One of the most common complication post a dental procedure under anaesthesia is lip biting.
Depending upon the duration(short and long acting)of anesthesia the restlessness may cause scratching, biting, sucking, playing and pinching of the anesthetized area resulting in swollen red, hot and painful lips, cheek and tongue that are misunderstood as infection. These chewed up areas may result out of curiosity with the unfamiliar sensation causing kids to associate with a peculiar feeling of numbness and tingling.
Anesthetic wears off in 2-4 hours and children do not have the ability to understand the post treatment instructions. Even after the advise is given to the care givers, lip biting may not always be avoided. Most of the soft tissue injuries, the swelling worsen over next 2-3 days and is associated with the various phases of re-epithelialization. A red painful swollen area followed by a yellowish, white plaque (soft scab)and then sloughing. Lesion typically heals in 10-14 days and most of the lesion heals without antibiotics. They are the therefore often categorized as ulcers of non bacterial origin.
According to the studies conducted soft tissue injuries was highest in youngest age group with 18% among children lesser than 4 years ;16% with 4-7 years;13% in 8-11 years and &7% among 12 years of age and older. Higher cases of self inflicted injuries were reported among children with challenging behavior like ADHD (Attention deficit hyperactive disorders) and mental disorders or patients with decrease motor coordination.
During this period, conditioning of the caregivers to allay the anxiety is imperative with the understanding that these injured tissues will heal without antibiotics. Apply ice pack for 3 days ( 15 minutes on 15 off)for one hour three times a day. Rinse with salt water for two times/day for three days. Give painkillers like paracetamol, apply topical numbing ointment and use chlorhexidine gluconate (0.12%)to debride ulcerated soft tissues.
Follow up with the team of dental professional dedicated to the care of child like pediatric dentist, pediatrician and anesthetist is a key to achieve safe and successful treatment in patient with special needs.
GAMEFACE 