Drs. Levitt & Appelbaum - Pre & Post Op Care

Nitrous Oxide
Prior to your Appointment
After the Sedation Appointment
Care of the Mouth after Local Anesthetic
Care of the Mouth after Trauma
Care of the Mouth after Extractions
Care of Sealants
Oral Discomfort after a Cleaning

Nitrous Oxide

Some children are given nitrous oxide/oxygen analgesia, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen analgesia is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child's nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry recognizes this technique as a very safe, effective technique to use for treating children's dental needs. The gas is mild, easily taken, with normal breathing; and is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.
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Prior to your Appointment:

If you have any questions or concerns about your child's appointment, please call
(314) 567-1122 or (636) 946-5225.

Please notify us of any change in your child's health and/or medical condition.
Please arrive 10 minutes before the appointment.
You must tell the doctor of any drugs that your child is currently taking and any drug reactions.
Please dress your child in loose fitting, comfortable clothing.
Please make sure that your child goes to the bathroom immediately prior to or when arriving at the office.
Your child can have a light meal two hours prior to her/his visit.
The child's parent or legal guardian must remain at the office during the complete procedure.
Please watch your child closely while the medication is taking effect. Hold them in your lap or keep them close to you. Do not let them "run around."
Your child will act drowsy and may become slightly excited at first.

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After the Sedation Appointment

Your child will be drowsy and will need to be monitored closely. Keep your child away from areas of potential harm.
If your child vomits, help them bend over and turn their head to the side to ensure that they do not inhale the vomit.
Because we use local anesthetic to numb your child's mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and /or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.

Please call our office (314) 567-1122 or (636) 946-5225 for any questions or concerns that you might have.

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Care of the Mouth after Local Anesthetic

Your child has had local anesthetic for their dental procedure:

If the procedure was in the lower jaw... the tongue, teeth, lip and surrounding tissue will be numb or asleep.
If the procedure was in the upper jaw... the teeth, lip and surrounding tissue will be numb or asleep.

Often, children do not understand the effects of local anesthesia, and may chew, scratch, suck, or play with the numb lip, tongue, or cheek. These actions can cause minor irritations or they can be severe enough to cause swelling and abrasions to the tissue. Please monitor your child closely for approximately two hours following the appointment. It is often wise to keep your child on a liquid or soft diet until the anesthetic has worn off.

Please do not hesitate to call the office if there are any questions.
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Care of the Mouth after Trauma

Please keep the traumatized area as-clean-as possible. A soft wash cloth often works well during healing to aid the process.
Watch for darkening of traumatized teeth. This could be an indication of a dying nerve (pulp).
If the swelling should re-occur, our office needs to see the patient as-soon-as possible. Ice should be administered during the first 24 hours to keep the swelling to a minimum.
Watch for infection (gum boils) in the area of trauma. If infection is noticed - call the office so the patient can be seen as-soon-as possible.
Maintain a soft diet for two to three days, or until the child feels comfortable eating normally again.
Avoid sweets or foods that are extremely hot or cold.
If antibiotics or pain medicines are prescribed, be sure to follow the prescription as directed.

Please do not hesitate to call the office if there are any questions.
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Care of the Mouth after Extractions

Do not scratch , chew, suck, or rub the lips, tongue, or cheek while they feel numb or asleep. The child should be watched closely so he/she does not injure his/her lip, tongue, or cheek before the anesthesia wears off.
Do not rinse the mouth for several hours.
Do not spit excessively.
Do not drink a carbonated beverage (Coke, Sprite, etc.) for the remainder of the day.
Do not drink through a straw.
Keep fingers and tongue away from the extraction area.

Bleeding - Some bleeding is to be expected. If unusual or sustained bleeding occurs, place cotton gauze firmly over the extraction area and bite down or hold in place for fifteen minutes. This can also be accomplished with a tea bag. Repeat if necessary.

Maintain a soft diet for a day or two, or until the child feels comfortable eating normally again.
Avoid strenuous exercise or physical activity for several hours after the extraction and no swimming for 24 hours.

Pain - For discomfort use Children's Tylenol, Advil, or Motrin as directed for the age of the child. If a medicine was prescribed, then follow the directions on the bottle.

Please do not hesitate to contact the office if there are any questions.
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Care of Sealants

By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Since, the covering is only over the biting surface of the tooth, areas on the side and between teeth cannot be coated with the sealant. Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

Your child should refrain from eating ice or hard candy, which tend to fracture the sealant. Regular dental appointments are recommended in order for your child's dentist to be certain the sealants remain in place.

The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten. If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!
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Oral Discomfort after a Cleaning

A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a "rough cleaning" but, to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after cleaning was performed:

1) A warm salt water rinse 2 - 3 times per day
(1 teaspoon of salt in 1 cup of warm water)

2) For discomfort use Children's Tylenol, Advil, or Motrin as
directed for the age of the child.

Please do not hesitate to contact the office if the discomfort persists for more than 7 days or if there are any questions.
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