Pediatric Oral Surgery

Early dental care and visits to an oral surgeon helps identify problems, prevent future oral health issues, and ensure teeth properly develop. We offer pediatric services at all of our offices in Sunnyvale, San Jose, and Milpitas, California.

Oral health services for children and teens

Our oral surgeons at Beech & Reid Oral & Dental Implant Surgery provide pediatric oral surgery services to children and young teenagers. Pediatric dentistry is important to maintain proper development and oral hygiene in children. If a general dentist notices an oral health issue that requires more advanced care or anesthesia, he or she will refer the child to an oral surgeon for treatment.

We understand how stressful it can be to have your child undergo surgery. Our team is here to answer questions, provide detailed instructions, and ensure you and your family feel comfortable and confident in our care. Contact our office if your child needs baby teeth extractions and or any other dental care with sedation. Please contact us at any one of our three locations in Sunnyvale, San Jose, or Milpitas to schedule your first visit.

Pediatric dentistry and oral surgery in Sunnyvale, San Jose, and Milpitas, CA

Prior to performing any surgery, you and your child will meet with one of our oral surgeons during the consultation. It is possible we may need to take 3D scans of the child’s face and mouth to assess the size and position of the teeth and facial bone structures. We offer a variety of pediatric services and will customize treatment to suit your child’s needs.

Baby Teeth Extractions

If baby teeth do not fall out in time, they may need to be extracted to make way for an adult tooth. A baby tooth may also need to be removed if it is badly decayed or damaged and cannot be saved by other means. If left untreated, baby teeth can decay and cause gum disease or damage to the adult tooth beneath it.

The extraction is performed using local anesthesia to numb the area and involves your surgeon gently elevating the tooth and removing it with forceps.

We offer the full range of anesthesia options, from light conscious sedation to general anesthesia. Drs. Beech and Reid will tailor the sedation to meet the needs of your child based on their age, temperament, and the extent of the surgical procedure.

Extractions of Supernumerary Teeth

Children should have 20 natural baby teeth and adults should have 32 adult teeth. Any extra teeth that develop are called supernumerary teeth. As they fight for room in the dental arch, they can push other teeth out of alignment or prevent them from being able to erupt through the gums. If left untreated, supernumerary teeth can lead to tooth decay, gum disease, tooth loss, and severe dental crowding.

To extract a supernumerary tooth, we will administer local anesthesia and possibly another type of sedation similar to a standard tooth extraction. Sutures will be placed if necessary.

Extraction of Mesiodens Teeth

A mesiodens tooth is a rare type of supernumerary tooth that erupts in the middle of the mouth. A mesiodens typically emerges in the upper palate behind the front teeth. Because this extra tooth erupts on the palate instead of the dental arch, it becomes a trap for food and bacteria which can lead to cysts or tumors forming around it. Leaving a mesiodens untreated increases the risk of tooth decay, gum disease, or tooth loss due to the inability to maintain proper hygiene. These teeth can also push other teeth out of alignment and interfere with chewing.

Extraction of a mesiodens is performed using local anesthesia combined with a type of sedation. Once the child is comfortable, the surgeon will loosen and remove the tooth, then place sutures if necessary.

Frenectomy—Upper and Lower

In the mouth, the frenum is a muscle/gingival tissue that connects to the jaw. There is one on the upper arch that attaches the lips to the gums (labial frenum) and one on the bottom that attaches the tongue to the floor of the mouth (lingual frenum). If a frenum is too long or thick, it can affect an infant’s ability to properly nurse and speak. Children with an improperly developed lingual frenum are often referred to as being “tongue-tied.” If left untreated, infants can become malnourished due to the inability to properly latch and develop eating or speaking difficulties into adulthood.

A frenectomy procedure involves your surgeon numbing the area and excising the frenum to reach the desired length and shape. A laser frenectomy is the same process, except it uses a laser instrument instead of a scalpel or scissors. Sutures will be placed if necessary, and the whole procedure is completed in as little as 15 minutes.

Anesthesia and sedation options

At Beech & Reid Oral & Dental Implant Surgery, we strive to make patients of all ages feel welcome and comfortable throughout their treatment. Oral surgeons are the only dental professionals qualified to administer all forms of anesthesia, and we will help select the right method for your child’s needs. To further ensure the health and safety of our patients, every member of our staff maintains CPR and ACLS certifications.

Nitrous Oxide

Nitrous oxide, commonly known as laughing gas, is inhaled through a nasal mask. It is a safe and effective way to reduce anxiety and relax your child prior to treatment. Nitrous oxide is used in conjunction with a local anesthetic, and most patients tolerate their procedure well with this technique. Nitrous oxide quickly wears off once the gas is turned off, and your child will leave the office normally with no sedation side effects.


Versed (midazolam) is a conscious sedation administered orally before surgery. It helps reduce anxiety by rendering the patient into a sleep-like state. The child will be able to answer questions but will wake up with no memory of the procedure. It remains in the system for about 30 minutes and is ideal for shorter procedures. Versed can be combined with other types of sedation if needed.


Ketamine is a sedation medicine administered through an IV or intramuscular route that relieves pain. Similar to Versed, it renders the patient into a semi-conscious state where they are unable to feel pain but does not depress the patient's breathing. Most patients do not remember the procedure after it wears off, and it can be combined with other types of sedation if needed.

IV Sedation

IV sedation is administered into a vein in the arm or hand. Ideal for longer procedures, this method of sedation renders the child into a semi-conscious state. The child will be unable to feel pain, but will still be conscious enough to respond to the surgeon. This is different from general anesthesia, in which the child is completely unconscious. After the procedure, the IV is removed and the child rests until the sedation wears off. He or she will be sleepy for the rest of the day and should be monitored by a responsible adult for 24 hours.

Instructions for pediatric oral surgery

Instructions for Pediatric Oral Surgery

For young children we will schedule them in the morning for surgery. The child should have nothing to eat after midnight the night before surgery. This includes formula, milk, juices with pulp, and candy. A small amount of clear liquid is OK 2 hours before surgery. If the child is receiving Versed sedation, arrive 45 minutes before the surgery time.


Use over-the-counter ibuprofen to manage any post-surgical discomfort. We may recommend giving ibuprofen to the child prior to surgery to help manage pain.

Post-operative instructions:

The child should bite on the provided gauze to control bleeding. You will need to change the gauze ONCE every 30 minutes for the first few hours after surgery. It will be important to ensure the gauze is directly over the extraction site and firm biting pressure is applied. Remove the gauze when eating or drinking to avoid choking. Make sure to remove all gauze from the mouth before taking naps or going to bed. Once bleeding has stopped, remove gauze from the mouth to minimize the risk of choking.


Start with clear, cool liquids after surgery. You can advance the child’s diet as he or she can tolerate. Do not let the child use a straw or drink carbonated beverages for at least the first 5 days after surgery. Soft foods include:

  • Milkshakes (add fruit, such as a banana)
  • Soft fish
  • Creamy soups and broths
  • Yogurt
  • Applesauce
  • Soft-cooked pasta
  • Mashed potatoes
  • Scrambled eggs
  • Pancakes
  • Steamed rice
  • Oatmeal/cream of wheat
  • Ice cream
  • JELL-O®
  • Pudding

Contact our office if you have any questions before or after your child’s oral surgery visit or to schedule an appointment with our expert surgeons.