Oral surgery in children—such as extractions, frenectomies, and removal of supernumerary teeth—presents unique challenges. These include dental anxiety, limited communication abilities, and emotional sensitivity.
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✅ Pediatric Patient Characteristics in Oral Surgery
Children differ significantly from adults in their response to clinical settings:
° Cognitive development affects their understanding of dental procedures.
° Emotional response includes fear of pain, separation anxiety, and past traumatic experiences.
° Communication skills are often limited, especially in younger children.
° Recognizing these traits is critical in developing patient-centered care strategies.
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PDF 馃斀 Guideline on Pediatric Oral Surgery ... Management of children under sedation or general anesthesia requires extensive training and expertise✅ Strategies for a Positive Pediatric Oral Surgery Experience
1. Comprehensive Preoperative Assessment
Key steps include:
° Assessing dental anxiety using tools like the Venham Picture Test or FLACC scale.
° Reviewing prior dental experiences and behavior patterns.
° Providing child-friendly explanations with visual aids and interactive models.
2. Behavior Management Techniques
Recommended by the American Academy of Pediatric Dentistry (AAPD):
° Tell-Show-Do: Builds trust and predictability.
° Positive reinforcement: Verbal praise, stickers, or small rewards.
° Voice control: Calm but firm tone to guide behavior.
° Distraction: Videos, music, or storytelling to divert attention.
° Parental presence: Used selectively based on the child's needs and behavior.
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Used when non-pharmacological techniques are insufficient:
° Nitrous oxide sedation: Safe and widely used for mild to moderate anxiety.
° Oral sedation: Midazolam and similar agents for more significant anxiety.
° General anesthesia: Reserved for extensive procedures or severe dental phobia, typically in a hospital setting.
4. Child-Friendly Dental Environment
Environmental modifications include:
° Soft colors and playful decor in the operatory.
° Dental tools with friendly designs or names.
° Friendly, trained staff skilled in pediatric communication.
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Strong communication builds trust and improves cooperation:
° Clear and simple explanations tailored to the child’s developmental level.
° Transparent discussion of surgical procedures and aftercare with parents.
° Giving the child limited choices (e.g., music selection) to increase their sense of control.
馃挰 Discussion
Research shows that untreated dental fear in childhood often continues into adulthood, negatively affecting oral health outcomes (Klingberg & Broberg, 2022). Combining behavior management with appropriate sedation techniques significantly reduces anxiety and improves surgical cooperation (Olumide et al., 2021). A child-focused, holistic approach is increasingly recognized as the gold standard in pediatric oral surgery, emphasizing both technical excellence and emotional support.
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Successful pediatric oral surgery involves more than technical skill. It requires tailored strategies that consider each child’s emotional, psychological, and developmental needs. The integration of behavior management, pharmacological tools, environmental modifications, and effective communication fosters a positive experience that encourages lifelong oral health habits.
馃摎 References
✔ American Academy of Pediatric Dentistry. (2023). Behavior Guidance for the Pediatric Dental Patient. The Reference Manual of Pediatric Dentistry. https://www.aapd.org/globalassets/media/policies_guidelines/bp_behavior.pdf
✔ Klingberg, G., & Broberg, A. G. (2022). Dental fear/anxiety and dental behaviour management problems in children and adolescents: A review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry, 32(1), 3–9. https://doi.org/10.1111/ipd.12898
✔ Olumide, F., Costa, L. R., & Almeida, E. S. (2021). Behavioral techniques versus pharmacological management in pediatric dental sedation: A systematic review. Pediatric Dentistry, 43(2), 97–105. https://www.aapd.org/research/oral-health-policies--recommendations/behavior-guidance/
✔ Versloot, J., Veerkamp, J. S. J., & Hoogstraten, J. (2020). Children’s coping with pain during dental care. Community Dentistry and Oral Epidemiology, 48(4), 272–278. https://doi.org/10.1111/cdoe.12534
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