A well-structured preoperative protocol is essential to ensure safety and optimal outcomes in pediatric oral surgery. This guide outlines the most up-to-date recommendations, covering medical evaluation, fasting guidelines, informed consent, emotional preparation, and family logistics.
📌 Recommended Article :
Dental Article 🔽 Updated Guidelines for Antibiotic Use in Pediatric Dentistry: Evidence-Based Recommendations ... This article discusses updated, evidence-based guidelines for antibiotic use in pediatric dental care, focusing on clinical indications, dosage, and the importance of antimicrobial stewardship.The approach integrates clinical safety with child-centered care, aligning with current standards in U.S. pediatric dentistry and anesthesia practice.
Advertisement
1. Preoperative Clinical and Anesthetic Evaluation
➤ Key steps:
a. Comprehensive medical history – chronic illnesses (heart disease, asthma, epilepsy, diabetes, immunodeficiencies).
b. Surgical and anesthetic history – prior complications, adverse reactions, malignant hyperthermia risk.
c. Medication and allergy review – drug and food allergies.
d. Focused physical exam – airway assessment (Mallampati, mouth opening, neck mobility), cardiovascular and respiratory systems, hydration status.
e. ASA physical status classification – determines anesthetic risk.
f. Lab tests – only when indicated (e.g., coagulation studies, CBC, blood glucose).
g. Weight and height – for accurate dosing.
📌 Recommended Article :
Dental Article 🔽 Severe Dental Infections: Symptoms, Treatment & Antibiotics ... Adhering to recommended antibiotic regimens and dosages is crucial to ensure efficacy and minimize the risk of resistance.2. Fasting and Fluid Management
Proper fasting minimizes the risk of pulmonary aspiration during general anesthesia or deep sedation.
➤ American Society of Anesthesiologists (2023) guidelines:
° Clear liquids (water, pulp-free juice, electrolyte solutions): up to 2 hours before surgery.
° Breast milk: up to 4 hours before.
° Infant formula: up to 6 hours before.
° Light meals (toast, cereal): up to 6 hours before.
°Fatty meals: minimum 8 hours before.
➤ Additional recommendations:
° Confirm fasting time at patient check-in.
° Document last oral intake in the medical record.
° Provide caregivers with written and visual fasting instructions.
📌 Recommended Article :
PDF 🔽 Oral cysts in newborns: Characteristics, diagnosis and treatment ... We share a list of cases of oral cysts in newborns, detailing the characteristics, diagnosis and treatment.3. Informed Consent and Emotional Preparation
Informed consent must be signed by the legal guardian and include:
a. Procedure description.
b. Expected benefits and risks.
c. Available alternatives.
d. Possible complications.
e. Anesthesia and sedation plan.
f. Postoperative care instructions.
➤ Emotional preparation for children:
° Use the Tell-Show-Do technique.
° Age-appropriate language and visuals (toys, storybooks).
° Parental presence during preparation when possible.
° Familiarization visits to the surgical area.
Additional item:
° Record the child’s anxiety level and strategies used to reduce it in the patient chart.
📌 Recommended Article :
PDF/Video 🔽 What is odontogenic infection? - Symptoms, diagnosis and treatment ... Learn about the complications, diagnosis and symptoms of odontogenic infections and the most effective treatment.4. Family Logistics and Home Care Planning
Caregiver preparation improves cooperation and recovery.
➤ Recommendations:
a. Designate a responsible adult to stay during the entire procedure.
b. Arrange safe transportation home (no public transit, no fatigued driver).
c. Ensure a 24-hour observation period post-surgery at home.
d. Minimize waiting time by coordinating arrival and surgery schedule.
e. Dress the child in comfortable clothing.
f. Remove jewelry, piercings, nail polish (for monitoring purposes).
➤ Additional recommendation:
° Provide caregivers with a pre-op checklist to ensure all requirements are met.
📌 Recommended Article :
PDF/VIDEO 🔽 What is Ludwig's Angina? What are the symptoms and treatment? ... Learn what Ludwig's angina is, its etiology, the symptoms that we should take into account, and the effective treatment (pharmacological and surgical).5. Surgical Team Coordination
➤ Checklist before surgery:
a. Verify patient identity twice.
b. Mark the surgical site.
c. Confirm pediatric-sized instruments are ready (forceps, aspirators, surgical tools).
d. Prepare emergency medications and monitoring equipment.
e. Take preoperative photographs if needed for records.
✍️ Conclusion
An effective pediatric oral surgery pre-op protocol combines thorough medical evaluation, evidence-based fasting, informed consent, emotional readiness, and strong caregiver coordination. Following these steps reduces anesthetic risks, improves child cooperation, and enhances recovery outcomes in U.S. pediatric dental settings.
📌 Recommended Article :
PDF 🔽 Manual of extraction techniques in pediatric dentistry - Step by step ... The characteristics of the primary teeth and the presence of the germs of the permanent teeth must be taken into account when performing a dental extraction.📚 References
✔ American Academy of Pediatric Dentistry. (2023). Guideline on behavior guidance for the pediatric dental patient. Pediatric Dentistry, 45(6), 302–315.
✔ American Society of Anesthesiologists. (2023). Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration. Anesthesiology, 138(2), 233–246.
✔ American Academy of Family Physicians. (2022). Preoperative evaluation in children. American Family Physician, 105(6), 640–648.
✔ Urbach Pediatric Dentistry. (n.d.). Pre-op instructions for nitrous oxide and oral sedation. Retrieved from https://urbachpediatricdentistry.com/pre-op-instructions/
✔ Timberlea Dental Clinic. (2019). Pediatric pre- and post-op instructions. Retrieved from https://timberleasc.ca/wp-content/uploads/2019/10/Pediatric-Pre-and-Post-Op-Instructions-1.pdf
✔ Bekids Dentistry. (n.d.). Surgical instructions: Before general anesthesia. Retrieved from https://www.bekidsdentistry.com/welcome/pediatric-dentistry/procedures/surgical-instructions/before-general-anesthesia/
📌 More Recommended Items
► What is frenectomy? Step by step surgical procedure
► Guide for the surgical management and oral pathology of the pediatric patient
► Antimicrobial therapies for odontogenic infections in children and adolescents