4 Most Common Types of Dental Surgery in Children

Dental surgery in children isn't a frequent practice but sometimes it is necessary. We'll tell you about the most common procedures.

Reviewed and approved by the dentist Vanesa Evangelina Buffa.

Written by Vanesa Evangelina Buffa

Last update: 11 October, 2022

In pediatric dental care, surgical procedures aren’t very common. However, dental surgery in children may be a necessity to solve some diseases in the mouth of little ones.

The circumstances that warrant this treatment are varied. From badly destroyed or traumatized teeth, extra teeth, difficulties in the natural eruption of the teeth, or problems having to do with the frenulum.

Here are the 4 most common types of dental surgery in childhood.

1. Exodontia or simple dental extractions

Dental extraction is a surgical act in which a tooth is removed from the infant’s mouth. Due to the conservative and preventive posture of recent times, it’s an increasingly less frequent dental surgery in children.

Therefore, this practice is reserved only for specific and strictly necessary cases, as it requires the use of local anesthesia, cuts in the gums, and the use of elements or maneuvers that can cause anxiety and fear in the child.

Before performing surgery, it’s important to perform X-rays, complementary studies, and take a detailed medical history of the child. Among the most relevant data to highlight are the child’s age, whether it’s a temporary or permanent tooth, the time remaining for the dental replacement, and the personal risk factors for the procedure. With accurate data, it’s possible to plan the intervention and avoid complications.

Below, we’ll share with you the situations that most frequently require extraction in children:

• The tooth elements are very destroyed, either by caries or trauma, and can’t be treated with endodontics or fillings.
• Baby teeth with infectious processes that compromise the permanent tooth germ.
• Temporary elements that interfere with the eruption of the permanent teeth.
• Natal and neonatal teeth that move and affect feeding or are risky for the baby.
• The need to reduce the number of teeth in the dental arch for orthodontic purposes. For example, as part of treatment with an appliance such as braces.

Subsequent rehabilitation to restore the aesthetics and functionality of the mouth are important aspects to take into account. This care will vary according to the particularities of the case. For example, if a professional decides to remove a baby tooth, they’ll need to consider the placement of a space maintainer to prevent future malocclusions.

2. Dental surgery of retained teeth in children

Retained teeth are those that, at the time of eruption, remain inside the bone and can’t come out. These elements can be covered by the bone and gum or only by the gingival mucosa.

Depending on the case, dental surgery is an alternative to extract the retained element from the maxilla of children. In general, it’s usually reserved for malpositioned teeth that develop cysts or in supernumerary teeth.

Another possible indication is to free the space to favor the natural eruption of the tooth. In the latter case, the treatment can be complemented with braces to help the tooth erupt.

3. Labial or lingual frenulum

It’s common for some children to have problems with their labial or lingual frenulum when they’re too short. Some of the negative consequences of this condition are difficulties with feeding, speaking, or tooth positioning. All of these can lead the pediatric dentist to suggest surgery to solve the problem.

Frenectomy is a simple surgical procedure from a technical point of view, which aims to free the connection of the frenulum with the two tissues to which it’s attached. In the case of the lingual frenulum, the connection of the tongue to the floor of the mouth is released to solve the ankyloglossia. The same surgery is performed on the labial frenulum in order to correct the tight junction of the lips with the gum.

The surgical techniques used are varied and are chosen according to the needs of each case. A key fact is that they can be performed at any age, so it’s worth considering when the impediments arising from these problems are considerable.

For example, lingual frenectomy is usually performed in infants in order to promote breastfeeding, and it’s best to perform it before the child begins to speak in order to avoid phonatory problems. Lip surgery, on the other hand, is usually performed to correct harmful habits or as part of orthodontic treatment.

4. Other situations

The types of dental surgery we’ve described are the most common ones performed on children, but there are other less common and more complex situations that also warrant dental surgery in children.

In some more complex disorders, the interventions are carried out by an interdisciplinary team that also involves a pediatric dentist. In any case, these procedures are performed by a maxillofacial surgeon under general anesthesia.

Here are some situations that lead to proceed in this way:

• Facial trauma: Accidents and severe blows to the mouth can lead to injuries and fractures to the jaws of children. To restore the anatomical structure of the mouth, interventions by an expert team of maxillofacial surgeons are necessary.
• Congenital malformations: Patients suffering from malformations in the hard and soft tissues of the mouth also require surgical correction by maxillofacial surgeons. Cleft lip and cleft palate are clear examples of this need. Surgeries to restore swallowing and speech functions to improve facial appearance are essential to improve the quality of life and social adaptation of these children.
• Pediatric oncology: The presence of tumors in the maxillofacial region requires surgical intervention as a team to rule out malignancy and ensure proper treatment.

Accompanying children after dental surgery

Beyond the type of dental surgery that’s been done on children, after the procedure, it will be necessary to provide some care to promote their speedy recovery.

It’s common during the postoperative period for children to experience pain, bleeding, and swelling. Implement these tips to alleviate their discomfort:

• Resorts to the use of some analgesic drugs indicated by the surgeon. It’s important to administer them following the professional’s recommendations.
• On the day of surgery, place ice compresses on the area at times. This reduces inflammation.
• Encourage rest to improve healing. Prevent the child from making quick, jerky movements, such as speech.
• Offer a soft and cool diet to avoid forcing the mouth and relieve pain and discomfort. Yogurts, ice cream, puddings, and gelatins are good choices.
• Avoid using straws and exposing the child’s mouth to heat sources. Hot drinks aren’t favorable either.
• Maintain oral hygiene with the appropriate technique for the case. Gently clean the area 24 hours after surgery. The dentist may suggest the use of a special antiseptic for several days.
• Take your child to the check-ups indicated by the surgeon. They are necessary to remove the stitches (if any) and check the evolution of the process.

Being aware of the postoperative period and accompanying the child in their recovery will help them feel better. And the dental surgery will be a simple memory that will have improved the health conditions in your child’s mouth.