XLA PAEDS

why do we xla

quanity of tooth

quality of tooth

type of pulpitits

when we are extracting how should the child be positioned

30 degrees vertical

where do we stand for xla

we always stand on the right hand side, facing the paitent BUT when right hand molars we stand behind

where do we position ourselves for upper teeth

right hand side, facing the patient

pt should be at operator shoulder level

where do we position for lower left

in front of patient

pts mouth should be at operator elbow

where do we stand for LRQ

behind patient

have patient as low as possible

what do we straight ater XLA

pinch the gums

Bite pack and ask patient to bite for 5 mins

remove the pack and examine the socket

we must achieve haemostatis before child leaves

what POST OPP should we give to paitents

must be given verbally+writing

Bleeding will have stopped before the patient leaves the surgery but saliva
washing over the socket will tinge pink – reassure that this is normal
• If bleeding starts once home, roll up a clean cotton handkerchief and bite for 20
minutes
• If bleeding persists, call surgery, if out of hours – A&E.
• Good oral hygiene should be encouraged.
• Advise patient and carer if LA has been administered not to bite, chew or suck the
lip or tongue
• Avoidance of injury in socket area through foodstuffs
• Avoid hot drinks
• Do not rinse or spit for the rest of the day
• Avoid exercise for rest of the day

what pain relief can we give and how should we follow up

Pain relief
• Simple analgesics will probably be required, these are best started before the
anaesthetic has totally lost effect.
• Sugar free Paracetamol suspensions are indicated
• 120-250 mg every 4-6 hours 1-5years
• 250-500mg every 4-6 hours 6-12years
• 500mg every 4-6 hours12-18 years
• Review in 1 week.
• Should return if any problems with bleeding, excessive pain or swelling occurs.
• Telephone number should be given.
• Review.
• At review appointment oral hygiene will in most cases deteriorated due to
avoidance of the site this needs to be corrected and reinforced.
• Check that healing is taking place and some sort of socket coverage is intact.

how should we administer LA

use the rule of 10 - if paitents age +tooth is more than 10 then use block if less then INF