Dental surgery is a general term used to describe a wide range of medical procedures that involves the teeth and gums. Dental surgery can mean a tooth extraction, a root canal, or tooth implants, etc. But among the dental surgeries for kids, the most common is tooth extraction, both for baby tooth or a permanent one. This article will cover tooth extraction, as well as lip and tongue tie release – a dental surgery usually performed in babies and toddlers.
Tooth extraction simply means the removal of a tooth. Tooth extraction is a fairly common dental procedure. Some children need to undergo tooth extraction because of several reasons. Some of these reasons are as follows:
- Some kids need to have a tooth removed because of severe decay or infection and the tooth cannot be restored.
- Some kids undergo tooth extraction because the tooth was fractured due to an accident or injury and it could not be restored anymore.
- Other kids need tooth extraction since their baby teeth have not fallen out yet, hindering the growth of permanent teeth.
- Tooth extraction is performed in children that need orthodontic treatment. By removing the tooth, overcrowding is reduced and giving way to neighboring teeth to grow properly or be straightened via braces.
Note that the procedure for children’s tooth extraction is not as complex as the process for adults. As a start, a local anesthetic will be applied to the tooth area. Once numbed, the pediatric dentist will then remove your child’s tooth using forceps. The dentist will be moving and rotating the tooth eventually detaching it from the ligaments that connect the tooth to the jawbone. There are times though that a tooth extraction procedure will require the dentist to remove some of the gum tissues near the specific tooth. If this is the case, your child will need to be sedated.
After tooth extraction, your child’s dentist will directly apply sterile gauze to the affected area as a little bleeding is expected. The gums will quickly form a protective blood clot so we advise that you avoid rinsing your child’s mouth for the first 24 hours. The following day after surgery, you can let your child gargle with salt water to make sure the area stays clean as well as help reduce the pain if any. Let your child eat soft food for the first few days, avoiding any hard or crunchy food for at least a week to make sure the area where the tooth was extracted remains clean and for the protective clot to stay in place. Encourage your child to drink plenty of water to keep their mouth clean and stay hydrated.
To manage pain, on the other hand, you may give your child oral medication like paracetamol or ibuprofen. You may also use an ice pack outside the jaw for any mild swelling. Make sure to call your pediatric dentist if your child gets a fever or if you notice any excessive swelling. Although very seldom, if there are any signs of an infection, your child’s dentist may prescribe antibiotics.
Lip and Tongue Tie Release
Our children’s mouths have small folds of tissues called frena or bands. These folds can be found under the tongue, inside the upper lip and the lower lip, and connecting the cheeks to the gums. Since the folds vary in size, some children may have very short or tighter fold attachments. Because of this, the lip or tongue’s movement is restricted. This is what we call tongue-tied. ‘Tongue-tied’ babies or smaller children may have a hard time nursing and may pose a challenge in speaking and swallowing later on. For the lip (labial frenum), it can also potentially affect a child’s teeth and dental hygiene. If left untreated, kids with lip and/or tongue-tie may experience the following:
- Dental problems like tooth decay, gingivitis, and tooth gap;
- For smaller kids, gagging or choking on solid foods;
- Difficulty with simple activities such as licking an ice cream cone and kissing
- Trouble saying some letters d, l, n, r, s, t, th, and z sounds, specifically for the ‘rolling r’ sound.
How will you know if your child is lip or tongue-tied?
There will be some indications or signs that you will notice if your child is lip or tongue-tied. Some of these signs are as follows:
- A child can’t move his or her tongue far from side to side
- A child can’t reach the upper gums or roof of the mouth
- A child can’t stick his or her tongue out past the gums
- A child has a V shape or heart shape at its tip when it’s sticking out
The lip and tongue are very crucial for these basic daily activities and need to be functioning properly. Hence, a dental surgery called lingual or labial frenectomy may need to be performed. This lip and tongue-tie release surgery is aimed to improve the movement of the tongue or to close a gap in a patient’s upper front teeth, allowing the tongue or the lip to move freely.
This dental surgery can be performed in two ways, depending on a child’s lip and tongue-tie situation. The first one is what we call frenotomy. This simple surgery is done in a doctor’s office. It generally does not require any anesthesia. The doctor takes a pair of specially cleaned scissors and clips the frenum. This band does not have many nerves or blood vessels. In effect, this procedure will not be that painful and bloody and your baby can breastfeed right away. The second type is what we call frenuloplasty. This procedure is done for children with frenums that are too thick. Your child will be given drugs for him or her to sleep through the procedure. The doctor will then cut the frenum and put in a few stitches that will eventually dissolve on their own as it heals. In some cases, frenuloplasty is performed in a hospital via laser surgery instead so your child will not require any stitching.
These pediatric surgeries are generally very successful and helpful in preventing any speech, eating, or dental problems in the long run. However, as with any medical procedure, isolated risks such as bleeding, infection, and scarring can happen. You also need to reconsider if your child has any allergies toward anesthesia use since this will be given before the surgery to help him or her fall asleep and feel no pain.
These pediatric dental surgeries are common and generally simple. That is why having a well-trained and knowledgeable pediatric dentist administer the procedure is vital. Pediatric dentists receive specialized and in-depth training in oral development particularly focused on treating our children’s teeth and overall dental health.
Pulling a Tooth (Tooth Extraction), WebMD (https://www.webmd.com/oral-health/guide/pulling-a-tooth-tooth-extraction#1)
Tips for Recovering from a Tooth Extraction, Healthline (https://www.healthline.com/health/tooth-extraction-aftercare#1)
Parent information for children having dental extractions, The Rotherham NHS Foundation Trust (https://www.therotherhamft.nhs.uk)
What Is Tongue-Tie in Babies?, WebMD (https://www.webmd.com/children/tongue-tie-babies#1)
Identifying and Treating a Lip Tie in Babies and Toddlers, HealthLine (https://www.healthline.com/health/lip-tie)
Frenums And Frenectomy, Colgate (Https://www.colgate.com/en-us/oral-health/basics/mouth-and-teeth-anatomy/frenums-and-frenectomy-1016 )