Address

4825 Bethesda Ave., Suite 310
Bethesda, MD 20814
Google map

FAQ

What are the common oral surgery procedures in children?
Why remove baby teeth in children?
Why remove adult teeth in children?
What is canine exposure and why is it necessary?
How are injuries managed in children?
What is the best treatment approach?
Are these procedures safe?
Managing your child’s anxiety
What is the best anesthesia option for children? Are they safe?
Children on medications for ADHD?
How soon can your child return to school or normal activities?
What is the expected recovery?

What are the common oral surgery procedures in children?
Extraction of primary or baby teeth for orthodontic reasons, canine exposure or extraction of adult premolars in older kids, management of mouth and face injuries

Why remove baby teeth in children?
A baby or primary tooth with large decay may be restored if it occurs at a very early age. Pediatric dentists are the appropriate specialists for such treatments. However, if the tooth is deeply decayed, is causing significant pain, or is infected, extraction is often the best treatment option. A space maintainer may then be recommended depending on the tooth and age of your child.
Another reason for extraction of primary teeth is for orthodontic reasons. Your child may be in the mixed dental phase, where some adult teeth have already come in or are on their way. Occasionally, due to tight space, the adult teeth get stuck or begin to come in incorrectly. Extraction of selected baby (primary) teeth during developmental age helps to minimize crowding of the adult teeth later, and improve alignment in the mouth. Any baby tooth may be extracted for this purpose, although the canine teeth (#C, H, M, R) are the most common. This adjunctive procedure helps shorten future orthodontics treatment.

Why remove adult teeth in children?
Sometimes, the jaw size is so restricted that there simply isn’t enough room for all the adult teeth to come in properly and therefore become crowded. When patient reaches age 12 or 13, orthodontists may recommend extraction of the first premolars to help create adequate space for the adult canines and other teeth. Typically all four premolars are extracted at the same time. Teeth crowding may also be due to jaw size problems. In this case, the orthodontist may choose to keep all the permanent teeth, align them orthodontically and then recommend a jaw correction procedure.

What is canine exposure and why is it necessary?
The adult canine teeth erupt between ages of 12 to 14. However, they may become impacted, stuck or misaligned during the development phase. The orthodontist will often request what is called a “canine exposure” to be done by the oral surgeon to aid them in realigning the canine tooth. A canine exposure is a 30-minute procedure, often performed under IV sedation or nitrous oxide, which usually heals five to seven days. The surgeon exposes the tooth surgically, attaches a bracket with a special chain that is used later by the orthodontist to guide the canine in the mouth using orthodontic techniques. This procedure is recommended to help align the canine in its proper position and avoid potential damage to adjacent teeth that can occur when it is left impacted.

How are injuries managed in children?
Children fall often and occasionally can suffer cuts and bruises to the face and mouth. When this happens, you may call Dr. Kazemi immediately for evaluation in the office and avoid the emergency rooms. Skin and gum lacerations can be easily repaired . Traumatized baby teeth that can not be saved can also be extracted using IV sedation or nitrous oxide. More significant injuries, such as jaw fractures, will require treatment in a hospital. Dr. Kazemi is on staff at the Suburban Hospital and Washington Hospital Center.

What is the best treatment approach?
It is best to extract all recommended teeth by an oral surgeon at the same time. Exposure of canine is often done at same time the baby canine tooth is removed. Any injuries must be managed immediately, either in office or hospital as indicated. Most procedures take 10-15 minutes. If IV sedation is administered, there will be a 30- to 45-minute recovery before a child can go home. With nitrous oxide (laughing gas), no recovery necessary is necessary and a child may go home immediately.

Are these procedures safe?
Procedures on children are safe and predictable when performed by a trained, skillful, and experienced oral surgeon using specialized instruments and techniques. Dr. Kazemi specializes in pediatric related procedures and has performed it successfully on thousands of children and teens. The office is designed and equipped for surgical procedures for children, and the team assisting Dr. Kazemi is trained specifically for such procedures. Methodical, exacting, and detailed protocols are followed strictly to make sure every child is safe, comfortable, and a remarkable experience.

Managing your child’s anxiety
Anxiety is not uncommon among children, especially if they had bad experiences previously. We resolve this in several ways. First, the use of child-specific IV sedation allows them to take a nap during the procedure. This helps to make them comfortable and reduce anxiety. Second, they will be cared by a group of affable staff members who take time to personally connect with each child and allay their fears and concerns. Your child is given full “perceived” control of the events that take place and they approve each step along the way. At no time is a child ever held down, talked to loudly, or strapped. These methods are outdated and ineffective. Finally, the procedure is done in a conservative fashion to help minimize or avoid swelling, pain, and complications that others report as bad experiences.

What is the best anesthesia option for children? Are they safe?
A person’s dental experience as a child greatly affects their outlook and confidence in dentistry as adults. The best way to manage your child’s anxiety and assure a non-traumatic experience is to have a child-specific IV sedation form of anesthesia. It is the most recommended option and chosen by many parents. However, for very minor procedures in older and more cooperative children, nitrous oxide (laughing gas) and local anesthesia may be adequate. In the very young age group (age 3 to 5) an intramuscular dose of certain medications can also be sufficient. Dr. Kazemi is trained and licensed in administering of office anesthesia. It is very safe and effective. You can rest assured that Dr. Kazemi and his well-trained staff monitor children continually, and make sure that only enough anesthesia is given for the duration of the procedure.
IV sedation is a very safe and predictable in healthy patients when administered by an experienced clinician with proper training and accepted protocol. The patient is continually monitoring during anesthesia and emergency equipment is on hand, if necessary. The medications used have a long history of safety and are short-acting. Anesthesia is also safe In patients with respiratory problems or cardiovascular disease, providing that precautions are taken. To avoid possible airway compromise, patients with severe upper respiratory compromise, such as severe cold with stuffy nose and productive cough are best to postpone the surgery until they feel better.
The facility is equipped with emergency equipment and medications and the entire team is trained to manage any possible complications quickly and properly. The surgeon is CPR and ACLS certified and can manage any complications that arise effectively and quickly. Suburban hospital is in close proximity in the event additional assistance is required.

Children on medications for ADHD?
Many children are on medications for ADHD (such as Ritalin). These medications do not impose any problems with respect to the surgery, anesthesia, or post operative medications, and they maybe continued as prescribed.

How soon can your child return to school or normal activities?
Most children return to school and some normal activities within the first day after surgery. Many parents schedule the procedure on a Thursday or Friday and their child is ready to go back to classroom by Monday. There is no problem with going out the following day, although it’s best to rest for a day or two. Of course there is always variations in overall response and recovery.

What is the expected recovery?
Pain: The level and duration of pain generally depends on the complexity of the surgery, technique, and child’s tolerance. Most children complain very little of pain after extractions and other minor oral surgery procedure and don not require any pain medications. Ibuprofen (Advil) or Acetaminophen (Tylenol) is certainly adequate for relief of most types of discomfort in children, and may be necessary for one to two days. Very rarely do they need a stronger medication such as Tylenol with codeine.
Swelling: No swelling is expected with extractions in children, unless the tooth is unusually impacted or malpositioned. But there can be some swelling in the event of injuries, which resolves in seven to 10 days.
Diet: Upon arrival home, children may have some water, juices, soups, puree, shakes, puree, and very soft food. A soft diet is recommended up to three to five days. No hard, crispy, or very spicy foods should be eaten during this period. The general rule is: if they have to chew it, it’s probably too hard. After five to seven days, patients may gradually return to normal foods.
Activity: Parents should make sure that their child gets plenty of rest on day of procedure. Some children feel quite well even on the day of extraction and can resume gentle activities. If IV sedation was given, it’s best to rest on day of surgery and resume some activities on the following day. No sports for two to three days.

DC Web Designer : inQbation