Minor oral surgical procedures are sometimes needed in children to address conditions like dental infections, unerupted teeth, and oral lesions. Common procedures include incision and drainage of abscesses, removal of unerupted or impacted teeth, frenectomies, and excision of cysts or tumors. These procedures aim to remove the cause of problems and relieve pain or swelling, and are generally low-risk when performed by an experienced pediatric dentist.

1. Minor Oral Surgical
Procedures in
Children
Dr. Anjana G
Reader
Department of Pediatric
Dentistry

2. Conditions that require oral
surgery in Children
Periodontal disease
Oral trauma & Fractured teeth
Caries & Odontogenic infections
Unerupted and impacted teeth
Supernumerary teeth eg. mesiodens

3. Conditions that require oral
surgery in Children
Oral lesions in the newborn such as
Dental lamina cysts (Epstein's pearls & Bohn's
nodules)
Congenital epulis (Neumann's tumor)
Eruption cysts
Mucocele

4. Conditions that require oral
surgery in Children
Oral structural anomalies such as
Maxillary frenum,
Mandibular labial frenum,
Mandibular lingual frenum/ankyloglossia,
Natal and neonatal teeth etc

5. Mucoperiosteal flap
• Crevicular incision around the neck of the
teeth incising the interdental papillae
• In edentulous cases a continuous incision on
the ridge
• Base of the flap should be wider to maintain
good blood supply.
• No releasing incisions are usually placed on
the palate

6. Releasing
Incision
Incision placed in
an obtuse angle to
make base wider

7. Mucoperiosteal flap on an edentulous ridge

8. Incision & Drainage
• When the dentoalveolar abscess localizes into a soft
fluctuant mass (points), it should be drained to reduce
pain & swelling.
• Conduction anesthesia should be used.
• Topical anesthesia over the swelling will considerably
reduce the pain from the quick, sharp thrust of the
blade through the most dependant area.

9. I & D

10. Extraction of supernumerary
tooth
• Most common reason for the lack of
eruption of maxillary incisors – Presence of
a supernumerary tooth.
• It should be removed before the eruption
potential of the permanent incisor is lost.

13. Apicoectomy
• Done if the periapical lesion persists after
conventional treatment and there is post
operative discomfort after completion of
RCT.
• Periapical curettage and root resection will
usually solve the problem.

15. Apicoectomy of a premolar and molar

16. Frenectomy
Rationale
• Gingival recession
• Diastema
• Accumulation of debris by gingival
reflection & opening of sulcus.

17. Labial Frenectomy - Technique
• Complete excision should be done
• Incision made perpendicular to the Frenum
in the mucobuccal fold
• Incision extended around the Frenum on
either side
• The tissue thus lineated is excised
• Sutures are placed and should be removed
after 7-10 days

18. The labial Frenum often attaches to the center of the upper lip and
between the upper two front teeth.

22. V - Y Plasty

25. Dental Lamina Cysts
(Bohn’s nodules/ Epstein pearls)
• Bohn’s nodules are odontogenic cysts that
arise from the dental lamina.
• They are filled with keratin.
• Epstein pearls are epithelial inclusion cysts.
• The condition is harmless but worries new
mothers who may mistake the nodules for
emerging teeth.

26. Dental lamina cysts
• Whitish-yellow nodules
which appear on the gums
or hard palate.
• A physical examination
will differentiate between
Dental Lamina Cysts and
natal teeth.
• No treatment is necessary.
The cysts will disappear
within 1-2 weeks of birth.

27. Eruption Cyst
• Seen in association with an erupting
primary or permanent tooth.
• Usually disappears when the tooth erupts
• If it becomes painful, infected or bleeds, it
should be drained and the overlying tissue
should be excised.

29. Mucocele
• Mucous extravasation cyst.
• Caused by traumatic severance or obstruction of
minor salivary gland ducts
• Pooling of mucous occurs in the tissue
• Most commonly seen site is lower lip
• Excision along with surrounding minor salivary
glands to prevent recurrence is the treatment

31. Ranula
• Occurs on the floor of the mouth in association
with the ducts of the sublingual and
submandibular salivary glands
• Painless and enlarges slowly
• Simple excision of the lesion is curative.
• It seldom recurs unless, of course, the area
is re-injured.
• Large ranulas may be unroofed and allowed
to heal by secondary intent.
• Incision is the treatment of choice if the lesion is
deep seated.

33. Epulis
• Congenital Epulis is a rare tumor of only the
newborn, also known as granular cell tumor of the
newborn or Neumann's tumor.
• This tumor arises from the mucosa of the gingiva,
most commonly from the anterior part of the
maxillary alveolar ridge.
• Is typically seen as a mass protruding out of the
newborn child's mouth, which may interfere with
respiration or feeding.

34. Epulis
• The tumor has a marked
female preponderance of
8:1.
• The recommended
treatment is prompt
surgical resection.
• Recurrences of the tumor
and damage to future
dentition have not been
reported, suggesting that
radical excision is not
warranted.

35. Osteomyelitis
• An acute or chronic infection of the bone and bone
marrow characterized by pain, high fever, and an
abscess at the site of infection.
• The infection, which may be caused by a variety of
microorganisms, reaches the bone through an open
wound or fracture or through the bloodstream.

36. Osteomyelitis
• Radiographically diffuse radioluscency with
poorly defined margins (Moth eaten appearance).
• Treatment includes antibiotics and surgery.
• Curettage of the area to remove bony sequestra
and treatment of carious teeth should be done.

38. Suture materials
Surgical silk can be used for closure of most
of the oral soft tissues.
Other choices are
• Surgical gut,
• Chromic cat gut,
• Monofilament nylon,
• Polyglycolic acid.