements for your other children to be cared for
• Several children will be having their dental operation on the same day as your child. All the children will have their assessment and be prepared for the operation before the dental operations can begin
• Your child will remain in the Unit for some time following the dental operation and will only be discharged once the nursing staff are satisfied that it is safe to do so
• Car parking - details of the hospital site will be sent with your appointment letter
• Your child should not wear jewellery, make-up or nail varnish
• Please bring a pair of pyjamas or nightdress for your child
• Please bring any medication your child is taking at the time of the appointment
• Your child should be looked after at home for the next 24 hours. Please make sure that you have appropriate pain relief medicine at home

Please contact the department within the hospital facilitating the appointment (as per your appointment letter) if:

• Your child is unwell, develops a cough or a cold before the appointment
• To cancel or rearrange your child’s appointment
• You need to change your child’s details (address/telephone number)

After the operation

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 tingling to the soft tissues from the effects of the local anaesthetic
• Have some pain or discomfort for a few days. Healing can take 7 to 10 days and discomfort is to be expected during this time

Immediate After Care

• Your child should rest for 24 hours, not take exercise or use any form of wheeled transport e.g. bicycles, scooters, skate boards, and must not go out into the road or garden on their own for the remainder of the day
• Your child should be monitored at home by a responsible adult for 24 hours after the procedure is completed
• Your child may need to stay off school for a couple of days, depending on how quickly they recover

Mouth Care

• Do not rinse your child’s mouth for the rest of the day following the operation. If you do rinse, the clot of blood will be washed away and bleeding may start again
• Should bleeding occur, place a clean damp gauze or a folded clean handkerchief across the surgical site and bite on it for 15 minutes
• If excessive bleeding continues after carrying out the previous instructions, call NHS 111 who will advise
• After 24 hours gentle rinsing after meals with warm salty water is recommended to keep the area clean and encourage healing

Pain Relief

• The child will have had some pain relief during the procedure, however, simple paracetamol suspension or ibuprofen can be administered at home every 4 to 6 hours as per dosage instructions. We would advise that pain relief is continued for 48 hours initially and then reviewed
• Post operative pain is usually worse in the first 48 hours. If after several days the pain appears to be worsening, rather than improving, please contact your dentist for advice as your child may have developed an infection

Diet

• Soft food should be consumed for the first few days after the operation. Examples are: eggs, yoghurts, pasta, noodles, stews, soups etc
• Avoid sharp, crispy or hard foods
• Plenty of fluids are advised but avoid fizzy drinks
• Avoid the extremes of temperature hot/cold as this can cause bleeding to reoccur

Oral Hygiene

• Avoid brushing for 24 hours following the procedure
• After 24 hours, careful brushing with a fluoride toothpaste is recommended. Spit out when finished, do not rinse

Moving Forward

• It is very important that moving forward your child’s sugar intake is reduced and restricted to mealtimes only. Sugar free snacks, fruit, water, milk should only be available between meals
• Regular brushing with a fluoride toothpaste twice daily (one must be last thing at night) to remove food and bacteria from teeth that cause the decay
• Children aged 8 years and under should be supervised and assisted with their brushing
• We recommend visiting your own dentist in 3 months’ time for a check-up. Your dentist can advise best practice and offer preventative measures to reduce the likelihood of decay affecting your child’s teeth