Big extraction under GA

[Nogodsnomasters]

Hello everyone,

My foster daughter has to have 8 baby teeth removed under general anesthesic due to previous neglect. It's 4 on each side of her mouth, mostly back ones as the majority of her front ones are adult now (she's 7yrs old). She is understandable nervous, I on the other hand - absolutely shitting myself.

Weirdly I am not nervous about the GA as my nephew has had GA before for something else and my SIL has reassured me on that front. It's the after and recovery. Foster daughter has a very weak stomach so I'm expecting vomiting, does anyone know if the nausea/vomiting lasts long after a GA? Is there a potential of a dry socket where a milk tooth removal is concerned considering their little milk teeth come out naturally normally and leave a gap with no blood clot to seal it, would this be the same case with an extraction?

How long should she need off school or dosed with calpol or soft food offered for? When should she begin brushing again considering it's 4 on each side she can't really avoid the area like she could if one tooth were just removed.

I also have a son who faints at the sight of blood who I will have to keep away from her as long as she's spitting blood/using tissues - how long should I expect there to be bleeding for?

Good god that's a lot of questions, if anyone can answer even a few of them please if they have experience of this, it would be much appreciated. Her birthday is 3 days after the extraction and I'm hoping she'll be okay by then to celebrate.

Thanks!

This video might help with some of the questions. The Dr who made this film regularly does anaesthetics for child tooth extractions. I think it deals with after care as well.

They can give anti sickness drugs to help with vomitting after a GA.

These questions should have been answered at your pre-op OP.
Re school -she needs to be off the entire day of the procedure and usually the entire following day.
Nausea is usually immediately post op if it happens at all, it might not-paediatric dental GAs are usually short procedures. Usually patient would have an IV cannula in and something like ondansetron can be administered IV.

Dry and/or infected sockets can happen but it's much less likely in children than adults.
There will be some oozing from the extraction sites 24 hours post op. Resting up is absolutely vital. No exercise at all in this period. Or mouth rinsing post op on the day of the procedure. That will disturb the clots.
Probably best to use either old pillow slips or a towel over the pillow overnight. The bleeding ( haemostasis) will all be under control before your foster daughter is discharged.
Toothbrushing as normal around the front teeth at bedtime on procedure day and very gingerly around the back teeth, she should have permanent molars by 7.
Good luck OP. The trickiest thing is often the consent part for LAC as you won't be able to consent for GA. If one of her biological parents retains PR, they will have to sign consent at both pre-op and again immediately pre-op. If PR is with the LA, then SS LAC manager will have to consent. The latter is usually fraught with delays/ wrangling etc.
Foster parents can only usually consent for procedures under Local anaesthesia, anything involving sedation or GA is a more tricky. If you haven't had the pre-op appointment yet, this is something to bear in mind and the assessing Community / Hospital dentist will probably want your Foster daughter's SW contact details.

Thank you so much for this!! We've had the pre op assessment two weeks ago and tbh it was very rushed and the dentist only gave us instructions about covid testing on the day of the appointment and informed us which teeth would be removed etc and that they were all milk ones going, nothing about recovery or the procedure itself!

LAC manager came to the pre-op and signed consent forms and also has to attend the extraction at the beginning to sign further forms and then can leave - so we've been told!

Ok so if vomiting does take place it's usually just directly after the GA and not like a full day etc? Even moderate pain can cause foster daughter to throw up as she has such a sensitive tummy so I'm hoping with calpol we can manage this. Oh she absolutely will be off school the full day of the procedure and at least the next but I was worried it may take maybe 3 days and ruin her little birthday.

Thank you for the advice re pillow slip over night, I will absolutely be doing that!

GAs are much less emetogenic than they used to be, partly because the anaesthetic drugs are nicer and partly because we give antiemetics pretty routinely. Swallowing blood though can make you feel sick (although as per pp there shouldn’t be masses of bleeding post op).

Definitely mention the fear of vomiting to the anaesthetist. I've always found anaesthetists really good at trying to optimise care to the individual.