Pre-Op Instructions	Post-Op Instructions
Sedation Appointment	Care after Sedation
	Care after Sealants
	Care after Fillings/Crowns
	Care after Extractions

Sedation Appointment Instructions

If you have been told that your child will be receiving sedation medications, it is important for your child's safety that you follow these instructions carefully.  Failure to follow these instructions could result in serious injury.

The purpose of sedation medication is to make treatment easier for your child.  The action of the sedative medication is to help your child be calm and relaxed to assist and permit the highest quality of care under the safest conditions possible.  Use of sedative medication is intended to prevent the need to resort to general anesthesia and hospitalization to perform treatment.  Where sedation proves inadequate or unsuccessful, or not felt to be the most appropriate modality for your child, general anesthesia may be recommended to permit treatment to be accomplished.

Sedation medications are chosen with consideration of your child's medical history, type of dental treatment necessary, discomfort potential, length of time required, and child's reaction to noise and activity in the mouth.  Possibilities include:  a narcotic medication indicated for pain relief, an anti-histamine medication which helps control the gag reflex (often more accentuated in children than in adults), an anxiolytic medication to relax and provide mild amnesia.

Nitrous oxide gas used in combination with oxygen may be useful to help control gagging, pain, and apprehension.  The minimum amount necessary will be given.  The gas does not affect the child after the appointment.

Local anesthesia (injection) will probably be used for more complicated dental restorations.  Please do not tell your child in advance; usually they will not feel the anesthesia due to the sedation.

Parents are requested to remain in the office reception area during sedation and treatment time.  The sedation takes approximately 50 minutes to take effect and most restorative treatment is completed in 45 minutes.  Parents and patients are usually in the office less than 2 hours.

It is essential that NOTHING BE EATEN 6-8 HOURS BEFORE THE APPOINTMENT.  Clear fluids (water) may be given (small amounts) if ABSOLUTELY NECESSARY.

1. Do not give your child ANY medication which may affect the sedation without checking with one of the doctors first.

2. It is medically necessary that you inform the dentist of any changes in your child's medical history.

The following are some side or after-effects which may occur and should not cause for alarm:

• Some listlessness, dizziness, and possible upset stomach.

• The child may wish to nap or rest for a time, possibly for a few hours after treatment.

• It is not uncommon for the child to appear slightly agitated as medications are absorbed and should not be cause for alarm.  If this persists, it may indicate additional medication is needed, or an alternate modality (general anesthesia) may be needed.  As medications begin to wear off, the child will return to his/her normal state of responsiveness.

Some dizziness tends to wear off slowly, it is advised that you watch your child closely.  The child should not be sent back to school following the appointment and should remain indoors the remainder of the day.  No bike riding, running, etc., or physical activity should be done.

During transport to and from the office, please be sure to place the child in appropriate safety belts or child-seat.  We STRONGLY RECOMMEND a second adult be present to assist.

If you have any concerns or questions you may contact our office at (920) 592-8940.

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Care after Sedation

Activity:
Rest for the remainder of the day.  Try to provide a restful atmosphere for your child to rest.  Supervise all activities closely, because coordination and judgment have been shown to be impaired for as long as 24 hours after sedation.

Diet:
Encourage fluid intake for the next 24 hours to keep your child well hydrated.  Fluids should be clear (ie...7-up, gatorade, apple juice, water).  Follow a softer diet for the next day.  Soft diet examples are:  mashed potatoes, pudding, spaghetti, soups, etc.

Pain:
Give advil / motrin / ibuprofen as directed on label for pain.

Oral Hygiene:
If a fluoride treatment has been applied to your child's teeth they will appear yellow in color.  This is normal.  Do not brush your child's teeth until tomorrow morning.  The yellow color will brush away.

Call: Dr. James Van Miller, Dr. James Conrardy, or Dr. Eric VanMiller at (920) 592-8940 if any of the following develop.

• Vomiting that persists.

• Fever remaining elevated for 24 hours or a fever above 101 degrees.

• Difficulty breathing.

• Any other matter that causes concern.

If you feel you have an emergency and your doctor cannot be reached; go immediately to the emergency center.

Prevention:
After dental procedures are performed we want to do everything to prevent any future problems.  We recommend cleanings every 6 months, updating x-rays, and fluoride applications.  We also want oral hygiene to be the best it can.  Parental help with oral hygiene is important.  We recommend a minimum of brushing 2x/day as well as flossing before bedtime.  Your dentist may also recommend other preventive measures.

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Care after Sealants

A Sealant is a clear, or white shaded coating, that seals the deep pits and grooves on the chewing surfaces of back teeth to prevent decay.

It is a normal feeling for the bite to feel a little "high" after sealant placement.  Some children key into this temporary feeling more than others.  There may be a slight after taste immediately following application.  A rinse with water will help to reduce this taste.

As with all dental procedures, the longevity of sealants varies with each individual.  Effectiveness of sealants is influenced by bite patterns, grinding, ice or hard candy chewing, and bacterial plaque levels.  Good oral hygiene is important.  Soft drinks are no longer an occasional treat.  The bacteria in the mouth convert soft drink sugars into acid.  Diet soda is also high in acid.  This acid attacks not only the teeth but can contribute to sealant failures.  The condition of the sealants placed are checked at each recare visit.  Sealants can chip or wear out.  We will inform you if your child's teeth ever need to be resealed.  Any length of time that a sealant remains intact is successful as it has protected the tooth from decay for that time period.  Our goal with sealants is to maintain tooth structure for a lifetime of dental health!

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Care after Fillings/Crowns

1. Your child will experience numbness for approximately 1-3 hours.

2. Watch so your child does not bite the cheek, lips, or tongue.

3. Do not allow your child to eat for 1 hour.

4. During the first 24 hours following the appointment, follow a soft food diet. (A silver filling does not acquire 100% of its strength for 24 hours.)

5. If a stainless steel crown is inserted, avoid sticky foods.

6. Give Ibuprofen (Advil or Motrin) for discomfort prior to the numbness wearing off if extensive treatment has been performed.  Give a second dose 4 hours later if needed;   not to exceed the recommended dosage in a 24 hour period.

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Care after Extractions

1. Your child must bite on the gauze pack provided for 10 minutes, remove, place a new pack and continue until bleeding stops.

2. Do not allow your child to eat or drink for one hour.

3. If a surgical packing has been placed it will dissolve.

4. Give Ibuprofen (Advil or Motrin) for any discomfort, every 4 hours; not to exceed the recommended dosage in a 24 hour period.

5. Your child should eat softer type foods for the remainder of the day so that no irritation is created in the extraction area.  Tomorrow your child may resume routine eating habits.

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