{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:59:07Z","timestamp":1791219547179,"version":"4.1.0"},"reference-count":13,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,20]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Children with intellectual disability often experience difficulties in accessing routine dental care because behavioural limitations and associated medical conditions make treatment challenging. Untreated dental infections in such patients may pose significant health risks, particularly when systemic conditions are present. A child in middle childhood with moderate intellectual disability presented with pain and progressive swelling in the right posterior mandibular region. The patient was non-verbal and had underlying cardiac dysfunction and encephalopathy, which further complicated clinical management. Clinical and radiographic examination revealed a grossly carious mandibular first permanent molar associated with a periapical cyst, along with severe ankyloglossia. Due to limited cooperation and medical complexity, comprehensive dental management was performed under general anaesthesia, including extraction, cyst enucleation, diode laser-assisted frenectomy and preventive care. Recovery was uneventful, and the patient was referred for speech therapy. This case highlights the importance of coordinated multidisciplinary management for medically complex children requiring comprehensive dental rehabilitation.<\/jats:p>","DOI":"10.1136\/bcr-2026-273456","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:10:29Z","timestamp":1791216629000},"page":"e273456","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive dental management of odontogenic infection and ankyloglossia under general anaesthesia in a medically complex child with intellectual disability"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9109-2298","authenticated-orcid":false,"given":"Janvi","family":"Dave","sequence":"first","affiliation":[{"name":"Pediatric and Preventive Dentistry, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavna H","family":"Dave","sequence":"additional","affiliation":[{"name":"Pediatric and Preventive Dentistry, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema Dinesh","family":"Bargale","sequence":"additional","affiliation":[{"name":"Pediatric and Preventive Dentistry, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishnavi","family":"Patil","sequence":"additional","affiliation":[{"name":"Pediatric and Preventive Dentistry, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100509102163000_19.10.e273456.1","unstructured":"American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text rev. Washington, DC: American Psychiatric Association Publishing, 2022. Available: https:\/\/www.medialook.al\/wp-content\/uploads\/2020\/03\/DSM-5-By-American-Psychiatric-Association.pdf"},{"key":"2026100509102163000_19.10.e273456.2","unstructured":"World Health Organization . International Classification of Diseases 11th Revision (ICD-11): Disorders of intellectual development. Geneva: WHO, 2019. 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Management of dental patients with special health care needs. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry, 2025. Available: https:\/\/www.aapd.org\/research\/oral-health-policies--recommendations\/management-of-dental-patients-with-special-health-care-needs\/"},{"key":"2026100509102163000_19.10.e273456.8","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.tripleo.2011.02.016","article-title":"Prevalence of radix entomolaris in mandibular permanent first molars: a study in a South Indian population","volume":"112","author":"Chandra","year":"2011","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"2026100509102163000_19.10.e273456.9","first-page":"363","article-title":"Radix entomolaris: identification and morphology","volume":"98","author":"Carlsen","year":"1990","journal-title":"Scand J Dent Res"},{"key":"2026100509102163000_19.10.e273456.10","doi-asserted-by":"crossref","first-page":"S160","DOI":"10.4103\/0975-7406.191949","article-title":"Case reports and clinical guidelines for managing radix entomolaris","volume":"8","author":"Thomas","year":"2016","journal-title":"J Pharm Bioallied Sci"},{"key":"2026100509102163000_19.10.e273456.11","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.4103\/jfmpc.jfmpc_1147_19","article-title":"Management of radicular cyst in deciduous molar: A case report","volume":"9","author":"Talukdar","year":"2020","journal-title":"J Family Med Prim Care"},{"key":"2026100509102163000_19.10.e273456.12","first-page":"107","article-title":"Prevalence and distribution of odontogenic cysts: a 12-year retrospective study","volume":"356","author":"Mammadov","year":"2024","journal-title":"Georgian Med News"},{"key":"2026100509102163000_19.10.e273456.13","unstructured":"Noar J , Taylor G , Ashley P , et al . A guideline for the extraction of first permanent molars in children. London: Royal College of Surgeons of England, 2023. 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