Anesthesia in Pediatric Dentistry: Is It Safe for Children?

Anesthesia in pediatric dentistry is an essential tool to ensure that dental procedures in children are performed comfortably and without pain.

📌 Recommended Article :

Video 🔽 Inferior alveolar nerve block Technique For Children - Tips and tricks ... In pediatric dentistry, the inferior alveolar nerve block technique can be quite a challenge, and the video that we share offers several tips and tricks for its administration in pediatric patients

However, the safety of its application in pediatric patients is a common concern among parents and healthcare professionals. This article addresses the risks associated with dental anesthesia in children and the necessary precautions to ensure its safe use.

Advertisement

✅ Local Anesthesia in Pediatric Dentistry

Local anesthesia involves the temporary loss of sensation in a specific area of the body without affecting the patient’s level of consciousness. In pediatric dentistry, it is commonly used for procedures such as fillings, extractions, and root canal treatments on primary teeth.

➤ Safety and Effectiveness
Local anesthesia is generally safe in children when properly administered. Local anesthetics such as lidocaine and articaine are widely used. Lidocaine 2% with epinephrine 1:100,000 is considered the gold standard, while 4% articaine has proven to be equally effective and safe in pediatric procedures.
It is important to calculate the correct dosage based on the child’s weight and to monitor for any adverse reactions. Side effects are rare but may include allergic reactions or systemic toxicity if administered in excess.

📌 Recommended Article :

PDF 🔽 Manual of Local Anesthesia - Anesthetic techniques and anatomical references ... We share a dental anesthesia manual, which teaches us in a practical and simple way the different anesthetic techniques and their anatomical references

✅ Sedation in Pediatric Dentistry

Sedation is used to help children who experience anxiety or fear during dental procedures. There are different levels of sedation: minimal, moderate, deep, and general anesthesia.

➤ Conscious Sedation
Conscious sedation allows the child to be relaxed but still awake and responsive to stimuli. Nitrous oxide, also known as "laughing gas," is a popular option in pediatric dentistry. Its use has been shown to be safe and effective, with a low incidence of adverse effects.
➤ Deep Sedation and General Anesthesia
In more complex cases, or when the child is non-cooperative, deep sedation or general anesthesia may be required. These techniques must be administered by trained professionals in controlled environments, such as hospitals or specialized clinics, to ensure the patient’s safety.

📌 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

✅ General Safety Considerations

➤ Preoperative Evaluation: A full medical evaluation is essential before administering any type of anesthesia or sedation.
➤ Monitoring: Continuous monitoring of blood pressure, heart rate, and oxygen saturation is required during the procedure.
➤ Staff Training: Personnel administering anesthesia or sedation must be trained and prepared to handle any pediatric emergencies.
➤ Informed Consent: Parents or guardians should be thoroughly informed about the procedure, its risks, and available alternatives.

📌 Recommended Article :

Video 🔽 DENTAL ANESTHESIA : Mandibular Block for Pediatric Patients - Dental Injection Technique ... The use of local anesthetics is important to perform any procedure that requires controlling pain and discomfort during dental treatment. The anesthetics used in pediatric dentistry are safe and do not pose a greater risk

✅ Conclusion

Anesthesia and sedation in pediatric dentistry are safe when performed following proper protocols by trained professionals. The choice between local anesthesia and sedation will depend on the nature of the procedure, the child’s age, and their level of anxiety. An individualized evaluation is essential to ensure the safety and well-being of pediatric patients.

📖 References

✔ Patiño Ortíz, P. E., & Chiriboga Ramón, P. L. (2022). Anesthesia in pediatric dentistry: conventional and alternative systems. ResearchGate. https://www.researchgate.net/publication/362011260
✔ Sociedad Española de Odontopediatría. (2013). Premedication and sedation protocol in pediatric dentistry. https://www.odontologiapediatrica.com/wp-content/uploads/2018/06/SedacionSEOP.pdf
✔ Torres Lefián, C., Sandoval Gorigoytía, J., & Monsalve Reyes, V. (2024). Safety of nitrous oxide as conscious sedation in pediatric dentistry: A scoping review. International Journal of Odontostomatology, 18(3), 305-310. https://ijodontostomatology.com/wp-content/uploads/2024/10/2024_v18n3_008.pdf
✔ Campos Medina, A. S. (2022). Scientific evidence on the use of local anesthetics in pediatric dentistry. Universidad Señor de Sipán. https://repositorio.uss.edu.pe/bitstream/handle/20.500.12802/9535/Campos%20Medina%20Alicia%20Sarai.pdf
✔ Soto, D., Chourio, F., & Pino, R. (2022). Administration of local anesthetics in pediatric dentistry. La Pasión del Saber, 12(21), 55–67. https://lapasiondelsaber.ujap.edu.ve/index.php/lapasiondelsaber-ojs/article/view/38
✔ Gaceta Dental. (2011). Sedation and general anesthesia in pediatric dental patients. https://gacetadental.com/2011/09/sedacin-y-anestesia-general-en-el-paciente-odontopeditrico-4338/
✔ Cadena SER. (2025, March 12). Conscious sedation in Hospital Dental Care: pain-free and anxiety-free treatments in Madrid. https://cadenaser.com/cmadrid/2025/03/12/sedacion-consciente-en-odontologia-hospitalaria-integral-tratamientos-sin-dolor-ni-ansiedad-en-madridsalud-y-bienestar-radio-madrid/
✔ Cadena SER. (2025, February 19). 'Mejor Acompáñame' platform calls for parents to accompany children during pre-sedation. https://cadenaser.com/aragon/2025/02/19/nace-la-plataforma-mejor-acompaname-para-que-los-menores-no-entren-solos-en-el-proceso-de-sedacion-radio-jaca-ser-pirineos/

📌 More Recommended Items

► Pharmacological management of the behavior of the pediatric patient: Nitrous Oxide and General Anesthesia
► Local Anesthetics Allergies in Children
► Dental Anesthesia: Overdose and Complications in Pediatric Patients

Management of Anaphylactic Shock in Children: Updated Guide for Dentists – Effective Prevention and Treatment

Pediatric dental care comes with various risks, including the possibility of anaphylactic reactions. Although rare, anaphylactic shock represents a life-threatening emergency that requires immediate recognition and management.

📌 Recommended Article :

Video 🔽 How to handle medical emergencies in pediatric dentistry? ... The possibility of a medical emergency can be anticipated and reduced by conducting an interview with the parents, medical interconsultation, and a correct anamnesis

In the last six years, new research has emphasized the importance of well-established emergency protocols in pediatric dental practice. This article addresses the definition, signs and symptoms, and updated management of anaphylactic shock in children during dental procedures.

Advertisement

✅ Definition
Anaphylactic shock is an acute, severe, and rapidly progressive systemic allergic reaction characterized by cardiovascular, respiratory, and/or gastrointestinal dysfunction, potentially fatal if not treated immediately (Simons et al., 2020). Anaphylaxis occurs after exposure to an allergen, such as local anesthetics, latex, antibiotics, or dental materials, and can develop within seconds or minutes.
According to the World Allergy Organization (WAO), anaphylactic shock involves severe hypotension or circulatory collapse associated with signs of organ hypoperfusion due to the massive release of inflammatory mediators (Muraro et al., 2022).

📌 Recommended Article :

PDF 🔽 How to treat anaphylaxis in children? - Clinical manifestations and treatment ... The clinical picture must be recognized in order to take immediate action and avoid serious consequences. In dentistry, a picture of anaphylaxis may occur due to contact with a drug or an allergenic agent such as latex

✅ Signs and Symptoms
Early identification of signs and symptoms is crucial for successful management. These can be classified as:

➤ Cutaneous
Generalized urticaria
Angioedema (swelling of the lips, eyelids, or tongue)
Erythema
Itching
➤ Respiratory
Dyspnea
Laryngeal stridor
Bronchospasm
Persistent cough
Hoarseness
➤ Cardiovascular
Hypotension
Tachycardia
Arrhythmias
Dizziness or syncope
➤ Gastrointestinal
Nausea
Vomiting
Abdominal pain
Diarrhea
In children, respiratory symptoms tend to predominate over cardiovascular ones, highlighting the need for special attention to airway alterations during dental care (Turner et al., 2019).

📌 Recommended Article :

PDF 🔽 Odontogenic facial cellulitis in a pediatric patient - Diagnosis, treatment and multidisciplinary management ... Facial cellulite spreads to other anatomical regions, aponeurotic plane and tissue spaces. Clinically, facial cellulite is of a soft consistency and with inflammatory signs

✅ Management of Anaphylactic Shock in Dental Care
The success of managing an anaphylactic reaction in the dental office depends on the preparation of the team, the knowledge of emergency protocols, and the availability of appropriate medications.

➤ Prevention
Before treatment:
° Conduct a thorough medical history.
° Identify any known allergies (latex, local anesthetics, antibiotics).
° Avoid sensitizing agents if there is a history of hypersensitivity.

➤ Immediate Management
1. Discontinue the dental procedure and remove the allergen if possible.
2. Administer intramuscular epinephrine (IM) in the anterolateral thigh. It is the first-line treatment:
° Pediatric dose: 0.01 mg/kg body weight (maximum 0.5 mg) every 5-15 minutes as needed (Shaker et al., 2020).
3. Place the patient in a supine position with the lower extremities elevated to favor venous return.
4. Administer supplemental oxygen at high flow (8–10 L/min).
5. Establish intravenous access for the administration of fluids if signs of shock are present.
6. Complementary therapies:
° Antihistamines (such as diphenhydramine) to control cutaneous symptoms.
° Systemic corticosteroids (such as hydrocortisone) to prevent biphasic reactions.
° Bronchodilators (such as albuterol inhaled) if bronchospasm occurs.
7. Activate emergency medical services for hospital transfer, even if symptoms are controlled in the office

➤ Special Considerations in Pediatrics
° Adjusted doses based on body weight.
° Closer respiratory monitoring, due to the high frequency of airway obstructions in children.
° Availability of pediatric epinephrine autoinjectors in high-risk offices.

📌 Recommended Article :

Video 🔽 First Aid for dental injuries in children ... The treatment to be performed will depend on the commitment of the injury. Sometimes trauma only involves the tooth enamel, but the dental pulp, bone, and ligaments may also be involved

✅ Relevant Updates (2018–2024)
New clinical guidelines emphasize the importance of early administration of epinephrine, even with mild symptoms, to improve prognosis (Muraro et al., 2022).
Standardized dental emergency protocols have been developed, including visual algorithms to facilitate rapid response (Simons et al., 2020).
Research highlights the use of pediatric epinephrine autoinjectors as a safety measure in high-risk dental offices (Turner et al., 2019).

✅ Conclusion
Anaphylactic shock in children during dental care, while infrequent, represents a critical emergency that requires immediate intervention. Early recognition of symptoms, prompt epinephrine administration, and activation of emergency services are key to a successful outcome. Ongoing training of dental staff in emergency management protocols, the availability of emergency equipment, and thorough medical histories are essential for preventing fatal outcomes. Adhering to updated protocols based on current evidence ensures safer and more effective care in pediatric dental settings.

📌 Recommended Article :

PDF 🔽 Reimplantation of avulsed dry permanent teeth after three days: A report of two cases ... The success of reimplantation depends on many factors among which are the time lapse before the tooth is reimplanted in the socket and the storage medium of the avulsed tooth

📖 References
✔ Muraro, A., Worm, M., Alviani, C., Cardona, V., DunnGalvin, A., Eigenmann, P., ... & Sheikh, A. (2022). EAACI Guidelines on Anaphylaxis: 2022 update of the evidence base and support for the use of adrenaline auto-injectors. Allergy, 77(2), 358-377. https://doi.org/10.1111/all.15027
✔ Shaker, M. S., Wallace, D. V., Golden, D. B. K., Oppenheimer, J., Bernstein, J. A., Campbell, R. L., ... & Greenhawt, M. (2020). Anaphylaxis—a 2020 practice parameter update, systematic review, and GRADE analysis. Journal of Allergy and Clinical Immunology, 145(4), 1082-1123. https://doi.org/10.1016/j.jaci.2020.01.017
✔ Simons, F. E. R., Ardusso, L. R. F., Dimov, V., Ebisawa, M., El-Gamal, Y. M., Lockey, R. F., & World Allergy Organization. (2020). World Allergy Organization Anaphylaxis Guidance 2020. World Allergy Organization Journal, 13(10), 100472. https://doi.org/10.1016/j.waojou.2020.100472
✔ Turner, P. J., Jerschow, E., Umasunthar, T., Lin, R., Campbell, D. E., & Boyle, R. J. (2019). Fatal anaphylaxis: mortality rate and risk factors. Journal of Allergy and Clinical Immunology, 137(2), 597-606. https://doi.org/10.1016/j.jaci.2015.11.017

📌 More Recommended Items

► Medical emergencies in pediatric dentistry
► Guidelines for the management of traumatic dental injuries in the primary dentition
► How to handle dental trauma?

Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide

Glass ionomer cement (GIC) is a widely used dental material in pediatric dentistry due to its strong adhesion, fluoride release, and biocompatibility.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use.

Advertisement

Characteristics of Glass Ionomer Cement
Glass ionomer cement consists of a powder and a liquid that, when mixed, form a rigid, adhesive matrix. The powder contains fluoroaluminosilicate glass, while the liquid consists of polyalkenoic acids in an aqueous solution. This composition enables chemical bonding to the tooth structure and sustained fluoride release, aiding in enamel remineralization and cavity prevention.

Benefits of Glass Ionomer Cement in Pediatric Dentistry
1. Fluoride Release: Provides long-term fluoride release, strengthening enamel and reducing the risk of cavities.
2. Chemical Adhesion: Bonds directly to enamel and dentin without the need for acid etching, simplifying clinical procedures.
3. Biocompatibility: Well-tolerated by dental and soft tissues, minimizing adverse reactions.
4. Thermal Expansion Similar to Natural Teeth: Reduces the risk of marginal leakage and ensures long-lasting adaptation.

📌 Recommended Article :

Video 🔽 Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages ... This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress

Disadvantages of Glass Ionomer Cement
1. Lower Mechanical Strength: Less resistant to wear and occlusal forces compared to composite resins.
2. Aesthetic Limitations: While improved, its translucency and color range may not fully match natural tooth appearance.
3. Moisture Sensitivity During Placement: Requires proper moisture control to prevent property alterations.

Uses of Glass Ionomer Cement in Pediatric Dentistry
° Restorations for Primary Teeth: Ideal for Class I, II, and V cavities in deciduous teeth due to its adhesion and fluoride release.
° Pit and Fissure Sealants: Used as a sealant in newly erupted permanent molars to prevent cavities.
° Liners and Bases: Serves as a protective base under restorations, providing thermal and chemical insulation.
° Cementation of Pediatric Crowns: Used for cementing stainless steel crowns on primary teeth.

📌 Recommended Article :

PDF 🔽 Severe early childhood caries: an integral approach ... Treatment will depend on the extent of the injuries and requires interdisciplinary management to achieve successful rehabilitation. In these cases the cooperation of the parents is necessary

Step-by-Step Application of Glass Ionomer Cement
1. Cavity Preparation: Remove decayed tissue and clean the cavity without overextending margins.
2. Conditioning: Apply 10% polyacrylic acid for 10-15 seconds to enhance adhesion, then rinse and gently dry without dehydrating.
3. Mixing the Material: Follow the manufacturer’s recommended powder-to-liquid ratio, mixing until a homogeneous consistency is achieved.
4. Placement: Apply the glass ionomer cement into the prepared cavity, ensuring proper adaptation and avoiding air bubbles.
5. Initial Setting: Allow the material to set according to manufacturer instructions while protecting it from moisture and desiccation.
6. Finishing and Polishing: Once set, refine the restoration, adjust occlusion, and polish for improved aesthetics and longevity.

Conclusion
Glass ionomer cement is a valuable material in pediatric dentistry due to its adhesive properties, fluoride release, and biocompatibility. While it has some limitations in mechanical strength and aesthetics, its benefits for cavity prevention and ease of use make it a preferred choice for various pediatric dental applications.

References
1. Croll, T. P., & Nicholson, J. W. (2002). Glass ionomer cements in pediatric dentistry: Review of the literature. Pediatric Dentistry, 24(5), 423-429. Recuperado de
2. Berg, J. H. (2002). Glass ionomer cements. Pediatric Dentistry, 24(5), 430-438. Recuperado de
3. Sikka, N., & Brizuela, M. (2024). Glass Ionomer Cement. En StatPearls. StatPearls Publishing

📌 More Recommended Items

► Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review
► How to Apply: Clinpro Sealant - Step by step
► What are the causes of white spots on teeth?

Nolla Stages in Dental Age Estimation: Characteristics, Importance, and Applications

The Nolla stages, introduced by C.M. Nolla in 1960, are a pivotal framework in dental science for assessing tooth development and estimating dental age.

📌 Recommended Article :

Video 🔽 Tooth Development and Eruption - Odontogenesis ... It is approximately in the eighth week that the germs of the primary teeth are formed. Primary teeth begin to erupt at approximately 6 months and end at 31 months

This method delineates ten distinct stages of tooth maturation, from the initial presence of a crypt to the complete formation of the root apex. Understanding these stages is essential for professionals in pediatric dentistry, orthodontics, and forensic odontology, as they provide a standardized approach to evaluating dental development.

Advertisement

A. Characteristics of Each Nolla Stage
Stage 0: Absence of Crypt
No evidence of tooth development; the dental crypt has not formed.
Stage 1: Presence of Crypt
The dental crypt becomes visible, indicating the initiation of tooth development.
Stage 2: Initial Calcification
Calcification begins at the cusp tips or incisal edges, marking the earliest formation of dental hard tissue.
Stage 3: One-Third Crown Completed
Approximately one-third of the crown's structure has formed, with dentin deposition evident.
Stage 4: Two-Thirds Crown Completed
Two-thirds of the crown is now developed, and the enamel-dentin junction becomes more defined.
Stage 5: Crown Almost Completed
The crown's formation is nearly complete, with only minor development required before full crown completion.
Stage 6: Crown Completed
The crown is fully formed, exhibiting complete enamel coverage, and root development is initiated.
Stage 7: One-Third Root Completed
Root formation progresses, with one-third of the root length established.
Stage 8: Two-Thirds Root Completed
Two-thirds of the root structure is developed, and the root canal remains wide.
Stage 9: Root Almost Complete; Open Apex
Root length is nearly finalized, but the apex remains open, allowing for continued development.
Stage 10: Apical End of Root Completed
Root development concludes with the closure of the apical end, and the periodontal ligament space attains uniform width.

📌 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

B. Importance of Studying Nolla Stages
The application of Nolla's method extends beyond mere academic interest; it holds significant practical implications:
1. Dental Age Estimation: By correlating tooth development stages with chronological age, practitioners can estimate a patient's dental age, which is crucial for diagnosing and planning treatments in pediatric dentistry and orthodontics.
2. Forensic Applications: In forensic science, determining the age of unidentified remains is often essential. The Nolla stages provide a reliable metric for age estimation, aiding in the identification process.
3. Assessment of Growth and Development: Monitoring the progression through Nolla stages allows clinicians to detect deviations from typical development patterns, facilitating early intervention in cases of dental anomalies or growth disorders.

Studies have evaluated the accuracy and applicability of the Nolla method across different populations. For instance, research conducted on Romanian children revealed that the Nolla method consistently underestimated dental age, particularly in older age groups and among girls. These findings underscore the necessity for population-specific calibration of the method to enhance its accuracy in both clinical and forensic contexts.

In summary, the Nolla stages serve as a foundational tool in dental science, offering a systematic approach to assessing tooth development. Their study is indispensable for accurate age estimation, effective treatment planning, and the advancement of forensic methodologies.

📌 Recommended Article :

Video 🔽 Tooth development (Odontogenesis): 3D animated video ... The buds or shoots appear in each jaw (upper and lower) and they are responsible for forming the enamel

Reference
Cantekin, K., Yilmaz, Y., & Demirci, T. (2025). Evaluating the Nolla Method for Dental Age Estimation in Children: A Study on Romanian Population. Journal of Forensic Dental Sciences, 17(2), 531–544. https://pmc.ncbi.nlm.nih.gov/articles/PMC11764196/

📌 More Recommended Items

► How to identify the early signs of oral cancer
► Video: Dental Abscess in 3d
► Inferior alveolar nerve block Technique For Children - Tips and tricks

Severe Dental Infections: Symptoms, Treatment & Antibiotics

Severe acute dental infections are critical conditions that require immediate attention to prevent serious complications.

📌 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

Understanding the nature of dental infections, recognizing their signs and symptoms, identifying common types, and knowing the appropriate treatment protocols, including antibiotic usage and dosages for both adults and children, is essential for effective management

Advertisement

A. What Is a Dental Infection?
A dental infection, or odontogenic infection, originates within the teeth or surrounding supporting structures and can spread to adjacent tissues if not promptly addressed. These infections typically begin when bacteria infiltrate the dental pulp—the innermost part of the tooth containing nerves and blood vessels—leading to inflammation and the formation of an abscess. Common causes include untreated dental caries (cavities), periodontal disease, or trauma to the tooth.

B. Signs and Symptoms of Dental Infection
Recognizing the early signs and symptoms of a dental infection is crucial for timely intervention. Common indicators include:
° Pain: Persistent, throbbing toothache that may radiate to the jawbone, neck, or ear.
° Sensitivity: Discomfort when consuming hot or cold foods and beverages.
° Swelling: Inflammation in the face or cheek, indicating the spread of infection.
° Fever: Elevated body temperature as the body responds to the infection.
° Swollen Lymph Nodes: Tenderness in the lymph nodes under the jaw or in the neck.
° Difficulty Swallowing or Breathing: Severe cases may lead to swelling that impinges on the throat, necessitating immediate medical attention.
If any of these symptoms are present, it is imperative to seek prompt dental care to prevent the infection from spreading and causing more severe health issues.

📌 Recommended Article :

PDF 🔽 Antibiotics and its use in pediatric dentistry: A review ... Good knowledge about the indications of antibiotics is the need of the hour in prescribing antibiotics for dental conditions

C. Common Severe Acute Dental Infections
° Pericoronitis: This infection occurs around the crown of a partially erupted tooth, often a wisdom tooth. Symptoms include redness, swelling, and pain in the gums. If untreated, it can lead to severe complications like Ludwig's angina or sepsis.
° Acute Dentoalveolar Abscess: A localized collection of pus in the alveolar bone at the root apex of a tooth, typically resulting from untreated dental caries or trauma. Symptoms include intense pain, swelling, and tenderness. Treatment involves drainage of the abscess and addressing the source of infection.
° Cellulitis: A diffuse inflammation of the soft tissues that can spread rapidly, leading to swelling, redness, and severe pain. It may result from untreated dental abscesses and can progress to life-threatening conditions if not managed promptly.

D. Treatment of Dental Infections
The primary goal in treating dental infections is to eliminate the source of infection and prevent its spread. Treatment strategies include:
° Drainage of Abscess: Incision and drainage procedures are performed to release pus and reduce pressure. This can be achieved through root canal therapy or tooth extraction, depending on the severity and location of the infection.
° Antibiotic Therapy: Antibiotics are prescribed to control and eradicate bacterial infections, especially if there are signs of systemic involvement or if the infection is spreading. The choice of antibiotic depends on the severity of the infection, patient age, and any known allergies. It's crucial to follow local guidelines and consult with a healthcare professional for individualized treatment plans.

📌 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

E. Commonly Used Antibiotics and Dosages
1. For Adults:
° Amoxicillin: 500 mg every 8 hours or 1,000 mg every 12 hours.
° Clindamycin: 300 mg or 600 mg every 8 hours.
° Metronidazole: 500–750 mg every 8 hours.
2. For Children:
° Amoxicillin:
1–11 months: 125 mg every 8 hours.
1–4 years: 250 mg every 8 hours.
5–11 years: 500 mg every 8 hours.
° Phenoxymethylpenicillin:
1–5 years: 125 mg every 6 hours.
6–11 years: 250 mg every 6 hours.
For severe infections, consider 12.5 mg/kg (max. 1 g) every 6 hours.
° Metronidazole:
1–2 years: 50 mg every 8 hours.
3–6 years: 100 mg every 12 hours.
7–9 years: 100 mg every 8 hours.
10–17 years: 200 mg every 8 hours.
For severe infections or children at extremes of body weight, consider 30 mg/kg (max. 1 g) every 8 hours.

📌 Recommended Article :

Video 🔽 How to Reduce a TMJ Dislocation? ... Dislocation of the temporomandibular joint is a painful condition that occurs when the mandibular condyle becomes fixed in the anterosuperior aspect of the articular eminence

Conclusions
Effective management of severe acute dental infections involves timely diagnosis, appropriate antibiotic therapy, and, when necessary, surgical intervention. Adhering to recommended antibiotic regimens and dosages is crucial to ensure efficacy and minimize the risk of resistance. Always consider patient-specific factors, such as age, weight, and allergy history, when selecting an antibiotic. Consultation with dental and medical professionals is essential for optimal patient outcomes.

You may also like :
► Correct use of analgesics and anti-inflammatories in pediatric dentistry - Indications and secondary effects
► Appropriate use of antibiotics in pediatric odontogenic infections
► What is Ludwig's Angina? What are the symptoms and treatment?

Occlusal Splints: Types, Benefits, and Who Needs Them

Occlusal splints, also known as bite guards, night guards, or dental orthotics, are removable dental devices that cover the occlusal (biting) surfaces of teeth. They are used to manage conditions such as bruxism (teeth grinding), temporomandibular joint disorders (TMDs), and excessive dental wear.

📌 Recommended Article :

Video 🔽 How to Reduce a TMJ Dislocation? ... Dislocation of the temporomandibular joint is a painful condition that occurs when the mandibular condyle becomes fixed in the anterosuperior aspect of the articular eminence

A. Purpose of Occlusal Splints
Occlusal splints serve several key functions:
° Protecting Teeth from Wear: They act as a protective barrier between the upper and lower teeth, preventing enamel erosion and fractures caused by grinding.
° Reducing Jaw and Muscle Pain: By repositioning the jaw and alleviating pressure on the TMJ, they help relieve pain and muscle tension.
° Preventing Further Dental Damage: Patients with bruxism or TMD can experience cracked or worn-down teeth; splints help mitigate this risk.

Advertisement

B. Types of Occlusal Splints
There are different types of occlusal splints, depending on the patient’s needs:
° Stabilization Splints – Also called flat-plane splints, these are used to prevent bruxism and relieve muscle tension.
° Repositioning Splints – These are designed to reposition the lower jaw to relieve TMJ discomfort.
° Soft Splints – Made of a softer material, these are typically used for mild bruxism cases.
° Dual-Laminate Splints – A combination of hard and soft materials, offering comfort and durability.

📌 Recommended Article :

Video 🔽 What are the consequences of bruxism? ... In many cases, the patient does not know that he suffers from bruxism, and is detected when he attends the dentist motivated by another consultation

C. Materials Used in Occlusal Splints
Occlusal splints are typically made from the following materials:
° Hard Acrylic Resin (PMMA - Polymethyl Methacrylate): The most common material, it is highly durable and provides excellent stability.
° Thermoplastic Materials: Softer and flexible, these materials offer more comfort but are less durable.
° EVA (Ethylene Vinyl Acetate): Used in softer night guards, providing a balance between comfort and protection.
Dual-Layered Materials: Some splints combine a hard outer shell with a soft inner lining for both protection and comfort.

📌 Recommended Article :

Video 🔽 Massage Tutorial: Myofascial release for TMJ/jaw pain ... On this occasion we share with you a video tutorial on massages to relax the muscles involved in this painful TMJ syndrome

D. Who Needs an Occlusal Splint?
Patients who may benefit from occlusal splints include:
° Bruxism Sufferers – Those who grind or clench their teeth, especially at night.
° Patients with TMD – Individuals experiencing jaw pain, clicking sounds, or limited movement of the jaw.
° People with Dental Restorations – Those with veneers, crowns, or implants that need extra protection from excessive force.

📌 Recommended Article :

Article 🔽 Bruxism: A medical or dental issue? ...The parafunctional activities of bruxism cause hypersensitivity in teeth, headaches, painful muscles of the jaw and temporomandibular joint (TMJ)

Conclusion
Occlusal splints are essential devices for protecting teeth, managing jaw disorders, and preventing long-term dental complications. Their effectiveness depends on proper diagnosis and professional customization by a dentist.

References
1. Crout, D. K. (2017). Anatomy of an occlusal splint. General Dentistry, 65(2), 52-56. AGD
2. Okeson, J. P. (2014). Management of Temporomandibular Disorders and Occlusion (7th ed.). Elsevier.
3. Jagger, R. (2003). The effectiveness of occlusal splints for sleep bruxism. Evidence-Based Dentistry, 4(2), 39-40.
4. Wright, E. F. (2014). Occlusal Appliance Therapy. In Manual of Temporomandibular Disorders (pp. 149–222). Wiley-Blackwell.
5. Clark, G. T., & Minakuchi, H. (2006). Oral Appliances. In Laskin, D. M., Greene, C. S., & Hylander, W. L. (Eds.), Temporomandibular Disorders: An Evidence-based Approach to Diagnosis and Treatment (pp. 377–390). Quintessence Publishing.

You may also like :
► Can children suffer from bruxism?
► VIDEO: Signs and symptoms of TMJ disorders
► Bruxism: Why do you need a dental splint?

Enamel Erosion: Causes, Symptoms, Prevention, and Treatment for a Healthy Smile

Enamel erosion is a dental condition characterized by the progressive loss of the tooth's outermost layer, known as enamel. This irreversible process can lead to various oral health issues if not addressed promptly.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

Understanding the causes, symptoms, prevention strategies, consequences, and treatment options is essential for maintaining optimal dental health.

Advertisement

A. Causes of Enamel Erosion
Enamel erosion occurs when acids wear away the enamel on teeth. These acids can originate from external sources, such as certain foods and beverages, or internal sources, like stomach acids. Common causes include:
° Dietary Habits: Frequent consumption of acidic foods and drinks, such as citrus fruits, soft drinks, sports drinks, and wine, can erode enamel.
° Gastroesophageal Reflux Disease (GERD): Stomach acids can reach the mouth and erode enamel in individuals with GERD.
° Frequent Vomiting: Conditions that induce regular vomiting, like bulimia or alcoholism, expose teeth to stomach acids, leading to erosion.
° Dry Mouth (Xerostomia): Saliva helps neutralize acids; reduced saliva production can increase the risk of enamel erosion.

📌 Recommended Article :

Video 🔽 What are the causes of white spots on teeth? ... The white spots have the appearance of intense white clouds on the enamel surface, which affects aesthetics and in some cases shows poor oral hygiene

B. Symptoms of Enamel Erosion
As enamel erosion progresses, individuals may experience:
° Sensitivity: Heightened sensitivity to hot, cold, or sweet foods and beverages.
° Discoloration: Teeth may appear yellowish due to the exposure of underlying dentin.
° Rounded or Transparent Edges: The edges of teeth may become smooth, rounded, or translucent.
° Cracks and Chips: Teeth may become more susceptible to cracking or chipping.

📌 Recommended Article :

PDF 🔽 Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review ... The application of fluoride varnish is an effective method against tooth decay that can appear in the primary or permanent dentition. It is also effective in treatments against tooth sensitivity

C. Prevention of Enamel Erosion
Preventive measures are crucial to protect enamel from erosion:
° Limit Acidic Intake: Reduce the consumption of acidic foods and beverages.
° Use a Straw: When drinking acidic beverages, use a straw to minimize contact with teeth.
° Rinse After Eating: Rinse the mouth with water after consuming acidic substances to neutralize acids.
° Maintain Good Oral Hygiene: Brush twice daily with fluoride toothpaste and floss regularly.
° Regular Dental Check-ups: Visit the dentist routinely for professional cleanings and assessments.

📌 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

D. Consequences of Enamel Erosion
If left untreated, enamel erosion can lead to:
° Increased Tooth Decay: Weakened enamel makes teeth more prone to cavities.
° Advanced Tooth Wear: Significant loss of tooth structure can occur, affecting appearance and function.
° Tooth Fractures: Thinned enamel increases the risk of teeth cracking or breaking.

E. Treatment of Enamel Erosion
While enamel cannot be regenerated, treatments aim to prevent further erosion and restore tooth function:
° Fluoride Treatments: Topical fluoride can strengthen remaining enamel and reduce sensitivity.
° Dental Bonding: Application of tooth-colored resin can protect damaged areas and improve aesthetics.
° Crowns or Veneers: In severe cases, coverings may be placed over affected teeth to restore appearance and function.

You may also like :
► Severe early childhood caries: an integral approach
► Tooth Development and Eruption - Odontogenesis
► ORAL HYGIENE : How to care for your baby's gums

Management of Severe Acute Dental Infections

Severe acute dental infections are a critical concern in dentistry, as they can progress rapidly, causing systemic complications and posing a life-threatening risk if not managed promptly.

📌 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

This article provides an overview of the etiology, clinical presentation, and management strategies for severe dental infections, emphasizing evidence-based approaches.

Advertisement

A. Etiology and Pathogenesis
Severe dental infections are often caused by bacterial invasion into the dental pulp or surrounding structures. Common sources include:
° Untreated dental caries: Progression into pulpitis and periapical abscess.
° Periodontal infections: Spread to adjacent tissues.
° Traumatic injuries: Leading to necrosis of the pulp.
° Post-surgical complications: Including infections after extractions or implant placement.
The most frequently implicated bacteria are anaerobic organisms such as Prevotella and Fusobacterium, often in polymicrobial infections.

📌 Recommended Article :

PDF 🔽 Odontogenic facial cellulitis in a pediatric patient - Medical-dental management considerations ... We share an article that details the clinical characteristics, pharmacological and multidisciplinary management of odontogenic facial cellulite in children

B. Clinical Presentation
Patients with severe dental infections typically present with:
° Localized swelling: Often associated with pain and erythema.
° Fever and malaise: Indicating systemic involvement.
° Trismus and dysphagia: In cases of space infections such as Ludwig’s angina.
° Fluctuant abscesses or purulent drainage.
In advanced cases, airway compromise may occur, necessitating emergency intervention.

C. Management Strategies
1. Early Diagnosis
Timely identification of infection severity is crucial. Clinical examination, imaging (e.g., periapical radiographs, CT scans), and laboratory tests (e.g., white blood cell count) help guide diagnosis.
2. Drainage and Debridement
The cornerstone of treatment is surgical drainage to evacuate pus and relieve pressure. This may involve:
° Incision and drainage (I&D) of abscesses.
° Endodontic therapy: For infections localized to the pulp.
° Tooth extraction: For non-restorable teeth.
3. Antibiotic Therapy
Antibiotics are essential when systemic involvement is evident. Empiric therapy targets anaerobes and includes:
° Amoxicillin-clavulanate.
° Clindamycin (for penicillin-allergic patients).
°Metronidazole, in combination with penicillin or other broad-spectrum antibiotics.
Antibiotics should be adjusted based on culture and sensitivity results if available.
4. Supportive Care
° Analgesics: Non-steroidal anti-inflammatory drugs (NSAIDs) for pain control.
° Hydration and nutrition: To prevent systemic deterioration.
° Hospitalization: In cases of airway compromise, systemic sepsis, or failure of outpatient management.
5. Referral to Specialists
Complex infections, such as those involving the deep cervical spaces or spreading to the mediastinum, require multidisciplinary management by oral and maxillofacial surgeons, otolaryngologists, or infectious disease specialists.

📌 Recommended Article :

PDF 🔽 Odontogenic facial cellulitis in a pediatric patient - Diagnosis, treatment and multidisciplinary management ... Facial cellulite spreads to other anatomical regions, aponeurotic plane and tissue spaces. Clinically, facial cellulite is of a soft consistency and with inflammatory signs

D. Prevention
Preventive strategies include regular dental check-ups, patient education on oral hygiene, and prompt treatment of early dental caries or periodontal disease.

E. Conclusion
Severe acute dental infections demand swift and comprehensive management to prevent serious complications. Clinicians should focus on early diagnosis, appropriate surgical intervention, effective antimicrobial therapy, and interdisciplinary care in complex cases.

References
1. Flynn, T. R. (2006). Oral and maxillofacial infections: Current therapy. Oral and Maxillofacial Surgery Clinics of North America, 18(4), 493-511.
2. Brook, I. (2011). *Microbiology and management of endodontic infections in children. Journal of Clinical Pediatric Dentistry, 36(2), 189-193.
3. Kuriyama, T., et al. (2000). *Factors affecting the clinical outcome of odontogenic infections. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 90(1), 95-100.

📌 More Recommended Items

► What is odontogenic infection? - Symptoms, diagnosis and treatment
► What is dental abscess? - Causes, diagnosis and treatment
► What is pericoronitis? Causes, symptoms and treatment

Myths About Root Canal Treatment

Root canal treatment, or endodontic therapy, is a common dental procedure aimed at preserving natural teeth by treating infections or damage within the tooth's pulp. Despite its prevalence and success, several myths persist, causing unnecessary fear and misunderstanding among patients.

📌 Recommended Article :

Video 🔽 Pulpotomy of Deciduous Molar - Step by step ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

This article addresses and debunks these common misconceptions, providing accurate information to promote informed decisions about dental health.

Advertisement

Myth 1: Root Canal Treatment Is Extremely Painful
A prevalent myth is that root canal procedures are excruciatingly painful. This belief often stems from outdated perceptions of dental treatments. In reality, advancements in dental technology and anesthesia have significantly minimized discomfort. Most patients report that undergoing a root canal is no more painful than getting a standard filling. The application of effective local anesthetics ensures that the area is thoroughly numbed, leading to a comfortable experience during the procedure.

Myth 2: Tooth Extraction Is Better Than a Root Canal
Some individuals believe that extracting a problematic tooth is preferable to saving it through a root canal. However, preserving natural teeth is generally the best option for maintaining optimal dental function and health. Tooth extraction can lead to additional issues, such as shifting teeth, difficulty chewing, and potential bone loss in the jaw. Moreover, replacing an extracted tooth with a bridge or implant often involves more complex procedures and higher costs compared to a root canal treatment.

📌 Recommended Article :

Video 🔽 What is the difference between apexogenesis and apexification? The apex opening is usually very large in an immature tooth, and the canal walls are very thin, so appropriate treatment must be performed

Myth 3: Root Canal Treatment Causes Illness
A persistent myth suggests that root canal treatments can lead to systemic diseases. This misconception originates from outdated research that has been thoroughly debunked. Current scientific evidence indicates no correlation between root canal-treated teeth and conditions such as heart disease or arthritis. Organizations like the American Dental Association affirm that root canal procedures are both safe and effective, focusing on eliminating infection and preserving the natural tooth.

Myth 4: Root Canal-Treated Teeth Are Weak and Inevitably Fail
There is a common belief that teeth undergoing root canal treatment become brittle and are more likely to fail over time. While the removal of the tooth's pulp does eliminate its nerve supply, this does not render the tooth weak. With proper restoration, such as the placement of a crown or filling, and adherence to good oral hygiene practices, a root canal-treated tooth can function effectively and last a lifetime. The success rate of root canal treatments is notably high, often exceeding 95%.

📌 Recommended Article :

Video 🔽 Technique for Primary Molar Tooth Pulpotomy The treatment of dental pulp is not only carried out when there is caries, it is also carried out when the tooth is blown

Myth 5: Root Canal Treatment Is Only Necessary When Severe Pain Is Present
Many assume that a root canal is only required when experiencing severe tooth pain. However, a tooth may need a root canal even in the absence of pain. For instance, a tooth can be infected or dead without causing noticeable discomfort. Regular dental check-ups are crucial for detecting such issues early, allowing for timely intervention before more severe symptoms or complications arise.

Conclusion
Understanding the facts about root canal treatment is essential for dispelling myths that may cause unnecessary anxiety. Modern endodontic procedures are designed to be safe, effective, and as comfortable as possible. Preserving natural teeth through root canal therapy not only maintains dental function but also contributes to overall oral health. Consulting with dental professionals and relying on evidence-based information can help patients make informed decisions regarding their dental care.

References
- American Association of Endodontists. (n.d.). Root canal treatment: Frequently asked questions. Retrieved from https://www.aae.org/patients/root-canal-treatment/
- Ekdantam Dental Clinic. (n.d.). Common myths about root canal treatment. Retrieved from https://www.ekdantamclinic.com/common-myths-about-root-canal-treatment/
- Dr. D's Dentistry. (2024, September 2). 10 myths about root canal treatment: Debunked by dentists. Retrieved from https://drdsdentistry.com/10-myths-about-root-canal-treatment-debunked/

📌 More Recommended Items

► Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy
► Root Canal Treatment for children
► Apexogenesis: Step by step procedure

Root Canal Treatment for children

To perform a root treatment, the morphological characteristics of the primary tooth must be known. Keep in mind that caring for a child is more complex, so a correct anesthesia technique should be performed.


Although the basic aims of endodontic therapy in children are the same as those in adults, ie the removal of infection and chronic inflammation and thus the relief of associated pain, there are particular difficulties and considerations.

RECOMMENDED VIDEO
Mandibular Block for Pediatric Patients - Dental Injection Technique

👉 Read and download the full article "Root Canal Treatment for children" in PDF👈

Souce : nature.com
Authors : Carrotte, P. Endodontic treatment for children. Br Dent J 198, 9–15 (2005).

You may also like :
► Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry
► Pulpotomy of Deciduous Molar - Step by step

Secondary brain abscess in an 11-year-old boy due to a dental infection

This is the case of an abscess of a primary molar that is related to a brain abscess in an 11-year-old boy. The patient presented to the emergency for a headache and was discharged with a diagnosis of migraine.


In the article you can find out about the entire dental medical procedure that was carried out in order to determine the diagnosis and treatment of the child under 11 years old. We share the article by Drs Hibberd and Nguyen.

READ FULL ARTICLE HERE

Souce / Image : Canadian Dental Association
Authors : Christine E. Hibberd , BA (Hons), DMD ; Trang D. Nguyen , DDS

You may also like :
► Maryland bridge : How to do it?
► DENTAL PROSTHESES: What is the difference between ceramic, porcelain and metal crowns?

CORONAVIRUS : What to do if there is a dental emergency during the lockdown?

Quarantine is a measure that was imposed for the care of the population, since March 23, we cannot leave if it is not strictly necessary.

This obviously causes concern for our well-being and that of our family.


During this period we are not exempt from suffering from some type of dental emergency, therefore, it is important to know how to contact your dentist, know what services they continue to provide and what to do if a dental emergency occurs while isolating yourself.

READ FULL ARTICLE HERE

Souce : Phoebe Jobling / manchestereveningnews.co.uk

You may also like :
► Maryland bridge : How to do it?
► DENTAL PROSTHESES: What is the difference between ceramic, porcelain and metal crowns?