Management Considerations for Pediatric Oral Surgery and Oral Pathology

Abstract

This best practice defines, describes clinical presentation, and establishes criteria and therapeutic goals for common pediatric oral surgery procedures and oral pathological conditions. Pediatric oral surgery requires special considerations such as parental consent, knowledge of developing anatomy and dentition, potential for adverse effects on growth, behavior guidance. and peri- and post-operative management. Odontogenic infections usually are managed with pulp therapy, extraction, or incision and drainage. However, cases with systemic manifestations require antibiotic therapy. Extraction of erupted, unerupted, impacted, and supernumerary teeth are discussed with emphasis on a careful approach to avoid injury to adjacent teeth, permanent successors, and other hard and soft tissues. Considerations for surgical correction of frenulum attachments are reviewed. Guidance is provided for biopsies, a procedure which can establish a definitive diagnosis for most oral lesions. Common lesions in infants include Epstein pearls, Bohn nodules, and dental lamina cysts, and rare lesions include congenital epulis of the newborn and melanotic neuroectodermal tumor of infancy. Management of these lesions and natal and neonatal teeth is reviewed. Oral lesions in children and adolescents including eruption cysts, mucoceles, recurrent aphthous stomatitis, and pyogenic granuloma also are addressed. While most lesions are mucosal conditions, developmental anomalies, or inflammatory lesions, practitioners should be vigilant for neoplastic diseases.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and guidance on management considerations for pediatric oral surgery and oral pathology.

^{KEYWORDS: ORAL SURGICAL PROCEDURES, PATHOLOGY, ORAL, TOOTH EXTRACTION, DIAGNOSIS, ORAL}