Mostrando entradas con la etiqueta Oral Surgery. Mostrar todas las entradas
Mostrando entradas con la etiqueta Oral Surgery. Mostrar todas las entradas

domingo, 13 de julio de 2025

Indications and Contraindications of Serial Extractions in Pediatric Dentistry: Updated Clinical Guide

Serial Extractions

Serial extractions are a preventive orthodontic procedure used to manage severe crowding by sequentially removing selected primary and permanent teeth. Correct case selection is essential to ensure long-term success and avoid complications.

📌 Recommended Article :
Video 🔽 I wear braces and my gums are swollen, why? ... The brackets accumulate a greater amount of food remains, so patients should keep in mind that they are obliged to maintain adequate and constant oral hygiene, and with all the hygiene items recommended by their doctor.
This article reviews the clinical importance, key indications and contraindications, and current recommendations based on recent scientific evidence.

Advertisement

Clinical Importance of Serial Extractions
Serial extractions help manage space deficiencies during mixed dentition, guiding permanent teeth into more favorable positions. When indicated appropriately, they can:

° Reduce the need for complex orthodontic treatments in adolescence.
° Minimize treatment duration and need for permanent extractions later.
° Maintain balanced facial growth and dental function.

As Proffit et al. (2019) highlight, interceptive orthodontics, including serial extractions, plays a crucial role in guiding proper occlusal development in growing patients.

📌 Recommended Article :
Video 🔽 ORTHODONTICS : Serial extraction of primary teeth ... This procedure is part of an orthodontic planning, in which there must previously be a series of studies to decide which pieces are going to have to be extracted.
Indications for Serial Extractions
Serial extractions are recommended when the following conditions are met:

1. Severe Crowding (>4–5 mm per quadrant)
The primary indication is significant space deficiency that prevents proper eruption of permanent teeth.

2. Negative Tooth–Arch Size Discrepancy
When the total mesiodistal width of permanent teeth exceeds the basal arch length, serial extractions help achieve alignment.

3. Altered or Asynchronous Eruption Patterns
When the eruption sequence is delayed or misaligned, especially in anterior segments, creating space can improve outcomes.

4. Skeletal Class I Pattern
Serial extractions are most effective in patients with normal skeletal growth and no vertical or sagittal disharmonies.

5. Ideal Age: 8–11 Years (Early Mixed Dentition)
The ideal timing is when the first permanent molars and incisors are present, and canines and premolars are developing.

📌 Recommended Article :
Video 🔽 How we can manage orthodontic pain and discomfort? ... Another discomfort that is generated during treatment is pain, and this video gives you a series of recommendations to deal with that painful process.
Contraindications for Serial Extractions
This procedure is not recommended in the following situations:

1. Skeletal Malocclusions (Class II or III)
Patients with significant jaw discrepancies, open bites, deep bites, or crossbites may require orthopedic intervention instead.

2. Presence of Harmful Oral Habits
Thumb sucking, tongue thrust, or mouth breathing must be addressed first, as they can compromise treatment outcomes.

3. Hypodontia or Congenitally Missing Teeth
Teeth should not be extracted if others are absent, as this may worsen spacing or occlusal issues.

4. Mild Crowding or Adequate Arch Space
Unnecessary extractions may cause undesirable gaps or misalignment in otherwise manageable dentitions.

5. Eruption Anomalies or Tooth Impactions
Ectopic eruptions or impacted teeth may require surgical exposure or space creation through other orthodontic means.

📌 Recommended Article :
Video 🔽 Can Someone With Periodontal Disease Get Braces? ... The orthodontist will examine the oral health of the patient, that means that the patient must not have cavities and neither gingivitis or periodontitis.
Updated Clinical Recommendations

° Comprehensive diagnostic workup is essential: panoramic and cephalometric X-rays, dental cast analysis, and space evaluation.
° Collaborate with an orthodontist early in treatment planning.
° Educate parents and caregivers about the rationale, timeline, and phases of serial extraction.
° Ensure long-term follow-up to monitor permanent tooth eruption and intervene if deviations occur.

📌 Recommended Article :
Video 🔽 How To Deal With Braces Discomfort - Animated video ... Rubbing the bracket on the mucosa, canker sores, a wire poking, a wire comes out of a bracket or a bracket comes off, are some of the discomforts that the patient will refer to throughout the treatment.
💬 Discussion
When applied correctly, serial extractions can greatly reduce future treatment complexity. However, inappropriate indication—such as in skeletal malocclusion cases—may lead to unwanted effects, such as arch collapse or residual spacing. The procedure does not replace orthodontic treatment but is rather a preventive adjunct to simplify it (Jarjoura et al., 2020).
Current research supports the effectiveness of serial extractions in well-selected Class I cases. Multidisciplinary coordination and long-term monitoring are key to avoiding complications and ensuring occlusal harmony.

💡 Conclusion
Serial extractions remain a valuable strategy in pediatric orthodontics, but only when properly indicated. Understanding both indications and contraindications allows clinicians to plan treatment safely and predictably. When combined with accurate diagnosis and follow-up, this preventive approach can optimize dental development and reduce the need for future interventions.

📚 References

✔ Jarjoura, K., Goonewardene, M., & Fleming, P. S. (2020). Serial extraction in orthodontics: A systematic review of effectiveness and efficiency. Orthodontics & Craniofacial Research, 23(2), 122–131. https://doi.org/10.1111/ocr.12338

✔ Proffit, W. R., Fields, H. W., Larson, B., & Sarver, D. M. (2019). Contemporary Orthodontics (6th ed.). Elsevier.

✔ Singh, G., & Clark, W. (2018). Interceptive orthodontics: Key concepts and clinical applications. Dental Clinics of North America, 62(3), 457–471. https://doi.org/10.1016/j.cden.2018.03.002

📌 More Recommended Items

Oral breathing: new early treatment protocol
How Does Myobrace Work? - Video
Clear Aligners for Early Treatment of Anterior Crossbite - Indications and Benefits

viernes, 11 de julio de 2025

Serial Extractions in Pediatric Dentistry: Clinical Phases, Benefits, and Updated Guidelines

Serial Extractions

Serial extractions are a preventive orthodontic technique used to manage severe crowding in mixed dentition. By removing selected primary and permanent teeth in a planned sequence, clinicians can guide the eruption and alignment of permanent teeth.

📌 Recommended Article :
Video 🔽 How we can manage orthodontic pain and discomfort? ... Another discomfort that is generated during treatment is pain, and this video gives you a series of recommendations to deal with that painful process.
This article provides an evidence-based review of the clinical phases of serial extractions, their benefits, indications, and current recommendations.

Advertisement

What Are Serial Extractions?
Serial extractions refer to the planned and sequential removal of selected primary and permanent teeth to address space discrepancies and facilitate proper eruption of permanent teeth (Proffit et al., 2019). This interceptive orthodontic approach is typically used in children aged 8 to 11 with moderate to severe crowding, where early intervention may reduce the need for complex orthodontic treatment in adolescence.

Why Are Serial Extractions Important?
Properly timed serial extractions can provide several key benefits:

° Prevent severe malocclusions.
° Reduce treatment time and complexity in future orthodontic therapy.
° Support balanced facial aesthetics and functional occlusion.
° Minimize the need for extraction of permanent teeth later in adolescence.

Long-term studies show that patients who undergo serial extractions have more stable outcomes compared to those treated with orthodontic appliances alone (Valentine & Howitt, 2019).

📌 Recommended Article :
Video 🔽 Importance of Early Orthodontic Treatment: 'Underbites' ... Proper tooth alignment keeps you from biting your cheeks, lips, or tongue when you eat. There are several factors that could cause a person to develop an underbite.
Phases of the Serial Extraction Protocol

1. Diagnostic Phase
An accurate diagnosis is critical for success. The initial assessment should include:
° Clinical evaluation and dental history.
° Panoramic and cephalometric X-rays.
° Dental model analysis and space assessment.
° Measuring tooth–arch discrepancies.
Candidates for serial extraction typically present more than 4 mm of crowding per quadrant, without skeletal anomalies (Jarjoura et al., 2020).

2. Phase I: Extraction of Primary Teeth
° Common teeth removed: Primary canines and first molars.
° Goal: Facilitate the eruption and alignment of permanent incisors and canines.
° Best timing: Around ages 8–9, with radiographic confirmation of permanent tooth development.

3. Phase II: Extraction of Permanent Premolars (If Needed)
° Indicated in cases of persistent crowding after incisors and canines have erupted.
° Typically performed between ages 10–11, once two-thirds of premolar root formation is complete.
° Must consider periodontal health and adjacent tooth position.

4. Phase III: Orthodontic Guidance and Monitoring
° Use of fixed or removable appliances to guide final alignment.
° Monitoring eruption and alignment every 4–6 months.
° Making necessary adjustments to the treatment plan based on eruption patterns.

📌 Recommended Article :
Video 🔽 Can Someone With Periodontal Disease Get Braces? ... Orthodontics is the dental specialty that is responsible for preventing and correcting changes in occlusion and maxillary position. Previously, the patient must be examined and evaluated by the orthodontist.
Updated Clinical Recommendations

° Serial extraction should always follow thorough orthodontic planning.
° Multidisciplinary collaboration between pediatric dentists and orthodontists is crucial.
° Families should be fully informed of the steps, benefits, and timeline of treatment.
° Continued monitoring is essential until eruption of all permanent teeth.

📌 Recommended Article :
Video 🔽 How To Deal With Braces Discomfort - Animated video ... Rubbing the bracket on the mucosa, canker sores, a wire poking, a wire comes out of a bracket or a bracket comes off, are some of the discomforts that the patient will refer to throughout the treatment.
💬 Discussion
While highly effective in selected cases, serial extractions are not suitable for all patients. They do not correct skeletal discrepancies, and thus are not indicated in patients with Class II or Class III malocclusions, open bites, or significant jaw misalignments.
When properly implemented, serial extractions can simplify future orthodontic treatment and improve long-term stability. Clinical evidence supports their use in cases of severe crowding with favorable growth patterns (Proffit et al., 2019; Jarjoura et al., 2020).

💡 Conclusion
Serial extractions are a valuable early intervention technique in pediatric dentistry and orthodontics. With careful diagnosis, proper case selection, and phase-specific monitoring, this protocol offers a predictable and efficient way to manage space discrepancies and support ideal dental development. Incorporating this approach can lead to improved long-term functional and aesthetic outcomes.

📚 References

✔ Jarjoura, K., Goonewardene, M., & Fleming, P. S. (2020). Serial extraction in orthodontics: A systematic review of effectiveness and efficiency. Orthodontics & Craniofacial Research, 23(2), 122–131. https://doi.org/10.1111/ocr.12338

✔ Proffit, W. R., Fields, H. W., Larson, B., & Sarver, D. M. (2019). Contemporary Orthodontics (6th ed.). Elsevier.

✔ Valentine, F., & Howitt, J. W. (2019). Long-term outcomes of serial extraction: A 20-year follow-up. American Journal of Orthodontics and Dentofacial Orthopedics, 155(3), 411–419. https://doi.org/10.1016/j.ajodo.2018.06.015

📌 More Recommended Items

What are impacted canines? - Treatment
6 signs that your child may need early orthodontic treatment
Causes of Gum problems with braces

martes, 8 de julio de 2025

Dental Implants: What They Are, How They're Placed, and How Long They Last

Dental Implants

Dental implants are one of the most effective and long-lasting solutions for replacing missing teeth. With modern technology and evidence-based protocols, implants offer a stable, aesthetic, and functional alternative for restoring smiles.

📌 Recommended Article :
Video 🔽 Prevention of peri-implantitis - 3D Video ... Prevention is the best way to avoid peri-implantitis, thus ensuring the permanence and stability of the dental implant. Let's see this interesting 3D video
This article explains what dental implants are, how they’re placed, how long they last, and how to care for them to ensure their long-term success.

Advertisement

What Are Dental Implants?
A dental implant is a titanium post surgically inserted into the jawbone, acting as an artificial tooth root. Once healed, it serves as the base for a dental crown, bridge, or denture.
Titanium is biocompatible, meaning it integrates naturally with the bone through a process called osseointegration. This provides strong support for prosthetic teeth and helps preserve bone structure. According to recent clinical studies, dental implants have a success rate of over 95% (Moraschini et al., 2021).

How Are Dental Implants Placed?
The implant process typically involves several steps and may take a few months to complete:

1. Initial Assessment:
A thorough dental exam, including 3D imaging, is done to evaluate bone volume and develop a treatment plan.
2. Surgical Placement:
Under local anesthesia, the implant is placed into the jawbone through a small incision. The procedure usually takes 30–60 minutes per implant.
3. Healing and Osseointegration:
Over the next 3–6 months, the bone heals and integrates with the implant, forming a stable foundation.
4. Abutment and Crown Placement:
Once osseointegration is complete, a connector (abutment) is attached to the implant, followed by a custom-made crown.

📌 Recommended Article :
Video 🔽 What is Peri-implantitis and how do we prevent it? 3D video ... Professional evaluation is important to determine peri-implantitis, but there are signs and symptoms that the patient may notice and that motivate him to see the specialist
How Long Do Dental Implants Last?
On average, dental implants last 15 to 25 years, and many can last a lifetime with proper care. Several factors influence their longevity:

° Patient's overall health and oral hygiene
° Quality of surgical technique and materials
° Smoking and alcohol use
° Presence of chronic diseases (e.g., diabetes, osteoporosis)
° Regular dental checkups

A 2023 systematic review found a 94.6% implant survival rate after 10 years (Jung et al., 2023).

📌 Recommended Article :
Video 🔽 Dental Implants Post-Op Instructions ... Currently, surgical techniques ensure good results, but the patient must collaborate with the post-operative process
Best Practices for Implant Maintenance
To keep your implants healthy and functional long-term, follow these essential recommendations:

° Brush twice a day with a soft-bristled toothbrush and use interdental brushes or floss.
° Schedule dental cleanings and checkups every 6 months or as advised.
° Avoid smoking, which increases the risk of peri-implantitis (inflammation around implants).
° Manage systemic conditions, especially diabetes and gum disease.
° Use a night guard if you grind your teeth (bruxism).

📌 Recommended Article :
Video 🔽 What's the Difference Between Dental Implants and Bridges? ... A correct evaluation by the dentist ensures a good rehabilitation, the most important thing is that we leave the dental office with a nice smile
💬 Discussion
Dental implants have transformed modern restorative dentistry. They provide unmatched function, aesthetics, and bone preservation when compared to traditional dentures or bridges. However, they require careful planning, maintenance, and patient commitment.
Potential complications such as bone loss, infection, or implant failure are preventable with proper hygiene, follow-up care, and a well-coordinated dental team. Patient education is critical to the long-term success of implant therapy.

💡 Conclusion Dental implants are a reliable and permanent solution for missing teeth. With a high success rate and natural appearance, they restore both function and confidence. Longevity depends on professional care, patient health, and consistent maintenance. When placed and maintained correctly, implants can last a lifetime.

📌 Recommended Article :
Video 🔽 Patient Prevention: Dental Implant Failures ... The patient must be informed before performing the surgery, about the care they should have after the surgical procedure, regarding their diet and hygiene, thus avoiding serious consequences
📚 References

✔ Jung, R. E., Zembic, A., Pjetursson, B. E., Zwahlen, M., & Thoma, D. S. (2023). Systematic review of the survival rate and incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a follow-up of 10 years. Clinical Oral Implants Research, 34(1), 24–38. https://doi.org/10.1111/clr.13930

✔ Moraschini, V., Poubel, L. A. D. C., Ferreira, V. F., & Barboza, E. D. S. P. (2021). Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: A systematic review. International Journal of Oral and Maxillofacial Surgery, 50(6), 767–777. https://doi.org/10.1016/j.ijom.2020.08.012

📌 More Recommended Items

Step-by-Step Dental Implants: A Guide for Patients
Common Complications of Dental Implants: Diagnosis and Treatment Guide
Dental implant: What complications can there be after surgery?

domingo, 6 de julio de 2025

How to Prevent Dry Socket After Tooth Extraction: Signs, Prevention, and Treatment Guide

Dry Socket

Dry socket, or alveolar osteitis, is one of the most common and painful complications following tooth extraction—particularly of mandibular molars. It occurs when the post-extraction blood clot is dislodged or fails to form properly, exposing the underlying bone and nerves.

📌 Recommended Article :
Video 🔽 Tooth Extraction Aftercare Tips ... Before extracting a tooth, the dental surgeon must instruct the patient on pre and post operative care. These recommendations are intended to protect the wound and the healing process
Preventing dry socket is a key responsibility shared by both dental professionals and patients, involving proper surgical technique, patient education, and targeted pharmacological management.

Advertisement

What Is Dry Socket?
Dry socket is a localized inflammation of the alveolar bone following the loss or breakdown of the blood clot in the socket. It typically occurs 2 to 5 days after extraction and results in intense pain, delayed healing, and possible infection.

📌 Recommended Article :
PDF 🔽 Guideline on Pediatric Oral Surgery ... Radiographs can include intraoral films and extraoral imaging if the area of interest extends beyond the dentoalveolar complex
Signs and Symptoms
Key clinical features include:

° Severe, throbbing pain that radiates to the ear, jaw, or temple
° Empty-looking socket with exposed bone
° Foul odor or bad taste in the mouth
° Partial or total loss of the blood clot
° Swollen lymph nodes or low-grade fever (less commonly)

Radiographically, no bone destruction is observed, but clinically, the socket appears dry and inflamed.

📌 Recommended Article :
Video 🔽 How To Prevent A Dry Socket ... At the time that the surgical procedure is completed, the surgeon must instruct the patient on the care that must be taken to avoid an infectious process
Risk Factors

° Smoking or tobacco use
° Poor oral hygiene
° Use of oral contraceptives
° Traumatic or complicated extractions
° Previous history of dry socket
° Improper post-op instructions or non-compliance

📌 Recommended Article :
Video 🔽 How is a palatine torus removed? - Step by Step ... The surgical procedure is ambulatory, under local anesthesia, and the postoperative period does not save any major complications as long as you follow the professional's instructions and recommendations
In-Office Prevention Strategies

1. Atraumatic Surgical Technique
° Minimize trauma to the bone and surrounding soft tissue
° Use copious irrigation during extraction to avoid heat-induced bone damage (Bjørnland et al., 2010)
2. Socket Debridement and Saline Irrigation
° Gently irrigate the socket post-extraction to remove debris or bacteria
° Avoid aggressive curettage
3. Antimicrobial Agents
° Application of 0.12% chlorhexidine gel or rinse has shown significant efficacy in reducing dry socket incidence (López-Carriches et al., 2006)
4. Medicated Dressings (when needed)
° Use of eugenol-based pastes in high-risk patients can provide protection and antibacterial effect
5. Proper Suturing
° If appropriate, sutures help stabilize the clot and reduce risk of contamination

📌 Recommended Article :
Dental Article 🔽 Antibiotic Prophylaxis in Pediatric Dentistry: When and How to Use It Safely in 2025 ... Antibiotic prophylaxis in pediatric dentistry is a preventive measure used to avoid serious systemic infections, such as infective endocarditis, in children undergoing dental procedures.
Home Care and Patient Instructions
Aftercare is critical in dry socket prevention. Patients should be instructed to:

° Avoid smoking or vaping for at least 72 hours
° Refrain from spitting, sucking through straws, or vigorous rinsing
° Eat soft, lukewarm foods and avoid hard, spicy, or crunchy foods
° Rinse gently with saline or chlorhexidine, starting 24 hours post-extraction
° Maintain proper oral hygiene, avoiding brushing directly on the surgical site

📌 Recommended Article :
Video 🔽 Post-extraction care for wisdom teeth - Tips and recommendations ... The procedure is outpatient, and the patient must comply with the pre- and post-operative recommendations. These recommendations aim to avoid some complications such as hemorrhages and alveolitis
Pharmacological Support

1. Analgesics
° NSAIDs (e.g., ibuprofen 400–600 mg every 6–8 hours) are first-line for pain control
° For severe pain, acetaminophen + codeine or tramadol may be prescribed temporarily
2. Antibiotics
° Routine prophylactic antibiotics are not recommended unless the patient is immunocompromised or has systemic infection signs
° Topical antibiotics (e.g., tetracycline in socket) may help in high-risk cases (Halabi et al., 2021)
3. Antiseptics
° Chlorhexidine gluconate 0.12% as a rinse or gel pre- and post-operatively to reduce bacterial load

📌 Recommended Article :
PDF🔽 Manual of extraction techniques in pediatric dentistry - Step by step ... We share an article that shows us the anatomical considerations and the appropriate surgical technique when extracting teeth in pediatric patients
Treatment of Established Dry Socket
Once dry socket develops, treatment focuses on symptom relief and promoting healing:

° Irrigation of the socket with warm saline to remove debris
° Application of medicated dressing, such as eugenol-containing pastes (e.g., Alvogyl)
° Pain control with systemic analgesics
° Follow-up visits every 24–48 hours to monitor healing and reapply dressing as needed

Dry socket typically resolves within 7–10 days with appropriate care.

📌 Recommended Article :
PDF/Video 🔽 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
💬 Discussion
Dry socket is a painful yet preventable complication of dental extractions. Although its exact pathophysiology is not fully understood, current evidence supports that bacterial contamination, fibrinolytic activity, and patient behavior all contribute to clot breakdown. Research consistently shows that chlorhexidine use, atraumatic technique, and strong postoperative compliance significantly reduce the risk. Dental professionals must tailor prevention strategies based on individual risk factors, while empowering patients with clear post-op education.

💡 Conclusion
Dry socket prevention requires a combination of clinical precision and effective communication. Dentists should use atraumatic techniques, antiseptic protocols, and evidence-based pharmacological approaches. Patients, on the other hand, play a key role in avoiding risky behaviors post-extraction. Together, these efforts can dramatically reduce the incidence and severity of alveolar osteitis, improving patient comfort and recovery.

📚 References

✔ Bjørnland, T., Kvello, M., & Barkvoll, P. (2010). The effect of chlorhexidine rinse on the incidence of alveolar osteitis after third molar surgery: A prospective randomized study. Acta Odontologica Scandinavica, 68(5), 261–266. https://doi.org/10.3109/00016357.2010.494601

✔ Halabi, M., Barakat, H., Kaddoura, I., & Mahfouz, M. (2021). Prevention and treatment of dry socket: A systematic review. International Journal of Dentistry, 2021, 6631747. https://doi.org/10.1155/2021/6631747

✔ López-Carriches, C., Salido, M. P., & Blanco, C. A. (2006). Prevention of dry socket with chlorhexidine gel. Medicina Oral, Patología Oral y Cirugía Bucal, 11(5), E483–E488. https://www.medicinaoral.com/pubmed/medoralv11_i5_p483.pdf

📌 More Recommended Items

What is pericoronitis? Causes, symptoms and treatment
Ludwig's angina in a pediatric patient - Case report (diagnosis, symptoms and treatment)
Ankyloglossia in infants - Diagnosis and surgical protocol

martes, 1 de julio de 2025

Effective Pediatric Oral Surgery Management: Proven Strategies for a Positive Experience

Oral Surgery

Oral surgery in children—such as extractions, frenectomies, and removal of supernumerary teeth—presents unique challenges. These include dental anxiety, limited communication abilities, and emotional sensitivity.

📌 Recommended Article :
Video 🔽 How To Prevent A Dry Socket ... At the time that the surgical procedure is completed, the surgeon must instruct the patient on the care that must be taken to avoid an infectious process
A successful surgical experience depends on more than clinical technique; it also relies on emotional support, behavior management, and a child-friendly environment. Dental providers must apply comprehensive strategies that meet the developmental, emotional, and psychological needs of young patients.

Advertisement

Pediatric Patient Characteristics in Oral Surgery
Children differ significantly from adults in their response to clinical settings:

° Cognitive development affects their understanding of dental procedures.
° Emotional response includes fear of pain, separation anxiety, and past traumatic experiences.
° Communication skills are often limited, especially in younger children.
° Recognizing these traits is critical in developing patient-centered care strategies.

📌 Recommended Article :
PDF 🔽 Guideline on Pediatric Oral Surgery ... Management of children under sedation or general anesthesia requires extensive training and expertise
Strategies for a Positive Pediatric Oral Surgery Experience

1. Comprehensive Preoperative Assessment
Key steps include:

° Assessing dental anxiety using tools like the Venham Picture Test or FLACC scale.
° Reviewing prior dental experiences and behavior patterns.
° Providing child-friendly explanations with visual aids and interactive models.

2. Behavior Management Techniques
Recommended by the American Academy of Pediatric Dentistry (AAPD):

° Tell-Show-Do: Builds trust and predictability.
° Positive reinforcement: Verbal praise, stickers, or small rewards.
° Voice control: Calm but firm tone to guide behavior.
° Distraction: Videos, music, or storytelling to divert attention.
° Parental presence: Used selectively based on the child's needs and behavior.

📌 Recommended Article :
Video 🔽 How to control bleeding after extraction? ... Post-treatment bleeding is a common complication after tooth extraction, so it is important that the dentist makes recommendations to avoid any type of problems
3. Pharmacologic Management
Used when non-pharmacological techniques are insufficient:

° Nitrous oxide sedation: Safe and widely used for mild to moderate anxiety.
° Oral sedation: Midazolam and similar agents for more significant anxiety.
° General anesthesia: Reserved for extensive procedures or severe dental phobia, typically in a hospital setting.

4. Child-Friendly Dental Environment
Environmental modifications include:

° Soft colors and playful decor in the operatory.
° Dental tools with friendly designs or names.
° Friendly, trained staff skilled in pediatric communication.

📌 Recommended Article :
Dental Article 🔽 8 interesting facts about the Wisdom Tooth ... While they often emerge in late adolescence or early adulthood, their presence and impact on oral health have been subjects of extensive study
5. Effective Communication with Children and Parents
Strong communication builds trust and improves cooperation:

° Clear and simple explanations tailored to the child’s developmental level.
° Transparent discussion of surgical procedures and aftercare with parents.
° Giving the child limited choices (e.g., music selection) to increase their sense of control.

💬 Discussion
Research shows that untreated dental fear in childhood often continues into adulthood, negatively affecting oral health outcomes (Klingberg & Broberg, 2022). Combining behavior management with appropriate sedation techniques significantly reduces anxiety and improves surgical cooperation (Olumide et al., 2021). A child-focused, holistic approach is increasingly recognized as the gold standard in pediatric oral surgery, emphasizing both technical excellence and emotional support.

📌 Recommended Article :
PDF 🔽 Pulpotomy Medicaments used in Deciduous Dentition: An Update ... It is important that all clinicians, particularly for pediatric dentists, be up to date with the recent trends in this area of dental treatment for children
💡 Conclusions
Successful pediatric oral surgery involves more than technical skill. It requires tailored strategies that consider each child’s emotional, psychological, and developmental needs. The integration of behavior management, pharmacological tools, environmental modifications, and effective communication fosters a positive experience that encourages lifelong oral health habits.

📚 References

✔ American Academy of Pediatric Dentistry. (2023). Behavior Guidance for the Pediatric Dental Patient. The Reference Manual of Pediatric Dentistry. https://www.aapd.org/globalassets/media/policies_guidelines/bp_behavior.pdf

✔ Klingberg, G., & Broberg, A. G. (2022). Dental fear/anxiety and dental behaviour management problems in children and adolescents: A review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry, 32(1), 3–9. https://doi.org/10.1111/ipd.12898

✔ Olumide, F., Costa, L. R., & Almeida, E. S. (2021). Behavioral techniques versus pharmacological management in pediatric dental sedation: A systematic review. Pediatric Dentistry, 43(2), 97–105. https://www.aapd.org/research/oral-health-policies--recommendations/behavior-guidance/

✔ Versloot, J., Veerkamp, J. S. J., & Hoogstraten, J. (2020). Children’s coping with pain during dental care. Community Dentistry and Oral Epidemiology, 48(4), 272–278. https://doi.org/10.1111/cdoe.12534

📌 More Recommended Items

Mandibular tumors in pediatric patients. Report of 04 cases of aggressive tumors
Marsupialization of a large mandibular cyst in a pediatric patient - Clinical Case
What is frenectomy? Step by step surgical procedure

jueves, 26 de junio de 2025

Antibiotic Prophylaxis in Pediatric Dentistry: When and How to Use It Safely in 2025

Antibiotic Prophylaxis

Antibiotic prophylaxis in pediatric dentistry is a preventive measure used to avoid serious systemic infections, such as infective endocarditis, in children undergoing dental procedures.

📌 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
The practice is guided by evidence-based protocols from organizations such as the American Heart Association (AHA) and the American Academy of Pediatric Dentistry (AAPD). Its use must be justified, as improper administration increases the risk of adverse effects and antibiotic resistance.

Advertisement

What Is Antibiotic Prophylaxis in Pediatric Dentistry?
This involves the preventive administration of antibiotics before invasive dental procedures in children who are at high risk for systemic infections. The aim is to minimize transient bacteremia that could colonize vulnerable tissues, such as the heart valves, particularly in immunocompromised or medically complex pediatric patients.

Mechanism of Action
Antibiotics used for prophylaxis work by eliminating or reducing oral bacteria that can enter the bloodstream during dental procedures. The antibiotic is given 30–60 minutes before treatment to achieve optimal blood levels.

° Amoxicillin inhibits bacterial cell wall synthesis (bactericidal).
° Clindamycin inhibits bacterial protein synthesis (bacteriostatic or bactericidal depending on concentration).
° Macrolides (azithromycin, clarithromycin) also inhibit protein synthesis and are used in penicillin-allergic patients.

📌 Recommended Article :
PDF 🔽 Guideline on use of antibiotic therapy for pediatric dental patients ... Some microorganisms may develop resistance to a single anti-microbial agent, while others develop multidrug-resistant strains
Clinical Indications

1. High-Risk Cardiac Conditions (Per AHA Guidelines)
Antibiotic prophylaxis is recommended for children with:
° Prosthetic heart valves or materials
° History of infective endocarditis
° Certain congenital heart defects (unrepaired, recently repaired with residual defects, or cyanotic CHD)
° Cardiac transplant recipients with valve disease

2. Immunocompromised Patients
Including those with:
° Cancer undergoing chemotherapy
° Neutropenia
° Organ transplants
° Long-term corticosteroid therapy
° IV bisphosphonate therapy

3. High-Risk Dental Procedures
Prophylaxis is recommended only for invasive procedures such as:
° Tooth extractions
° Periodontal surgery
° Deep scaling and root planing
° Any procedure causing mucosal or gingival bleeding

📌 Recommended Article :
PDF 🔽 Antibiotics and its use in pediatric dentistry: A review ... Antibiotics are among the most frequently prescribed medication for the treatment as well as prevention of bacterial infection in modern medicine
Recommended Antibiotics and Pediatric Dosing


💬 Discussion
Current research and AHA/AAPD guidelines stress that antibiotic prophylaxis should only be used when clinically indicated. Studies have shown that eliminating routine prophylaxis in low-risk patients did not increase the incidence of infective endocarditis. Misuse or overuse contributes to antibiotic resistance, Clostridioides difficile infection, and other complications.
Dentists must evaluate each child’s medical history and assess whether the risk justifies prophylactic use. Furthermore, educating caregivers on the responsible use of antibiotics is essential to support safe dental practices.

💡 Conclusion
Antibiotic prophylaxis in pediatric dentistry is a valuable tool for preventing severe infections but should be limited to patients with specific high-risk conditions. Updated guidelines from the AHA and AAPD emphasize evidence-based decision-making and individual risk assessment. Dental professionals must stay informed and adhere to standardized protocols to ensure the best outcomes for pediatric patients.

📚 References

✔ American Academy of Pediatric Dentistry. (2024). Use of antibiotic therapy for pediatric dental patients. The Reference Manual of Pediatric Dentistry, 533–537.

✔ Wilson, W. R., Gewitz, M., Lockhart, P. B., et al. (2021). Prevention of viridans group streptococcal infective endocarditis: A scientific statement from the American Heart Association. Circulation, 143(20), e963–e978. https://doi.org/10.1161/CIR.0000000000000969

✔ Suda, K. J., Calip, G. S., Zhou, J., et al. (2019). Assessment of the appropriateness of antibiotic prescriptions before dental procedures. JAMA Network Open, 2(5), e193909. https://doi.org/10.1001/jamanetworkopen.2019.3909

✔ Hollingshead, C. M., & Brizuela, M. (2023). Antibiotic prophylaxis in dental and oral surgery practice. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470357/

✔ Zovko Končić, M., & Ivanušić, I. (2024). Antibiotic prophylaxis in dentistry: Recommendations and guidelines. Dentistry Journal, 12(11), 364. https://doi.org/10.3390/dj12110364

📌 More Recommended Items

Severe Dental Infections: Symptoms, Treatment & Antibiotics
Antibiotics in dental infections in children. Which one to use?
Dental pain in pediatric dentistry - Assessment tools

lunes, 16 de junio de 2025

Risk Factors, Signs & Modern Management of Tongue Cancer: 2025 Review

Tongue Cancer

Tongue cancer—primarily squamous cell carcinoma (SCC)—represents a significant portion of head and neck malignancies. Although relatively rare (less than 1 % of new cancer cases), its incidence is rising among younger, non‑smoking populations .

📌 Recommended Article :
Video 🔽 Top 10 Mouth Cancer Symptoms ... The early detection of cancer ensures a better recovery and success of the treatment, for that we must know the warning signs and the changes that happen in our mouth
This review synthesizes risk factors, clinical presentation, diagnostic pathways, treatment modalities, and preventive strategies over the past six years.

Advertisement

Risk Factors

° Tobacco smoking and smokeless tobacco: Primary risk factor; smoking increases risk 3–6× and smokeless forms similarly elevate risk.
° Alcohol consumption: Heavy alcohol use independently increases risk (~20 % of oral cancers), synergizes with tobacco to cause ~72 % of head and neck cancers.
° HPV infection: High-risk strains (HPV‑16/18) are strongly linked to base‑of‑tongue SCC; rising HPV-driven oropharyngeal cancers.
° Betel nut and paan chewing: Doubles oral cancer risk even without tobacco, contributing up to 40 % of cases in endemic regions.
° Chronic inflammation and oral dysbiosis: Emerging research links chronic oral irritation/infections with oxidative stress and carcinogenesis.
° Non-modifiable factors: Includes age (≥ 40), male sex (2× risk), race (higher in African‑American men), family or personal cancer history.

📌 Recommended Article :
Video 🔽 How to identify the early signs of oral cancer ... Like all cancer, it is important to take into account all the signs of its presence to avoid its spread, and that is the reason for this video
Signs & Symptoms

° Non-healing ulcers or sores, red/white patches (erythroplakia, leukoplakia).
° Lumps or thickening on tongue; easy bleeding.
° Pain, burning, numbness, or discomfort in mouth/jaw .
° Functional issues: difficulty chewing, swallowing, speaking; ear, throat, or jaw pain; loose teeth .
° Late-stage signs: neck lymphadenopathy, weight loss, bleeding, voice changes.

Diagnosis

° Clinical exam: Visual and manual inspection, mirror or endoscopic (nasendoscopy) evaluation.
° Biopsy & histopathology: Essential for definitive diagnosis. HPV testing often included.
° Imaging: CT, MRI, ultrasound, PET‑CT to assess tumor extent and lymph node involvement.

📌 Recommended Article :
Video 🔽 The Importance of Dental Health During Cancer Treatment ... Knowledge is our best prevention weapon, that's why we share an interesting article that explains in detail the complications that can occur during cancer treatment and how we can prevent it
Treatment

° Surgery: Primary for early-stage disease; transoral resections for oral tongue; neck dissection as needed.
° Radiation therapy: Often adjuvant post-surgery or primary modality for advanced/inoperable cases.
° Chemotherapy & chemoradiation: Platinum-based regimens, especially for HPV-negative or bulky disease .
° Targeted therapies & immunotherapy: Emerging modalities; microenvironment-targeted immunotherapy under study.
° Supportive care: Speech/swallow rehabilitation, nutritional support to manage side effects.

Prevention

° Smoking cessation and reduced alcohol intake are the most effective strategies.
° HPV vaccination (recommended through age 45) may reduce HPV-driven tongue cancer.
° Avoid betel nut/paan; improve oral hygiene and diet (fruit/vegetable intake).
° Regular dental/oral screenings with prompt evaluation of lesions persisting >2–3 weeks .

📌 Recommended Article :
Video 🔽 What are Oral Potentially Malignant Disorders? ... Early detection is recommended in these cases, in this way we prevent neoplasms from developing and increase the possibility of successful treatment
💬 Discussion

Recent epidemiological trends indicate an increase in tongue cancer among young, non-smoking individuals, highlighting the growing importance of HPV and alternative risk factors. Concurrently, advancements in diagnostic imaging, minimally invasive surgical techniques, and immunotherapies offer improved outcomes and functional preservation. However, challenges persist: late-stage presentation, therapy-related toxicity, and disparities in access to HPV vaccination and specialist care.

💡 Conclusion

Tongue cancer is a multifactorial disease shaped by lifestyle, viral, environmental, and biological determinants. Contemporary understanding underscores the interplay of traditional risks—tobacco and alcohol—with newer drivers like HPV, chronic inflammation, and betel nut use. Early detection and a multidisciplinary treatment approach remain paramount. Preventive measures, especially smoking cessation, alcohol reduction, and HPV vaccination, are critical for reducing incidence.

📚 References

✔ American Cancer Society. (2021). Risk Factors for Oral Cavity and Oropharyngeal Cancers. Retrieved from American Cancer Society website.

✔ Cleveland Clinic. (2023). Tongue cancer: symptoms, causes & treatment. Cleveland Clinic.

✔ Mayo Clinic Staff. (2025, November). Tongue cancer: symptoms and causes. Mayo Clinic.

✔ Current trends on prevalence, risk factors and prevention of oral... Frontiers in Oral Health, 2024.

✔ Exploration Pub. (2024). Risk factors, prevention, diagnosis, and immunotherapy’s role in oral cancer.

✔ Verywell Health. (2024, April 22). Tongue Cancer: Everything You Need to Know.

✔ New York Post. (2025, May). Top Chef alum Shirley Chung cancer update.

📌 More Recommended Items

Warning signs of oral cancer - Identify and recognize the symptoms and lesions
Oral cancer: Risk factors, management, procedures and types of treatment
Why did oral HPV cases increase in men?