Nolla’s Stages: The Ultimate Guide for Dental Students

Understanding tooth development is a cornerstone of dental education, and Nolla’s Stages provide a systematic framework for assessing tooth formation. Developed by Carmen Nolla in 1960, this classification system is widely used to evaluate the developmental stages of primary and permanent teeth.

📌 Recommended Article :

Video 🔽 Nolla's Stages of Tooth Development - Video ... The Nolla classification establishes values for tooth formation and development from the presence of the crypt to apical closure.

For dental students, mastering Nolla’s Stages is essential for clinical practice, radiographic analysis, and treatment planning. This 2025 guide offers a detailed, updated exploration of Nolla’s Stages, including their application, significance, and tips for success.

Advertisement

✅ What Are Nolla’s Stages?
Nolla’s Stages describe the developmental process of teeth, from initial calcification to complete root closure. The system divides tooth development into 10 stages (0–10), applicable to both primary and permanent dentition. Each stage corresponds to specific radiographic and morphological changes, making it a valuable tool for dental diagnostics, orthodontics, and pediatric dentistry.

📌 Recommended Article :

Video 🔽 Tooth development (Odontogenesis): 3D animated video ... We share an interesting 3D animated video of the odontogenesis process, where we can observe the formation of the dental crown.

✅ Why Are Nolla’s Stages Important for Dental Students?

° Radiographic Interpretation: Nolla’s Stages help students analyze dental radiographs to assess tooth maturity.
° Treatment Planning: Understanding tooth development aids in planning interventions like extractions or orthodontic treatments.
° Age Estimation: The stages are used in forensic dentistry to estimate chronological age.
° Clinical Relevance: Knowledge of Nolla’s Stages enhances communication with colleagues and patients.

📌 Recommended Article :

Video 🔽 Development of tooth (Odontogenesis) Part I - II ... Cells are derived from the ectoderm that give rise to the dental germ and 3 parts are identified: enamel organ, dental papilla and dental follicle.

✅ Detailed Breakdown of Nolla’s Stages
Below is a concise explanation of each stage, optimized for clarity and student comprehension:Stage 0: No evidence of tooth formation (absence of crypt).

Stage 1: Presence of a crypt without calcification.
Stage 2: Initial calcification begins, visible as a thin radiopaque line.
Stage 3: One-third of the crown is calcified.
Stage 4: Two-thirds of the crown is calcified.
Stage 5: Crown is nearly complete, with minimal root formation.
Stage 6: Crown is fully formed, and root formation begins.
Stage 7: One-third of the root is formed.
Stage 8: Two-thirds of the root is formed.
Stage 9: Root is nearly complete, with an open apex.
Stage 10: Root is fully formed, with a closed apex.

Each stage can be identified on dental radiographs, such as panoramic or periapical X-rays, making Nolla’s classification practical for clinical settings.

📌 Recommended Article :

Video 🔽 Formation and development of the face and oral cavity (Orofacial Complex) ... The formation of the face starts from the five prominences (one frontonasal, two maxillary and two mandibular). The prominences develop giving rise to different regions of the face.

✅ How to Apply Nolla’s Stages in Dental Practice

1. Radiographic Analysis
Dental students must learn to identify Nolla’s Stages on radiographs. For example, a tooth in Stage 7 indicates early root development, which may influence decisions about orthodontic movement or extraction timing.
2. Orthodontic Planning
Orthodontists use Nolla’s Stages to determine the optimal timing for interventions. For instance, teeth in Stages 6–8 are ideal for certain orthodontic movements due to active root development.
3. Pediatric Dentistry
In pediatric patients, Nolla’s Stages help assess whether tooth development aligns with chronological age, aiding in the diagnosis of developmental anomalies.
4. Forensic Applications
Nolla’s Stages are used in forensic odontology to estimate age in unidentified individuals, especially in legal or disaster victim identification scenarios.

📌 Recommended Article :

Dental Article 🔽 Nolla Stages in Dental Age Estimation: Characteristics, Importance, and Applications ... This method delineates ten distinct stages of tooth maturation, from the initial presence of a crypt to the complete formation of the root apex.

✅ Tips for Dental Students to Master Nolla’s Stages

° Practice Radiographic Interpretation: Regularly review panoramic radiographs to identify stages accurately.
° Use Visual Aids: Create or use flashcards with images of each stage to reinforce learning.
° Collaborate with Peers: Discuss case studies with classmates to apply Nolla’s Stages in real-world scenarios.
° Leverage Technology: Use dental software or apps that simulate tooth development for interactive learning.
° Stay Updated: Follow recent studies on tooth development to understand variations across populations.

📌 Recommended Article :

PDF 🔽 Malformations and anomalies of the branchial arches - Diagnosis and management ... The branchial or pharyngeal arches are slits that are located on both sides of the embryo, and from them originate the muscles, bones, cartilage and nerves of the face, head and neck.

✅ Discussion: Relevance and Challenges of Nolla’s Stages in 2025
Nolla’s Stages remain a gold standard in dental education due to their simplicity and universal applicability. However, challenges exist:

° Variability Across Populations: Studies suggest that tooth development rates may vary due to genetic, environmental, or nutritional factors, which can complicate stage identification (AlQahtani et al., 2010).
° Technological Advances: Modern imaging techniques, like CBCT (Cone Beam Computed Tomography), offer more detailed views of tooth development, potentially supplementing Nolla’s Stages.
° Interdisciplinary Integration: Dental students must integrate Nolla’s Stages with other classification systems, such as Demirjian’s method, for comprehensive assessments.

Despite these challenges, Nolla’s Stages are still highly relevant in 2025, particularly for their accessibility and reliability in clinical and forensic settings. Dental curricula should emphasize hands-on radiographic training to bridge the gap between theory and practice.

📌 Recommended Article :

Dental Article 🔽 Nolla Stages: Clinical Guide and Comparative Table ... Dental age estimation is a key process in pediatric dentistry, orthodontics, and forensic sciences. The Nolla method (1960) established 11 stages of dental maturation, from the absence of calcification to the complete eruption of the tooth in the arch.

✍️ Conclusion
Nolla’s Stages offer dental students a robust framework for understanding tooth development, with applications in clinical practice, orthodontics, and forensic dentistry. By mastering these stages, students can enhance their diagnostic skills and contribute to better patient outcomes. In 2025, combining Nolla’s Stages with modern imaging and interdisciplinary approaches ensures their continued relevance. Dental students are encouraged to practice diligently, leverage technology, and stay informed about advancements in dental science to excel in their studies and careers.

📌 Recommended Article :

Dental Article 🔽 Medications and Developing Teeth: Dental Risks, Mechanisms, and Prevention in Children ... Understanding how specific medications affect dental development is crucial for pediatricians, dentists, and caregivers to make informed decisions and prevent long-term oral health issues.

📚 References

✔ Nolla, C. M. (1960). The development of the permanent teeth. Journal of Dentistry for Children, 27(4), 254–266.
✔ Demirjian, A., & Levesque, G. Y. (1980). Sexual differences in dental development and prediction of emergence. Journal of Dental Research, 59(7), 1110–1122. https://doi.org/10.1177/00220345800590070201
✔ Haavikko, K. (1970). The formation and the alveolar and clinical eruption of the permanent teeth: An orthopantomographic study. Proceedings of the Finnish Dental Society, 66(3), 103–170.
✔ Willems, G., Van Olmen, A., Spiessens, B., & Carels, C. (2001). Dental age estimation in Belgian children: Demirjian’s technique revisited. Journal of Forensic Sciences, 46(4), 893–895. https://doi.org/10.1520/JFS15033J

Nolla Stages: Clinical Guide and Comparative Table

Dental age estimation is a key process in pediatric dentistry, orthodontics, and forensic sciences. The Nolla method (1960) established 11 stages of dental maturation, from the absence of calcification to the complete eruption of the tooth in the arch.

📌 Recommended Article :

Video 🔽 Formation and development of the face and oral cavity (Orofacial Complex) ... The formation of the face starts from the five prominences (one frontonasal, two maxillary and two mandibular). The prominences develop giving rise to different regions of the face.

Its clinical value remains relevant due to its simplicity, reliability, and applicability across populations.

Advertisement

✅ Nolla stages: clinical description

✅ Clinical application in dentistry

➤ Pediatric dentistry
° Evaluates dental maturation to determine the right timing for interceptive treatments.
° Useful in diagnosing delayed or advanced eruption.
➤ Orthodontics
° Guides treatment planning during mixed dentition.
° Helps determine the timing for serial extractions or appliance placement.
➤ Forensic sciences
° Standard tool for estimating chronological age in children and adolescents.

📌 Recommended Article :

Video 🔽 Tooth development (Odontogenesis): 3D animated video ... We share an interesting 3D animated video of the odontogenesis process, where we can observe the formation of the dental crown.

✅ Comparison with other methods

💬 Discussion
The Nolla method remains one of the most reliable systems in daily clinical practice. Its main strength is the ease of radiographic application, making it a cost-effective and relatively accurate diagnostic tool. However, recent studies indicate variability in accuracy depending on the population being assessed (Cadenas de Llano-Pérula et al., 2020).
Compared to Demirjian, Nolla offers more stages but less validation in multicenter research. In Latin America and the U.S., it continues to be widely used in preventive orthodontics and forensic applications.

📌 Recommended Article :

PDF 🔽 Malformations and anomalies of the branchial arches - Diagnosis and management ... Learn what the alterations and malformations of the branchial arches are, detailing the clinical management and treatment.

✍️ Conclusion
The Nolla system is a fundamental clinical guide for assessing dental development in children and adolescents. Its usefulness in pediatric dentistry, orthodontics, and forensic sciences keeps it relevant, though combining it with other methods is recommended for higher diagnostic accuracy across populations.

📚 References

✔ Cadenas de Llano-Pérula, M., Alonso-Ezpeleta, O., & Vicente, A. (2020). Dental age estimation using Nolla’s and Demirjian’s methods: A comparative study in a Spanish population. Forensic Science International, 310(110261). https://doi.org/10.1016/j.forsciint.2020.110261
✔ Nolla, C. M. (1960). The development of permanent teeth. Journal of Dentistry for Children, 27(4), 254–266.
✔ Willems, G., Oliveira-Santos, C., Froneman, M., & Thevissen, P. W. (2018). Dental age estimation in children: A widely used method revisited. Forensic Science International, 292, 124–128. https://doi.org/10.1016/j.forsciint.2018.09.002

📌 More Recommended Items

► Medications and Developing Teeth: Dental Risks, Mechanisms, and Prevention in Children
► Nolla's Stages of Tooth Development - Video
► Tooth Development and Eruption - Odontogenesis

Pediatric Oral Surgery Preoperative Protocol: Complete Clinical Guide

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

Amoxicillin vs Clindamycin in Pediatric Dentistry: Updated Clinical Guide 2025

Choosing between amoxicillin and clindamycin in pediatric dentistry requires a clear understanding of their mechanisms of action, clinical indications, weight-based dosing formulas, and safety profiles.

📌 Recommended Article :

Dental Article 🔽 Antibiotic Selection in Pediatric Dental Infections: Updated Clinical Criteria for U.S. Dentists ... This article outlines the evidence-based criteria for selecting safe and effective antibiotics for pediatric odontogenic infections, in accordance with U.S. clinical guidelines.

This 2025 updated review is designed for dental professionals in the United States, integrating current clinical guidelines and optimizing content for digital visibility.

Advertisement

✅ Mechanisms of Action

° Amoxicillin is a β-lactam antibiotic that inhibits bacterial cell wall synthesis, effective against gram-positive and some gram-negative bacteria.
° Clindamycin, a lincosamide, inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, blocking peptide translocation.

📌 Recommended Article :

PDF 🔽 Appropriate use of antibiotics in pediatric odontogenic infections ... We share updated information on the appropriate use of antibiotics in infectious processes of odontogenic origin in pediatric patients.

✅ Clinical Uses in Pediatric Dentistry

° Amoxicillin is the first-line antibiotic for pediatric dental infections due to its proven efficacy against the oral microbiota and favorable safety profile.
° Clindamycin is reserved for children allergic to penicillins or in cases of anaerobic infections, serving as a valuable alternative.

📌 Recommended Article :

PDF 🔽 Dental pain in pediatric dentistry - Assessment tools ... We share an article that reviews the important aspects of pain in pediatric dentistry, and the tools for a correct evaluation today.

✅ Dosage and Pediatric Dose Formula

1. Amoxicillin (children over 03 months and less than 88 lb/40kg):
20–40 mg/kg/day, divided every 8 hours, for up to 5 days
➤ Formula:
° Total daily dose (mg) = weight (kg) × mg/kg, divided into the number of doses per day.
° Example: A 20 kg child → 20 × 30 mg/kg = 600 mg/day → 200 mg every 8 h.

2. Clindamycin (oral, pediatric):
➤ Mild to moderate infections: 10–25 mg/kg/day, divided into 3 doses.
➤ Severe infections: 30–40 mg/kg/day, divided into 3–4 doses.
➤ Formula:
° Daily dose (mg) = weight × mg/kg, then split according to frequency.
° Example: 20 kg child, moderate infection → 20 × 20 mg/kg = 400 mg/day → ~133 mg every 8 h.

📌 Recommended Article :

PDF 🔽 Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation ...The article that we share offers us a review of the proper use of antibiotics in pediatric dentistry, considerations that we must take into account when prescribing antibiotics, and recommendations to calculate the dose in pediatric dentistry.

✅ Advantages and Disadvantages

💬 Discussion
In the US pediatric dental setting, amoxicillin remains the gold standard for treating most dental infections in children due to its high effectiveness, safety, and ease of administration. Clindamycin plays a critical role when first-line therapy is contraindicated, particularly in cases of penicillin allergy or infections dominated by anaerobic bacteria. However, clindamycin requires caution due to its higher gastrointestinal risk profile.

📌 Recommended Article :

PDF 🔽 Pharmacologic management for pediatric dental patients ... We share an article that tells us about pharmacological management in pediatric patients, as well as the care that the operator must have.

✍️ Conclusion
Amoxicillin is the preferred first-line treatment for pediatric dental infections, while clindamycin serves as a key alternative for allergic patients or specific anaerobic infections. Accurate weight-based dosing ensures safety and efficacy, aligning with current American Academy of Pediatric Dentistry guidelines.

📚 References

✔ American Academy of Pediatric Dentistry. (2022). Guideline on Use of Antibiotic Therapy for Pediatric Dental Patients. AAPD. https://www.aapd.org/globalassets/media/policies_guidelines/bp_antibiotictherapy.pdf

✔ Abdullah, F. M., et al. (2024). Antimicrobial management of dental infections: Updated review. Medicine, 103(28), e39. https://journals.lww.com/md-journal/fulltext/2024/07050/

✔ Goel, D. (2020). Antibiotic prescriptions in pediatric dentistry: A review. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC7114004/

✔ Johns Hopkins University. (2024). Clindamycin - ABX Guide. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540131/all/Clindamycin

✔ MedCentral. (2024). Clindamycin HCl Oral Monograph. https://www.medcentral.com/drugs/monograph/12235-382399/clindamycin-hcl-oral

📌 More Recommended Items

► Antibiotics and its use in pediatric dentistry: A review
► Guideline on use of antibiotic therapy for pediatric dental patients
► Antimicrobial therapies for odontogenic infections in children and adolescents

Updated Guide to Labial and Lingual Frenulum Management in Pediatric Dentistry

The labial and lingual frenula are normal anatomical structures, but when their attachment is abnormal or restrictive, they can interfere with oral function, facial development, and esthetics.

📌 Recommended Article :

Video/PDF 🔽 What is frenectomy? Step by step surgical procedure ... We share complete information about frenectomy, effectiveness and the step-by-step procedure regarding a clinical case. In addition to the case of a laser frenectomy in pediatric patients.

Early diagnosis in children is crucial to prevent issues related to speech, feeding, breathing, and oral hygiene. This guide provides an evidence-based overview of how to identify and manage frenulum-related conditions in pediatric patients.

Advertisement

✅ Diagnosis of Frenulum Abnormalities

1. Abnormal Maxillary Labial Frenulum
➤ Clinical Diagnosis:
° Low attachment (near the interdental papilla)
° Midline diastema
° Blanching of the papilla when the frenulum is pulled

➤ Evaluation Tools:
° Visual and tactile inspection
° Kotlow Classification for insertion level
° Periapical radiographs to assess spacing

➤ Classification (Miralles et al., 2009):
° Mucosal, gingival, papillary, penetrating

2. Lingual Frenulum (Ankyloglossia or "Tongue-Tie")
➤ Clinical Diagnosis:
° Limited tongue mobility
° Difficulties in breastfeeding, speech, or swallowing
° Heart-shaped appearance of the tongue tip

➤ Assessment Tools:
° Hazelbaker Assessment Tool (function and anatomy)
° Observation during oral functions (e.g., protrusion, suction)
° Referral to multidisciplinary specialists when needed

📌 Recommended Article :

PDF 🔽 Oral Surgery: Use of laser in lingual frenectomy in pediatric patients ... Among the benefits of using laser in frenectomy are: a quick surgical procedure, and a shorter and less painful post-operative period. Other benefits are: it promotes hemostasis and sterilizes the surgical site.

✅ Common Signs and Symptoms

✅ Consequences of Untreated Frenulum Issues

° Persistent midline diastema
° Periodontal recession due to tissue pulling
° Speech disorders (e.g., lisps, articulation delay)
° Breastfeeding difficulties in infants
° Orofacial myofunctional disorders
° Orthodontic complications later in life

📌 Recommended Article :

Video 🔽 What are impacted canines? - Treatment ... Impacted canines is a common anomaly, and is especially seen in the maxilla. The cause of the retention of the canine should be evaluated clinically and radiographically.

✅ Treatment Options for Frenulum Disorders

1. Labial Frenulum
➤ Management:
° Monitoring (especially in children under age 6 with physiological spacing)
° Surgical Frenectomy indicated when:

• Diastema persists after eruption of permanent incisors 
•  Orthodontic treatment is planned 
•  Gingival recession or tension is observed

➤ Surgical Techniques:
° Traditional scalpel technique
° Electrosurgery
° Diode laser (minimizes bleeding, faster healing)

2. Lingual Frenulum (Tongue-Tie)
➤ Management:
° Frenotomy: simple incision, typically for infants
° Frenectomy: complete removal, suitable for older children or severe cases
° Pre- and post-surgical myofunctional therapy
° Multidisciplinary approach: pediatric dentist, lactation consultant, speech-language pathologist

📌 Recommended Article :

PDF/Video 🔽 Ankyloglossia in infants - Diagnosis and surgical protocol ... We share the signs and symptoms for a correct diagnosis of ankyloglossia in infants and the surgical aspects of its treatment.

✅ Clinical Recommendations

° Assess frenula during the infant’s first dental or pediatric visit
° Treat ankyloglossia early if it impacts feeding or oral function
° Avoid surgery for purely esthetic reasons in primary dentition
° Use laser technology for anxious children or those needing fast recovery
° Always include functional assessment before deciding on surgery

💬 Discussion

Frenulum-related conditions are common in children but often overlooked. Evidence suggests that function-based assessment should take precedence over anatomical appearance when making treatment decisions. Early intervention in cases like tongue-tie can greatly improve oral and facial development. Diode lasers have significantly improved surgical outcomes in children, making the procedures less invasive and more tolerable. Still, collaboration between specialties remains the gold standard for long-term success.

📌 Recommended Article :

PDF/Video 🔽 Ameloblastoma in a pediatric patient - Characteristics, treatment and clinical case ... Ameloblastoma is an odontogenic tumor, non-malignant but locally aggressive, with high recurrence, and is evidenced as a facial swelling, or sometimes as a radiographic finding.

💡 Conclusion

° Early identification of abnormal frenula prevents future complications.
° Treatment decisions must prioritize function over appearance.
° Conservative surgical techniques are preferred in pediatric cases.
° A team-based approach enhances treatment outcomes, especially in tongue-tie.
° Parental education and regular follow-up are essential to successful management.

📚 References

✔ American Academy of Pediatric Dentistry (AAPD). (2023). Guideline on Management of the Frenulum in Pediatric Patients. https://www.aapd.org/research/oral-health-policies--recommendations/

✔ Baxter, R., & Dupont, J. (2020). Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More. Alabama Tongue-Tie Center.

✔ Hazelbaker, A. (2010). Assessment Tool for Lingual Frenulum Function (ATLFF). Columbus, OH.

✔ Kotlow, L. A. (2004). Oral diagnosis of abnormal frenum attachments in neonates and infants: evaluation and treatment of the maxillary and lingual frenum using the Erbium:YAG laser. Journal of the Laser and Health Academy, 2(3), 1–7.

✔ Miralles, R., et al. (2009). Clinical classification of upper labial frenulum insertions in children. Revista Chilena de Odontopediatría, 3(1), 23–27.

✔ Nakhash, A., et al. (2021). Surgical interventions for ankyloglossia in children: A systematic review and meta-analysis. International Journal of Pediatric Otorhinolaryngology, 145, 110714. https://doi.org/10.1016/j.ijporl.2021.110714

📌 More Recommended Items

► How to control bleeding after extraction?
► Oral Mucocele in Pediatric Patients: Clinical Features and Surgical Management
► Oral cysts in newborns: Characteristics, diagnosis and treatment

Dental Infections in Children: How to Identify Them and What to Do in Time

Dental infections are one of the most common oral health problems in children and can lead to serious complications if not treated promptly. Early detection is crucial to prevent pain, abscesses, or systemic effects.

📌 Recommended Article :

PDF 🔽 Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation ... In comparison, the metabolism of a drug in a child is different from that of an adult, so the administration of an antibiotic should be taking into account the diagnosis, age and weight of the pediatric patient.

This guide is designed for parents and healthcare professionals to recognize dental infections in children and take timely, effective action based on current evidence.

Advertisement

✅ What Are Pediatric Dental Infections?
Pediatric dental infections refer to localized or systemic infections originating from dental or periodontal tissues. The most frequent types in children include advanced tooth decay (pulpitis and abscesses), gingivitis, and plaque-induced periodontitis. These conditions can impact speech, nutrition, sleep, and a child’s overall health if not treated early.

📌 Recommended Article :

PDF 🔽 Antimicrobial therapies for odontogenic infections in children and adolescents ... We share a literature review that establishes guidelines for antimicrobial therapy in infections of odontogenic origin and clinical recommendations.

✅ Main Causes of Dental Infections in Children

° Tooth decay (dental caries): The most common cause. When untreated, it can reach the pulp and lead to an abscess.
° Poor oral hygiene: Plaque buildup from inadequate brushing and flossing.
° Dental trauma: Injuries that cause pulp necrosis and bacterial infection.
° Systemic health conditions: Children with weakened immune systems are more vulnerable.
° Diet high in sugar: Frequent intake of sugary snacks and drinks without proper oral care.

📌 Recommended Article :

Video 🔽 Management of antibiotics in odontogenic infections in pediatric dentistry ... Antibiotic treatment in pediatric dentistry should be carried out taking into account the pharmacodynamic characteristics of the pediatric patient.

✅ Warning Signs and Symptoms of a Dental Infection in Children

➤ Local Symptoms
° Persistent or throbbing tooth pain.
° Increased sensitivity to hot or cold.
° Swollen or bleeding gums.
° Presence of a pimple-like bump (fistula) on the gums.
° Bad breath that doesn’t go away.

➤ Systemic Symptoms
° Unexplained fever.
° Swelling in the face, cheeks, or neck lymph nodes.
° Difficulty chewing or opening the mouth.
° Poor appetite or trouble sleeping.

📌 Recommended Article :

PDF 🔽 Antibiotics and its use in pediatric dentistry: A review ... The purpose of this review article is to provide information on proper use of antibiotics in pediatric dental practice for control of oral infection, and in the management of children with systemic conditions which may alter disease resistance and healing response.

✅ What to Do If You Suspect a Dental Infection

1. Schedule a Pediatric Dental Visit Immediately
A dentist will assess the infection through a clinical exam and dental X-rays to determine the correct treatment.
2. Do Not Self-Medicate
Avoid giving your child antibiotics or pain relievers without professional advice. This can mask symptoms and promote antibiotic resistance.
3. Follow the Recommended Treatment
Depending on the severity, treatment may include draining an abscess, pulp therapy, tooth extraction, or a course of antibiotics.

📌 Recommended Article :

PDF 🔽 Guideline on use of antibiotic therapy for pediatric dental patients ... These recommendations are intended to provide guidance in the proper and judicious use of antibiotic therapy in the treatment of oral conditions.

✅ How to Prevent Dental Infections in Children

° Brush your child’s teeth twice a day with fluoride toothpaste starting with the first tooth.
° Visit the pediatric dentist every six months starting at age 1.
° Apply fluoride varnish and dental sealants if your child is at high risk for cavities.
° Limit sugary drinks and snacks.
° Supervise tooth brushing until at least age 7 or 8.

📌 Recommended Article :

PDF 🔽 Appropriate use of antibiotics in pediatric odontogenic infections ... Knowledge of antibiotic pharmacokinetics and pharmacodynamics prevents resistance and adverse drug reactions. In addition, we must take a correct anamnesis to avoid allergic processes.

💬 Discussion
Pediatric dental infections are largely preventable. When detected early, complications such as swelling, pain, or even facial cellulitis can be avoided. Despite advances in dental care, cavities remain the most common chronic disease in children. One key issue is that many caregivers are unaware of the early warning signs. Increasing oral health education among families and primary care providers is essential to reduce the burden of dental disease in children.

💡 Conclusion Early identification and proper management of dental infections in children can significantly improve their oral and overall health. Prevention strategies, routine dental checkups, and timely treatment are the foundation for reducing complications and ensuring a healthy smile throughout childhood.

📚 Reference

✔ American Academy of Pediatric Dentistry. (2023). Guideline on Pediatric Restorative Dentistry. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry. Retrieved from https://www.aapd.org/research/oral-health-policies--recommendations/restorative-dentistry/

📌 More Recommended Items

► How to manage dental infections? - Specific pharmacological treatment
► Are Antibiotics Enough To Treat A Tooth Infection?
► Antibiotic prescriptions in pediatric dentistry: A review

Post-Operative Care After Local Anesthesia in Dentistry: Updated 2025 Guide

Local anesthesia is a cornerstone of modern dentistry, allowing patients to undergo procedures such as extractions, fillings, deep cleanings, and minor surgeries without pain.

📌 Recommended Article :

PDF🔽 Considerations for Pediatric Local Anesthesia ... In pediatric dentistry, it is important to know the weight and body mass of the infant to calculate the correct dose of anesthesia, and good behavior management of the pediatric patient.

While generally safe and short-acting, it's essential to follow specific post-treatment instructions to avoid complications like accidental injuries or delayed healing. This updated guide outlines evidence-based recommendations for patients recovering from local dental anesthesia in 2025.

Advertisement

✅ What Is Local Anesthesia?
Local anesthesia temporarily blocks nerve signals in a specific area without affecting consciousness. Common anesthetics used in dentistry include lidocaine, articaine, and mepivacaine, typically administered via local infiltration or nerve blocks.

📌 Recommended Article :

PDF 🔽 Local anesthesia calculations: How to avoid overdose and toxicity in pediatric patients? ... Local anesthetic systemic toxicity is a consequence of overdose, it is rare but usually occurs in children. This event is avoidable if all safety measures are taken.

✅ Immediate Aftercare Following Local Dental Anesthesia

1. Avoid Chewing While Numb:
Wait until the numbness fully wears off (typically 1–3 hours) before eating solid food. This helps prevent accidental bites on the tongue, lips, or cheeks.

2. Don’t Touch the Numb Area:
Refrain from poking or rubbing the anesthetized area with fingers or objects, as you may unintentionally injure the tissue without noticing.

3. Avoid Hot Foods and Beverages:
Stick to cool or room-temperature drinks and foods until the sensation returns to avoid burns.

4. Monitor Children and Special Needs Patients:
Closely supervise young children or individuals with disabilities, as they may chew on their lips or cheeks out of curiosity, leading to serious injury.

5. Take It Easy for the Rest of the Day:
Avoid strenuous activity or exercise, especially if the procedure involved oral surgery.

6. Follow Medication Instructions:
If your dentist prescribed pain relievers or anti-inflammatories, take them as directed to manage discomfort once the anesthesia wears off.

📌 Recommended Article :

Video 🔽 Inferior alveolar nerve block Technique For Children - Tips and tricks ... The inferior alveolar nerve block technique is one of the most used, because it blocks the painful sensations of half of the tongue, lip, teeth and bone of the lower jaw.

✅ Possible Side Effects or Complications

° Allergic reactions (rare): itching, swelling, difficulty breathing
° Bruising or hematoma at the injection site
° Temporary nerve issues (e.g., rare facial nerve paralysis)
° Soft tissue injuries due to unintentional biting while numb

Contact your dentist immediately if you experience any of the above symptoms.

📌 Recommended Article :

PDF 🔽 Manual of Local Anesthesia - Anesthetic techniques and anatomical references ... The professional must know the appropriate administration technique for the dental procedure, the anatomical references, and the recommended dose for the patient.

💬 Discussion
Post-operative instructions following local anesthesia are often overlooked but are crucial for a smooth recovery. Proper patient education—especially for parents and caregivers—is key to preventing unnecessary injuries or complications. Technological advances like phentolamine mesylate (OraVerse®), which helps reverse soft tissue anesthesia, have improved patient comfort and safety in certain cases (Hersh et al., 2008). Including such tools in patient care plans can reduce downtime and enhance outcomes.

💡 Conclusion
Proper care after receiving local dental anesthesia ensures faster recovery and avoids complications. Avoid chewing or drinking hot beverages while numb, monitor for side effects, and follow all dental instructions closely. Educating patients about these steps should be an integral part of modern dental care.

📚 References

✔ Hersh, E. V., Lindemeyer, R. G., & Fleury, A. A. (2008). Reversal of soft tissue local anesthesia with phentolamine mesylate in pediatric patients. Pediatric Dentistry, 30(5), 406–414. https://pubmed.ncbi.nlm.nih.gov/19014076/

✔ Malamed, S. F. (2020). Handbook of Local Anesthesia (7th ed.). Elsevier Health Sciences.

✔ Meechan, J. G. (2019). How to avoid and manage common local anaesthetic complications. Dental Update, 46(3), 210–216. https://doi.org/10.12968/denu.2019.46.3.210

📌 More Recommended Items

► Dental Anesthesia: Overdose and Complications in Pediatric Patients
► Pharmacological management of the behavior of the pediatric patient: Nitrous Oxide and General Anesthesia
► DENTAL ANESTHESIA : Mandibular Block for Pediatric Patients - Dental Injection Technique