Oral Surgery Post-Operative Instructions for Pediatric Patients (<10 years old)

Post-operative Instructions

Care of the mouth after surgery has an important effect on your child’s healing.  Swelling, discomfort, and restricted jaw function are expected, so need not cause alarm.  These may be minimized by following the instructions below— please read them carefully.

  • Bleeding control
    • After the procedure, we will place gauze where the incisions are. It’s important that the gauze is placed in the correct place in your child’s mouth to apply pressure to the wound to help it stop bleeding
    • Change the gauze every 30-45 minutes until the bleeding stops (usually 1-2 hours). Changing the gauze too frequently may cause prolonged bleeding
    • Remove gauze once the bleeding stops, or when eating, drinking or sleeping
    • If the site begins bleeding again, reinsert gauze and apply firm pressure again for 30-45 mins until it stops again
    • Nose bleeds can also occur after surgery with general anesthesia and will typically resolve with pressure in the soft part of the nose for a few minutes
  • Prescriptions
    • Antibiotics are not routinely needed following straight forward oral surgery procedures
    • If you’ve been given a prescription for pain medication, take as instructed, but please ensure you check the instructions on the bottle to ensure you don’t exceed the maximum daily dose for your child’s weight
    • If you have NOT been given a prescription for pain medication, please use over the counter children’s Tylenol or Advil as directed in the bottle according to your child’s weight
    • It’s advisable for at least 24-48 hours to give pain medication to your child regularly (every 4-6 hours), as sometimes they don’t communicate the pain they’re having well at first
    • You should give your child pain medication as soon as you get home (so that it’s taking effect before the freezing starts to wear off)
    • If your child develops hives or a rash, discontinue the medication and contact our office immediately
  • Swelling control
    • Swelling and bruising are normal and may continue to reach their peak 2-4 days after surgery, after which time swelling should plateau and then slowly decrease over the next week or so
    • Apply ice packs to your child’s cheek(s) 20 mins on 20 mins off, for the first 24 hours to reduce the amount of swelling
    • If you have a sudden increase in pain or swelling more than 5 days after your procedure, please call the office to make a follow-up appointment
  • Diet
    • On the day of the procedure, start by giving your child clear liquids (water, Gatorade, apple juice) using a cup or spoon. Avoid using straws for the first week, as any negative pressure in the mouth can cause dry sockets or disrupt the stitches
    • Once your child is tolerating clear liquids well, move on to cool, soft foods for the rest of the day: e.g. banana, yogurt, milkshakes, Jell-O, pudding, protein shakes, smoothies, applesauce, avocado
    • The day after surgery, muscle stiffness and discomfort are the only restrictions to what you can eat or drink, so start with soft foods like scrambled eggs, mashed potatoes, pasta, soups, cooked vegetables, oatmeal, pancakes, meatloaf, macaroni and cheese. You can begin to progress your diet as tolerated from there
    • Avoid foods with small hard pieces that can get stuck down in the wounds (popcorn, nuts, seeds, berries, tortilla chips) for the first two weeks or until the sockets have healed over
  • Vomiting
    • If your child vomits, go back to small amounts of clear fluids when they ask for it, instead of heavier foods. Keep the volume of fluid small.  If they cannot tolerate any fluids, and you are worried they are becoming dehydrated (one wet diaper in 8 hours), take the child to the hospital for evaluation
  • Mouth opening exercises
    • It’s normal for mouth opening to be reduced for a while after surgery due to stiffness of the muscles that close your mouth. Starting the day after surgery, you should help your child start stretching his/her jaw open until mouth opening is back to normal levels again
  • Oral hygiene
    • Brush your child’s teeth as usual but avoid brushing the gums at the surgical sites for 2 weeks
    • Beginning the day after surgery, have your child rinse your mouth with warm salt water (1/2 tsp salt to a cup of warm water) after each meal and at bedtime for 2 weeks
    • Avoid over-the-counter mouthwashes (Scope, Listerine) for one week, as they may irritate the area
    • Stitches may be placed in some of the sites (not all sites require stitches), and these typically dissolve on the inside and fall out on their own in 3-5 days. Certain types of sutures may last longer, but will also be dissolvable. Try to leave them alone until they fall out
  • Nausea
    • Small sips of a carbonated drink (i.e Gingerale or Sprite) will usually help with nausea. Follow this with a clear diet: apple juice, clear tea, broths, and Jell-O.  If nausea continues, please contact our office for further instructions
  • Activity
    • As much as possible, have your child rest and relax on the day of the procedure – don’t try to push it on the first day even if your child is feeling well
    • It’s best to plan for your child to be off work or school for 2-3 days after surgery, but after the first day you may gradually resume your normal daily activities as tolerated
    • Avoid strenuous physical activity and sports for 5-7 days, after which time it’s okay to gradually return to normal activity unless your child feels throbbing in their jaw
  • Usual medications
    • Unless directed otherwise, your child may take all regular home medications without interruption

Keep in mind, the extent of your particular surgery will influence the magnitude of your symptoms during recovery.  The following conditions may occur and are not considered abnormal:

  • If your child had general anesthesia, a temporary sore throat or bleeding/discomfort in the nose may occur from the breathing tube that was in place for the surgery. This will get better with time
  • Your child’s lips may be dry and cracked. Keep moist with lip balm or Vaseline
  • Your child may have a slight ear-ache or headache
  • There may be a slight increase in your child’s temperature for 24 to 48 hours. This does NOT mean your child has an infection. If this continues past 48 hours, please contact our office
  • Please inform our office immediately if your child is unexpectedly admitted to the hospital within 10 days of treatment

If you have any questions at all, don’t hesitate to contact our office at 403-263-5193. During our regular business hours we’ll be happy to help you through any questions or problems you’re having, and outside of business hours you can call the same number and follow the prompts to be directed to the 24-hour on call surgeon.