MORE ABOUT TODAY’S VISIT

The sheet we texted you has everything you need for today and tonight. This page is the rest of it: the answers to “why,” and what to expect over the next few weeks.

If something is wrong right now, use the sheet. The red box and the phone numbers are on it. This page is for reading later, when things are calm.

Find your section below.

LAUGHING GAS (NITROUS OXIDE)

Why this is not the same as being put to sleep

People call it “being put to sleep,” and it is not that. Your child was awake and breathing on their own the whole time. They could hear us, answer us, and swallow and cough normally. The gas takes the edge off worry and takes the edge off feeling, so a visit that would have been hard is easier to sit through.

If your child ever needs real sedation, that is a different visit with its own instructions, its own preparation the night before, and its own consent conversation. It is never something we would do without setting it up with you first.

Why we run plain oxygen at the end

The last few minutes in the chair are pure oxygen, not gas. That clears the laughing gas out of your child’s body before they stand up. It is why most children walk out feeling like themselves.

Why it does not help with soreness tonight

The gas leaves the body quickly. That is the good part, because it is why the effects do not drag on into the evening. It is also why it does nothing for soreness later in the day. If your child had other work done today, the sheet for that work is what tells you how to handle soreness.

Feeling cold or shaky

Some children feel chilly or shivery as the gas wears off. It usually settles within about ten to twenty minutes. A blanket or a hoodie in the car is the whole fix.

Big feelings on the way home

Some children get weepy, giggly, silly, or grumpy for a little while after. It can look dramatic, and it passes. Crying in the car does not mean something went wrong or that your child is in pain. If it is still going strong an hour later, or if your child seems out of it rather than emotional, that is worth a call.

SILVER DIAMINE FLUORIDE (SDF)

Why the black spot stays black

The medicine works by hardening the soft, decayed part of the tooth. The dark color is that hardened surface. It is not a stain sitting on top that can be brushed or polished away, and it does not fade with time.

That is why the only way to change the color is to cover it. Once things are calm and steady, we can put a filling or a crown over the spot and the black is gone from view. There is no rush on that, and it is a normal, planned next step rather than a repair of something that went wrong.

How often this gets repeated

SDF is not a one-time treatment. The usual pattern looks like this:

• We look at the treated spot again in about 2 to 4 weeks to see whether it took.
• After that, we check it at every regular visit.
• We usually paint it again about every 6 months, and sometimes more often if the spot is one we are watching closely.

Painting it again is not a sign that the first time failed. Repeat visits are how this treatment is meant to work.

The dark spot on skin or lips

If a drop touched skin, it leaves a mark that looks a bit like a henna tattoo. It comes off as the skin sheds, usually over a week or two. Nothing needs to be done to it, and scrubbing will not speed it up.

A spot on the gums fades faster than one on skin. We do not have a firm number of days for that, and anyone who gives you one is guessing.

Talking to your child about it

Children notice a black tooth, and other children ask about it. It helps a lot if your child has a short, confident answer ready before someone asks. “It is medicine on my tooth” works well. So does “the black means it is fixed.”

If your child is self-conscious about where the spot is, tell us. Sometimes we can move a filling up the schedule.

SEALANTS

What a sealant actually is

The chewing surface of a back tooth is not flat. It has deep, narrow grooves running across it. Some of those grooves are narrower than a single toothbrush bristle, so a brush slides right over the top and never reaches the bottom. Food and germs pack down inside where nothing can get them out.

A sealant is a thin coating we paint into those grooves. It fills them in, so there is nowhere left for food and germs to sit, and the surface becomes something a toothbrush can actually clean.

Sealants chip, wear down, and sometimes come off

This is normal and expected. A sealant takes the full force of chewing every day, and it does not last forever.

That is why we look at every sealant at every checkup. If one has worn thin, chipped, or come off, we clean the tooth and put a new one on, usually in a few minutes and usually without any numbing.

If a sealant does come off between visits, your child is not worse off than before it was put on. The tooth goes back to how it was, and we put a new one on when we see it. Just tell us so it does not sit that way for a year.

Why the bite can feel “tall” for a day or two

A sealant adds a thin layer to the top of the tooth, so for a little while that tooth touches first. Most children stop noticing it within a day or two as they chew and it settles. If it is still bothering your child after about three days, call us. That takes a couple of minutes to smooth down and no numbing.

What a sealant does not do

A sealant covers the grooves on the chewing surface. That is one part of one surface of one tooth. It does not cover the sides of the tooth and it does not cover between the teeth, and those places still get cavities.

Brushing twice a day, flossing once a day, less sugar, and regular checkups are still the job. The sealant helps with the part of the tooth that brushing cannot reach. It does not replace the brushing.

SPACE MAINTAINER

Why your child has one

A baby tooth came out earlier than it should have. Baby teeth are not just placeholders for chewing; the one that came out was also holding a space open for the adult tooth growing underneath.

When that space is empty, the teeth on either side drift into it. A space maintainer is a small metal band and wire cemented to the tooth next door, and its whole job is to stop that drift. The adult tooth underneath comes in through the space that is kept open.

Does this mean my child will not need braces?

We do not know, and we will not tell you otherwise. There is no good evidence that a space maintainer prevents crooked teeth or reduces how much orthodontic work a child needs later.

What we do know is the mechanical part: it holds the space. And we know that reopening a space that has already closed is harder than keeping it open in the first place. That is the honest case for it, and it is a good enough one.

Why we ask you to call the same day it comes loose

These appliances come loose. It is the most common thing that happens to them, and the cement letting go is the usual reason.

If we see your child quickly, we can usually clean up the same appliance and cement it right back in. That is a short visit. If it stays out, the neighbouring teeth start moving into the space within days. Then the appliance no longer fits and has to be remade, and sometimes the space cannot be reopened without braces later.

So a loose space maintainer is not an emergency in the ER sense, but it is a today phone call, not a next-checkup phone call.

Why sticky food and fingers are the two rules

The band is held on by a thin layer of cement. Sticky food grips the metal and pulls, and a finger or a tongue pushing on it does the same thing from the other direction. Neither one breaks it in a single go. They loosen the cement a little at a time until one day it lets go.

What happens from here

Keep every checkup, at least every six months. At each one we check the fit, the cement, the bite, and how the adult tooth underneath is coming along.

The appliance stays in until that adult tooth comes through on its own. Then we take it out, which takes a few minutes and does not need numbing. Depending on your child’s age, that can be months away or it can be years away. We can tell you roughly where your child sits at the next visit.

ORTHODONTIC VISITS

After an adjustment: how the soreness runs

Teeth get sore because they are moving. The tenderness is strongest in the first day or two, eases off after that, and most of it is gone by about day three to five. Each adjustment tends to feel a bit easier than the one before.

Teeth can also feel slightly loose during treatment. That is expected. It is what has to happen for a tooth to move, and they firm up again as they settle into the new position.

Why a loose bracket is worth a call

A bracket is how the wire holds that particular tooth. When one comes loose, that tooth stops moving while the ones on either side keep going. Nothing is damaged by waiting a few days, but treatment takes longer, and it is the kind of delay that adds up over a year. It is not an emergency and it should not wait for the next scheduled visit either.

More on the poking wire

The sheet has the main fix, which is drying the spot and covering the end with wax. A few extras:

• If a small piece of wire has already come free in the mouth, clean tweezers can lift it out. Do not cut a wire that is still attached, and do not use pliers on it.
• A sore spot or a small ulcer where a wire rubbed will heal on its own once the wire is covered. Keep the wax on it until it does.
• A warm salt water rinse a few times a day helps that sore spot heal faster.

After the braces come off

Teeth feel strange for a few days. Slick, smooth, and bigger than your child remembers. That settles.

Cold and brushing can sting for a while after the glue is cleaned off. It usually calms down over the following weeks.

Gums may look puffy and bleed a little when brushing, because they were crowded around brackets for a long time. Brushing and flossing every day is what fixes that. Backing off because they bleed makes it last longer.

White or chalky squares where the brackets were are places where the enamel lost minerals during treatment. They are not new cavities and they are not decay happening now. Some fade over months. Some do not fully go away. We will look at them with you and talk about what helps.

Why the retainer schedule is what it is

Teeth are held in place by fibres in the gum and bone around them, and after a move those fibres take a long time to settle into the new shape. Until they do, the teeth want to go back. That pull is strongest right after the braces come off, which is why the wear schedule usually starts heavy and eases later.

The schedule on your sheet is your child’s, not a general rule. It depends on how far the teeth moved, which teeth moved, how old your child is, and how the bite came out. That is why we write it on the line rather than printing one number for everybody.

Most people need a retainer at night long term, often for life, though how often can change over the years. That is not a sign anything went wrong. It is just how teeth work.

If wear stops, teeth can drift back toward where they started, and getting them back can mean braces or aligners a second time. If your child has fallen out of the habit, do not wait for the next appointment to tell us. Call, and we will look at where things are.

Talking with a retainer in

It will sound funny at first, and some children lisp. Reading out loud for a few minutes, a few times a day, speeds this up more than anything else. It usually sorts itself out within a few days.

Retainer habits worth building now

• In the mouth or in the case. Nothing else, ever.
• Never wrapped in a napkin. That is how most retainers end up in a bin.
• Never loose on a table or a counter. Dogs chew them, and they are drawn to them.
• Out for eating. Water is fine with it in, and nothing else is.
• Cool water only for cleaning. Heat warps it, and a warped retainer does not fit.

Reviewed August 2026