Our partnering dentists and oral surgery for kids

What’s the most common oral surgery for kids? The extraction of wisdom teeth! You can count on your child’s Kool Smiles Kids Club partner to determine if – and when – wisdom teeth should be removed.

What, exactly, are wisdom teeth?

Wisdom teeth – often called third molars – are the last molars to come in. Although not everyone gets wisdom teeth, most people get will get a total of four. They emerge in the back of the mouth in the early teens or young
adulthood. If the teeth are properly aligned and healthy, that’s a win! But because most mouths are too small for four additional teeth, wisdom teeth emerge misaligned and can cause a number of problems, including pain,
damage to other teeth or nerves, bad breath and cysts. Chances are, your child’s wisdom teeth will need to be removed.

Removing wisdom teeth is the most common oral surgery for teenagers

Removing wisdom teeth requires oral surgery, which is performed in our partner offices as an outpatient operation

Here are some common reasons for having your child’s wisdom teeth removed:

  • The tooth is decayed or broken
  • Your child doesn’t have enough room in his or her mouth
  • The tooth is growing in at the wrong angle
  • The tooth is trapped, and only the tip has pushed through the gum
  • A fluid-filled sac, called a cyst, has formed around the tooth

Wisdom teeth are usually removed before they erupt and when the roots are not yet fully developed. In general, early removal ensures less pain and a quicker recovery.

How will I know my child’s wisdom teeth are coming in?

If your child’s wisdom teeth have already grown in, they’ll be at the very back of the mouth, behind the second molars. One way to check is by counting your child’s teeth! If you count more than 28, your child probably has at least one wisdom tooth. Your child’s dentist will take an x-ray to see where the wisdom teeth are positioned, and to determine if they should be removed.

What kind of anesthesia will my child receive?

Your child’s dentist will use local anesthesia on the surrounding tissue and gum in order to numb the area near the extraction. It’s natural for patients to be nervous, so your child’s dentist may add a sedative, like laughing gas (nitrous oxide). Depending on the positioning of the teeth and your child’s level of anxiety, the dentist may give an intravenous sedative.

The local anesthesia will make your child’s gums, tongue and cheek and possibly the lips numb. Children may not completely understand this and may chew or suck on the numb area which can cause trauma. To avoid this, have your child bite on Gauze or a clean washcloth until the numbness wears off. Your child should not eat anything post-op while there is still numbness to the mouth. Be sure to watch your child closely for the 2 hours following the operation so they do not harm themselves while they have numbness.

How can I prepare my child for oral surgery?

Be sure to follow any pre-op instructions you receive from the dentist! You’ll probably be instructed not to give your child anything to eat after midnight the day before surgery. Your child can drink water or other clear liquids up to three hours before surgery. The reason for these precautions? To make sure your child doesn’t experience complications from anesthesia.

How can I talk to my child about oral surgery?

Oral surgery doesn’t have to be daunting. The key is to talk about it. It’s perfectly normal to be worried as a parent, but you’ll want to be calm when you talk to your child. Make sure that you understand exactly what will happen – and that you’re comfortable with it.

Explain to your child why the surgery is necessary: Because it’s fixing a problem that will help keep their mouth and body healthy. If you or another friend or relative have gone through a similar surgery, you can mention that, as well. If your child is young, you can suggest bringing a favorite toy, book or blanket.

How long will it take my child to recover?

Recovery time depends on a number of things, including the difficulty of the extraction, the patient’s health and post-surgery care. Under normal circumstances, you can expect your child to recover from wisdom tooth extraction in about 4 to 7 days. If the tooth is under the gum, then healing may take longer.

After Care for Oral Surgery

As soon as you leave the office, your child may be sleepy on the way home. Be sure they have a seatbelt on.

When you arrive home, your child may wish to sleep for a few hours. You should elevate your child’s head and chest slightly. If your child does not sleep, they may be a bit groggy. It typically takes 4-6 hours for the sedative to wear off. Please make sure your child does not engage in physical activities on the first day. They should not be riding a bike or playing. Normal activities can resume in several days.

It can take a couple of hours for the local anesthesia to wear off. Be sure to keep an eye on your child during this time so they do not harm themselves. Your child should not attempt to eat anything while they are still experiencing numbness.

When your child wakes, they may be nauseous. This is normal. If they are hungry, try giving them clear broth (Lukewarm, not HOT), or apple sauce or Jell-O. Avoid dairy products on the first day.

Your dentist will tell you when they would like to see your child again post-op, but typically it will be around 3 weeks so that they can check the healing. If you need to see your dentist before the post-op check-up or have any questions, then you should contact your dentist.

What side effects can I expect after my child’s surgery?

In the first 2 days after your child has wisdom teeth removed, you may notice the following normal side effects.

Pain – Your child will have some pain and be sore. If your doctor recommends, you can give your child Motrin or Tylenol as recommended.

Bleeding – Bleeding is common and can occur for several hours after your child’s wisdom teeth are extracted. You can place clean, damp gauze into the empty socket and apply pressure for about 45 minutes. If bleeding is heavy, contact your child’s oral surgeon immediately.

Facial Swelling and Bruising – Your child will probably experience some swelling and bruising. You or your child can gently apply a cold compress or ice wrapped in cloth, in a schedule of 10 minutes on and 10 minutes off.

How can I help my child heal?

The good news is, you can play an important role in making sure your child has a speedy recovery! Here’s how:

  • Prepare an ice pack for your child to reduce swelling
  • Fix your child’s favorite soft foods, like mashed potatoes, for the first few
  • Make sure your child drinks plenty of water
  • Your child’s teeth should be brushed carefully after 24 hours – but the sockets should not be brushed
  • If your dentist prescribed an antibiotic, make sure your child takes the entire prescription as directed
  • Your child should rinse daily with saltwater after the first 24 hours
  • Your child may take an anti-inflammatory drug, such as Motrin or Tylenol, as directed for pain and swelling
  • Call your dentist if your child has a fever or if swelling and pain does not improve daily

To prevent the clot from dislodging, causing a dry socket, your child should avoid the following things:

  • Rinsing or spitting in first 24 hours
  • Any sucking actions, such as using a straw
  • Hot liquids for 24 hours
  • Avoid food until all the numbness from anesthesia has worn off

What problems should I watch out for?

While wisdom teeth extraction is a very safe and common practice, there are some risks involved. Here’s how you can make sure everything’s healing as it should.

Check for dry socket

A few days after surgery, ask your child to feel if the sockets where teeth were removed have clots in them. Dry socket is a fairly common complication that can occur when a blood clot fails to form or when the clot has been dislodged. Blood clotting is important part of healing and without the clot, your child may experience pain and odor. Typically, signs of dry socket appear 3 or 4 days after the surgery. Be sure to contact your child’s dentist or surgeon if you suspect a dry socket.

Check for paresthesia

Although paresthesia isn’t common with wisdom teeth extraction, it’s important to watch for signs. Paresthesia is when there is nerve damage that occurs during the extraction, resulting in numbness to the tongue, lips or chin. Usually this is not permanent, but it can be. Ask your child if he or she is experiencing any numbness after 24 hours. If the answer is yes, you should contact your child’s dentist or surgeon.

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