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## Complete Summary

#### GUIDELINE TITLE

Clinical guideline on pediatric oral surgery.

#### BIBLIOGRAPHIC SOURCE(S)

American Academy of Pediatric Dentistry (AAPD). Clinical guideline on
pediatric oral surgery. Chicago (IL): American Academy of Pediatric
Dentistry (AAPD); 2005. 9 p. \[61 references\]

#### GUIDELINE STATUS

This is the current release of the guideline.

### COMPLETE SUMMARY CONTENT

 SCOPE\
 METHODOLOGY - including Rating Scheme and Cost Analysis\
 RECOMMENDATIONS\
 EVIDENCE SUPPORTING THE RECOMMENDATIONS\
 BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS\
 CONTRAINDICATIONS\
 IMPLEMENTATION OF THE GUIDELINE\
 INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT
CATEGORIES\
 IDENTIFYING INFORMATION AND AVAILABILITY\
 DISCLAIMER

### SCOPE

#### DISEASE/CONDITION(S)

Diseases and disorders that require oral surgery, including

-   Caries

-   Periodontal disease

-   Oral trauma

-   Odontogenic infections

-   Fractured teeth

-   Unerupted and impacted teeth,

-   Supernumerary teeth and mesiodens

-   Oral lesions in the newborn such as Epstein\'s pearls, dental lamina
    cysts, Bohn\'s nodules, and congenital epulis (Neumann\'s tumor)

-   Eruption cysts

-   Mucocele

-   Oral structural anomalies such as maxillary frenum, mandibular
    labial frenum, mandibular lingual frenum/ankyloglossia, and natal
    and neonatal teeth

#### GUIDELINE CATEGORY

Evaluation\
Management\
Treatment

#### CLINICAL SPECIALTY

Dentistry\
Pediatrics\
Surgery

#### INTENDED USERS

Dentists

#### GUIDELINE OBJECTIVE(S)

To define, describe clinical presentation, and set forth general
criteria and therapeutic goals for common pediatric oral surgery
procedures that have been presented in considerably more detail in
textbooks and the dental/medical literature

#### TARGET POPULATION

Infants, children, and adolescents

#### INTERVENTIONS AND PRACTICES CONSIDERED

**Assessment**

1.  Physical exam

2.  Radiographical evaluation

**Treatment**

1.  Treatment of odontogenic infections and associated complications

    -   Pulp therapy

    -   Extraction, or incision and drainage

    -   Antibiotic therapy

    -   Hospitalization and referral/consultation with an oral and
        maxillofacial surgeon

2.  Extraction of erupted and unerupted teeth

3.  Management of fractured primary tooth roots

4.  Management of unerupted and impacted and supernumery teeth

5.  Evaluation and management of oral pathologies occurring in the
    newborn

6.  Surgical opening of eruption cyst

7.  Surgical excision of mucocele and adjacent minor salivary glands

8.  Frenectomy (for maxillary frenum and mandibular labial and lingual
    frenum)

9.  Frenuloplasty and frenectomy (for ankyloglossia)

10. Assessment and treatment of Riga-Fede

#### MAJOR OUTCOMES CONSIDERED

-   Risk of complications from surgical procedures

-   Spontaneous eruption and alignment of teeth

### METHODOLOGY

#### METHODS USED TO COLLECT/SELECT EVIDENCE

Hand-searches of Published Literature (Secondary Sources)\
Searches of Electronic Databases

#### DESCRIPTION OF METHODS USED TO COLLECT/SELECT THE EVIDENCE

A MEDLINE search was conducted using the terms \"pediatric,\" \"oral
surgery,\" \"odontogenic infections,\" \"impacted canines,\" \"third
molars,\" \"supernumerary teeth,\" \"mesiodens,\" \"mucocele,\"
\"eruption cyst,\" \"eruption hematoma,\" \"attached frenum,\"
\"ankyloglossia,\" \"gingival keratin cysts,\" \"Epstein pearls,\"
\"Bohn\'s nodules,\" \"congenital epulis of newborn,\" \"dental lamina
cysts,\" \"natal teeth,\" and \"neonatal teeth.\" Also, the manual
\"Parameters and Pathways: Clinical Practice Guidelines for Oral and
Maxillofacial Surgery\", developed by the American Association of Oral
and Maxillofacial Surgeons, was consulted.

#### NUMBER OF SOURCE DOCUMENTS

Not stated

#### METHODS USED TO ASSESS THE QUALITY AND STRENGTH OF THE EVIDENCE

Not stated

#### RATING SCHEME FOR THE STRENGTH OF THE EVIDENCE

Not applicable

#### METHODS USED TO ANALYZE THE EVIDENCE

Review

#### DESCRIPTION OF THE METHODS USED TO ANALYZE THE EVIDENCE

Not stated

#### METHODS USED TO FORMULATE THE RECOMMENDATIONS

Expert Consensus

#### DESCRIPTION OF METHODS USED TO FORMULATE THE RECOMMENDATIONS

The oral health policies and clinical guidelines of the American Academy
of Pediatric Dentistry (AAPD) are developed under the direction of the
Board of Trustees, utilizing the resources and expertise of its
membership operating through the Council on Clinical Affairs (CCA).

Proposals to develop or modify policies and guidelines may originate
from 4 sources:

1.  The officers or trustees acting at any meeting of the Board of
    Trustees

2.  A council, committee, or task force in its report to the Board of
    Trustees

3.  Any member of the AAPD acting through the Reference Committee
    hearing of the General Assembly at the Annual Session

4.  Officers, trustees, council and committee chairs, or other
    participants at the AAPD\'s Annual Strategic Planning Session

Regardless of the source, proposals are considered carefully, and those
deemed sufficiently meritorious by a majority vote of the Board of
Trustees are referred to the CCA for development or review/revision.

Once a charge (directive from the Board of Trustees) for development or
review/revision of an oral health policy or clinical guideline is sent
to the CCA, it is assigned to 1 or more members of the CCA for
completion. CCA members are instructed to follow the specified format
for a policy or guideline. All oral health policies and clinical
guidelines are based on 2 sources of evidence: (1) the scientific
literature; and (2) experts in the field. Members may call upon any
expert as a consultant to the council to provide expert opinion. The
Council on Scientific Affairs provides input as to the scientific
validity of a policy or guideline.

The CCA meets on an interim basis (midwinter) to discuss proposed oral
health policies and clinical guidelines. Each new or reviewed/revised
policy and guideline is reviewed, discussed, and confirmed by the entire
council.

#### RATING SCHEME FOR THE STRENGTH OF THE RECOMMENDATIONS

Not applicable

#### COST ANALYSIS

A formal cost analysis was not performed and published cost analyses
were not reviewed.

#### METHOD OF GUIDELINE VALIDATION

Peer Review

#### DESCRIPTION OF METHOD OF GUIDELINE VALIDATION

Once developed by the Council on Clinical Affairs (CCA), the proposed
policy or guideline is submitted for the consideration of the Board of
Trustees. While the board may request revision, in which case it is
returned to the council for modification, once accepted by majority vote
of the board, it is referred for Reference Committee hearing at the
upcoming Annual Session. At the Reference Committee hearing, the
membership may provide comment or suggestion for alteration of the
document before presentation to the General Assembly. The final document
then is presented for ratification by a majority vote of the membership
present and voting at the General Assembly. If accepted by the General
Assembly, either as proposed or as amended by that body, the document
then becomes the official American Academy of Pediatric Dentistry (AAPD)
oral health policy or clinical guideline for publication in the AAPD\'s
Reference Manual and on the AAPD\'s Web site.

### RECOMMENDATIONS

#### MAJOR RECOMMENDATIONS

**Odontogenic Infections**

In children, odontogenic infections may involve more than 1 tooth and
usually are due to carious lesions, periodontal problems, or trauma.
Prompt treatment of infections is important as children are prone to
dehydration, especially if they are not feeding well due to pain and
malaise.

With upper face infections, patients usually complain of facial pain,
fever, and inability to eat or drink. Care must be taken to rule out
sinusitis as symptoms may mimic an odontogenic infection. Occasionally
in upper face infections, it may be difficult to find the true cause.
Infections of the lower face usually involve pain, swelling, and
trismus. They frequently are associated with teeth, skin, local lymph
nodes, and salivary glands. In lower face swelling, dental infection is
diagnosed most frequently.

Most odontogenic infections are not serious and can be managed easily.
Treatment involves pulp therapy, extraction, or incision and drainage.
Infections of odontogenic origin with systemic manifestations (e.g.,
elevated temperature of 102 degrees to 104 degrees F, facial cellulitis,
difficulty in breathing or swallowing, fatigue, nausea) require
antibiotic therapy. Severe but rare complications of odontogenic
infections include cavernous sinus thrombosis and Ludwig\'s angina.
These conditions can be life threatening and may require immediate
hospitalization with intravenous antibiotics, incision and drainage, and
referral/consultation with an oral and maxillofacial surgeon.

**Extraction of Erupted Teeth**

**Maxillary and Mandibular Molars**

Primary molars have roots that are smaller in diameter and more
divergent than permanent molars. Root fracture in primary molars is not
uncommon due to these characteristics and the potential weakening of
their roots caused by the eruption of their permanent successors. To
avoid inadvertent extraction or dislocation of the permanent successor,
consideration should be given to the relationship of the primary roots
to the permanent successor crown. Primary molars with roots encircling
the successor\'s crown may need to be sectioned to protect the permanent
tooth\'s location. Molar extractions are accomplished by using slow
continuous palatal/lingual and buccal force allowing for the expansion
of the alveolar bone to accommodate the divergent roots and reduce the
risk of root fracture. When extracting mandibular molars, care should be
taken to support the mandible to protect the temporomandibular joints
from injury.

**Maxillary and Mandibular Anterior Teeth**

Primary and permanent maxillary and mandibular central incisors, lateral
incisors, and canines all have conical single roots. Extraction of
anterior teeth is accomplished with a rotational movement due to their
single root anatomies. Care should be taken to avoid placing any force
on adjacent teeth that could become luxated or dislodged easily due to
their root anatomy.

**Management of Fractured Primary Tooth Roots**

The dilemma to consider when treating a fractured primary tooth root is
that removing the root tip may cause damage to the succedaneous tooth,
while leaving the root tip may increase the chance for postoperative
infection and delay eruption of the permanent successor. The literature
suggests that if the tooth root can be removed easily, it should be
removed. If the root is very small, located deep in the socket, situated
in close proximity to the permanent successor, or unable to be retrieved
after several attempts, it is best left to be resorbed.

**Unerupted and Impacted Teeth**

**Impacted Canines**

Maxillary canines are second to third molars in frequency of impaction.
Early detection of an ectopically erupting canine is important to
minimize such an occurrence. Panoramic and periapical films are useful
in locating potentially ectopic canines. When the cusp tip of the
permanent canine is just mesial to or overlaying the distal half of the
long axis of the root of the permanent lateral incisor, canine palatal
impaction usually occurs. Extraction of the primary canines is the
treatment of choice when malformation or ankylosis is present or when
trying to correct palatally-impacted canines, provided there are normal
space conditions and no incisor resorption. One study showed that 78% of
ectopically erupting permanent canines normalized within 12 months after
removal of the primary canines: 64% when the starting canine position
overlapped the lateral incisor by more than half of the root and 91%
when the starting canine position overlapped the lateral incisor by less
than half of the root. If no improvement in canine position occurs in a
year, surgical and/or orthodontic treatment were suggested. Consultation
between the practitioner and an orthodontist may be useful in the final
treatment decision.

**Third Molars**

Panoramic or periapical radiographic examination is indicated in late
adolescence to assess the presence, position, and development of third
molars. The American Association of Oral and Maxillofacial Surgeons
(AAOMS) recommends that a decision to remove or retain third molars
should be made before the middle of the third decade. Little controversy
surrounds their removal when pathology (e.g., cysts or tumors,
non-restorable or recurrent caries, infection or pericoronitis,
detrimental changes of adjacent teeth or bone) is associated and/or the
tooth is malpositioned or nonfunctional (i.e., an unopposed tooth). A
systematic review of research literature from 1984-1999 concluded there
is no reliable evidence to support the prophylactic removal of disease
free impacted third molars. Although prophylactic removal of all
impacted or unerupted disease-free third molars is not indicated,
consideration should be given to removal by the third decade when there
is a high probability of disease or pathology and/or the risks
associated with early removal are less than the risks of later removal.
Removing the third molars prior to complete root formation may be
surgically prudent. Factors that increase the risk for complications
(e.g., coexisting systemic conditions, location of peripheral nerves,
history of temporomandibular joint disease) should be assessed. Referral
to an oral and maxillofacial surgeon for consultation and subsequent
treatment may be indicated. When a decision is made to retain impacted
third molars, they should be monitored for change in position and/or
development of pathology which may necessitate later removal.

**Supernumerary Teeth-Mesiodens**

Supernumerary teeth and hyperdontia are terms to describe an excess in
tooth number. Supernumerary teeth are thought to be related to
disturbances in the initiation and proliferation stages of dental
development. Although some supernumerary teeth may be syndrome
associated (cleidocranial dysplasia) or familial, most supernumerary
teeth occur as isolated events.

Supernumerary teeth can occur in either the primary or permanent
dentition. In 33% of the cases, a supernumerary tooth in the primary
dentition is followed by the supernumerary tooth complement in the
permanent dentition. Reports in incidence of supernumerary teeth can be
as high as 3%, with the permanent dentition being affected 5 times more
frequently than the primary dentition and males being affected twice as
frequently as females.

Approximately 90% of all single tooth supernumerary teeth are found in
the maxillary arch, with a strong predilection to the anterior region.
The anterior midline of the maxilla is the most common site, in which
case the supernumerary tooth is known as a mesiodens. A mesiodens can be
suspected if there is an asymmetric eruption pattern of the maxillary
incisors, delayed eruption of the maxillary incisors with or without any
over-retained primary incisors, or ectopic eruption of a maxillary
incisor. The diagnosis of a mesiodens can be confirmed with radiographs
including occlusal, periapical, or panoramic films. Three-dimensional
information needed to determine the location of the mesiodens or
impacted tooth can be obtained by taking 2 periapical radiographs and by
using either 2 projections taken at right angles to 1 another or the
tube shift technique (buccal object rule or Clark\'s rule).

Complications of supernumerary teeth can include delayed and/or lack of
eruption of the permanent tooth, crowding, resorption of adjacent teeth,
dentigerous cyst formation, pericoronal space ossification, and crown
resorption. Early diagnosis and appropriately timed treatment are
important in the prevention and avoidance of these complications.

Because only 25% of all mesiodens erupt spontaneously, surgical
management usually is necessary. A mesiodens that is conical in shape
and is not inverted has a better chance for eruption than a mesiodens
that is tubercular in shape and is inverted. The treatment objective for
a non-erupting permanent tooth mesiodens is to minimize eruption
problems for the permanent incisors. Surgical management will vary
depending on the size, shape, and number of supernumeraries and the
patient\'s dental development. The treatment objective for a
non-erupting primary tooth mesiodens differs in that the removal of
these teeth usually is not recommended as the surgical intervention may
disrupt or damage the underlying developing permanent teeth. Erupted
primary tooth mesiodens typically are left to shed normally upon the
eruption of the permanent dentition.

Extraction of an unerupted primary or permanent tooth mesiodens is
recommended during the mixed dentition to allow the normal eruptive
force of the permanent incisor to bring itself into the oral cavity.
Waiting until the adjacent incisors have at least two thirds root
development will present less risk to the developing teeth but still
allow spontaneous eruption of the incisors. In 75% of the cases,
extraction of the mesiodens during the mixed dentition results in
spontaneous eruption and alignment of the adjacent teeth. If the
adjacent teeth do not erupt within 6 to 12 months, surgical exposure and
orthodontic treatment may be necessary to aid their eruption. The
diagnosing dentist may consider a multidisciplinary approach when
treating difficult or complex cases.

**Pediatric Oral Pathology**

**Lesions of the Newborn**

Oral pathologies occurring in newborn children include Epstein\'s
pearls, dental lamina cysts, Bohn\'s nodules, and congenital epulis.
Epstein\'s pearls are common and found in about 75 to 80% of newborns.
They occur in the median palatal raphe area, as a result of trapped
epithelial remnants along the line of fusion of the palatal halves.
Dental lamina cysts, found on the crests of the dental ridges, most
commonly are seen bilaterally in the region of the first primary molars.
They result from remnants of the dental lamina. Bohn\'s nodules are
remnants of salivary gland epithelium and usually are found on the
buccal and lingual aspects of the ridge, away from the midline.
Epstein\'s pearls, Bohn\'s nodules, and dental lamina cysts typically
present as asymptomatic 1 to 3 mm nodules or papules. They are smooth,
whitish in appearance, and filled with keratin. No treatment is required
as these cysts usually disappear during the first 3 months of life.

Congenital epulis of the newborn, also known as granular cell tumor or
Neumann\'s tumor, is a rare benign tumor seen only in newborns. This
lesion is typically a protuberant mass arising from the gingival mucosa.
It is most often found on the anterior maxillary ridge. Patients
typically present with feeding and/or respiratory problems. Congenital
epulis has a marked predilection for females at 8-10:1. Treatment
normally consists of surgical excision. The newborn usually heals well
and no future complications or treatment should be expected.

**Eruption Cyst (Eruption Hematoma)**

The eruption cyst is a soft tissue cyst that results from a separation
of the dental follicle from the crown of an erupting tooth. Fluid
accumulation occurs within this created follicular space. Eruption cysts
most commonly are found in the mandibular molar region. Color of these
lesions can range from normal to blue-black or brown depending on the
amount of blood in the cystic fluid. The blood is secondary to trauma.
If trauma is intense, these blood filled lesions sometimes are referred
to as eruption hematomas.

Because the tooth erupts through the lesion, no treatment is necessary.
If the cyst does not rupture spontaneously or the lesion becomes
infected, the roof of the cyst may be opened surgically.

**Mucocele**

The mucocele is a common lesion in children and adolescents resulting
from the rupture of a minor salivary gland excretory duct with
subsequent spillage of mucin into the surrounding connective tissues
that may later be surrounded in a fibrous capsule. Most mucoceles are
well-circumscribed bluish translucent fluctuant swellings (although
deeper and long-standing lesions may range from normal in color to
having a whitish keratinized surface) that are firm to palpation. Local
mechanical trauma to the minor salivary gland is often the cause of
rupture. At least 75% of cases are found on the lower lip, usually
lateral to the midline. Mucoceles also can be found on the buccal
mucosa, ventral surface of the tongue, retromolar region, and floor of
the mouth (ranula). Superficial mucoceles and some mucoceles are
short-lived lesions that burst spontaneously, leaving shallow ulcers
that heal within a few days. Many lesions, however, require local
surgical excision with the removal of adjacent minor salivary glands to
minimize the risk of recurrence.

**Structural Anomalies**

**Maxillary Frenum**

A high or prominent maxillary frenum in children, although a common
finding, is often a concern, especially when associated with a diastema.
A comparison of attached frena with and without diastemas found no
correlation between the height of the frenum attachment and diastema
presence and width. Recent trends justify significantly fewer
frenectomies. Treatment is necessary only when the attachment exerts a
traumatic force on the gingiva or it causes a diastema to remain after
eruption of the permanent canines.

Treatment should be delayed until the permanent incisors and cuspids
have erupted and the diastema has had an opportunity to close naturally.
In an older child, if a frenum is present and the papilla blanches when
the upper lip is pulled, removal can be indicated. Again, the frenectomy
should be performed only after orthodontic treatment is completed and
the diastema is closed as much as possible. When indicated, a maxillary
frenectomy is a fairly simple procedure and can be performed in the
office setting.

**Mandibular Labial Frenum**

A high frenum can sometimes present on the labial aspect of the
mandibular ridge. This is most often seen in the central incisor area
and frequently occurs in individuals where the vestibule is shallow. The
mandibular anterior frenum, as it is known, occasionally inserts into
the free or marginal gingival tissue. Movements of the lower lip cause
the frenum to pull on the fibers inserting into the free marginal
tissue, which in turn, can lead to food and plaque accumulation. Early
treatment is indicated to prevent subsequent inflammation, recession,
pocket formation, and possible loss of the alveolar bone and/or tooth.

**Mandibular Lingual Frenum/Ankyloglossia**

Ankyloglossia is a developmental anomaly of the tongue characterized by
a short, thick lingual frenum resulting in limitation of tongue
movement. It can be categorized into 2 types. Total ankyloglossia is
rare and occurs when the tongue is completely fused to the floor of the
mouth. Partial ankyloglossia is variable and encompasses the remainder
of the cases.

The significance and management of ankyloglossia are very controversial.
Studies have shown a difference in treatment recommendations between
speech pathologists, pediatricians, otolaryngologists, and lactation
specialists. Most professionals, however, will agree that there are
certain indications for frenectomy.

A short lingual frenum can inhibit tongue movement and create
deglutition problems. Frenectomy for functional problems should be
considered on an individual basis. If evaluation shows that function
will be improved by surgery, treatment should be considered.

Ankyloglossia also can lead to problems with breastfeeding, speech,
malocclusion, and potential periodontal problems. During breastfeeding,
a short frenum can cause ineffective latch, inadequate milk transfer,
and maternal nipple pain, all of which can adversely affect feeding.
When indicated, frenuloplasty seems to be a successful approach to
facilitate breastfeeding. Although not as common as once thought, speech
pathology has been associated with ankyloglossia. In such cases,
frenectomy can be a treatment option, improving tongue mobility and
speech. It should not be performed, however, until an evaluation and
therapy by a qualified speech therapist have been completed.
Ankyloglossia also has been associated with Class III malocclusion. The
abnormal tongue position may affect skeletal development. Although there
are no clear recommendations, frenectomy in these cases should be
deferred until a complete orthodontic workup, diagnosis, and treatment
plan have been completed and any necessary referrals obtained.

**Natal and Neonatal Teeth**

Natal and neonatal teeth can present a challenge when deciding on
appropriate treatment. Natal teeth have been defined as those teeth
present at birth, and neonatal teeth are those that erupt during the
first 30 days of life. The occurrence of natal and neonatal teeth is
rare; the incidence varies from 1:1,000 to 1:30,000. The teeth most
often affected are the mandibular primary incisors. Although many
theories exist as to why the teeth occur, currently no studies confirm a
causal relationship with any of the proposed theories. The superficial
position of the tooth germ associated with a hereditary factor seems to
be the most accepted possibility.

If the tooth is not excessively mobile or causing feeding problems, it
should be preserved and maintained in healthy condition if at all
possible. Close monitoring is indicated to ensure that the tooth remains
stable.

Riga-Fede is a condition caused by the natal or neonatal tooth rubbing
the ventral surface of the tongue during feeding and causing ulceration.
Failure to diagnose and properly treat this lesion can result in
dehydration and inadequate nutrient intake for the infant. Treatment
should be conservative, if at all possible, consisting of smoothing
rough incisal edges or placing resin over the edge of the tooth to round
it. If conservative treatment does not correct the condition, extraction
is the treatment of choice.

An important consideration when deciding to extract a natal or neonatal
tooth is the potential for hemorrhage. Extraction is contraindicated in
newborns due to risk of hemorrhage. Unless the child is at least 10 days
old, consultation with the pediatrician regarding adequate hemostasis
may be indicated prior to extraction of the tooth.

#### CLINICAL ALGORITHM(S)

None provided

### EVIDENCE SUPPORTING THE RECOMMENDATIONS

#### TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

All oral health policies and clinical guidelines are based on 2 sources
of evidence: (1) the scientific literature; and (2) experts in the
field.

### BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS

#### POTENTIAL BENEFITS

Appropriate management and early treatment of infant, child, and
adolescent oral health needs and prevention of oral disease

#### POTENTIAL HARMS

Risk of complications from surgical procedures, including potential for
adverse effects on growth and development in the oral and maxillofacial
region and injury to developing tooth follicles

### CONTRAINDICATIONS

#### CONTRAINDICATIONS

Tooth extraction is contraindicated in newborns due to risk of
hemorrhage.

### IMPLEMENTATION OF THE GUIDELINE

#### DESCRIPTION OF IMPLEMENTATION STRATEGY

An implementation strategy was not provided.

#### IMPLEMENTATION TOOLS

Chart Documentation/Checklists/Forms\
Resources

For information about
[availability](#identifying-information-and-availability), see the
\"Availability of Companion Documents\" and \"Patient Resources\" fields
below.

### INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT CATEGORIES

#### IOM CARE NEED

Getting Better\
Staying Healthy

#### IOM DOMAIN

Effectiveness

### IDENTIFYING INFORMATION AND AVAILABILITY

#### BIBLIOGRAPHIC SOURCE(S)

American Academy of Pediatric Dentistry (AAPD). Clinical guideline on
pediatric oral surgery. Chicago (IL): American Academy of Pediatric
Dentistry (AAPD); 2005. 9 p. \[61 references\]

#### ADAPTATION

Not applicable: The guideline was not adapted from another source.

#### DATE RELEASED

2005

#### GUIDELINE DEVELOPER(S)

American Academy of Pediatric Dentistry - Professional Association

#### SOURCE(S) OF FUNDING

American Academy of Pediatric Dentistry

#### GUIDELINE COMMITTEE

Council on Clinical Affairs

#### COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Not stated

#### FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

#### GUIDELINE STATUS

This is the current release of the guideline.

#### GUIDELINE AVAILABILITY

Electronic copies: Available from the [American Academy of Pediatric
Dentistry Web site](http://www.aapd.org/media/policies.asp).

Print copies: Available from the American Academy of Pediatric
Dentistry, 211 East Chicago Avenue, Suite 700, Chicago, Illinois 60611

#### AVAILABILITY OF COMPANION DOCUMENTS

Information about the American Academy of Pediatric Dentistry (AAPD)
mission and guideline development process is available on the [AAPD Web
site](http://www.aapd.org/media/Policies_Guidelines/Intro.pdf).

The following implementation tools are available for download from the
AAPD Web site:

-   [Dental growth and development
    chart](http://www.aapd.org/media/Policies_Guidelines/RS_DentGrowthandDev.pdf)

-   [American Academy of Pediatric Dentistry Caries-Risk Assessment Tool
    (CAT)](http://www.aapd.org/media/Policies_Guidelines/RS_CAT.pdf)

#### PATIENT RESOURCES

None available

#### NGC STATUS

This NGC summary was completed by ECRI on August 19, 2005.

#### COPYRIGHT STATEMENT

This summary is based on the original guideline, which is subject to the
guideline developer\'s copyright restrictions.

### DISCLAIMER

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Date Modified: 11/3/2008