A young girl with a rare blood vessel birthmark inside her mouth received special dental care that worked really well. Doctors used imaging scans to see exactly where the birthmark was, then carefully treated her teeth without making the birthmark bleed. Instead of using strong anesthesia or surgery, the team used gentle preventive treatments like fluoride and special protective coatings. After her dental care, the girl’s eating habits actually improved. This case shows that kids with unusual mouth conditions can get safe, effective dental treatment when doctors work together and use careful, minimally invasive approaches.

The Quick Take

  • What they studied: How to safely treat a child’s teeth when she has a rare blood vessel birthmark (vascular malformation) inside her mouth that bleeds easily
  • Who participated: One 3.5-year-old girl born with a low-flow venous malformation (a tangle of abnormal blood vessels) that covered her left cheek, upper lip, roof of mouth, and surrounding areas
  • Key finding: Doctors successfully completed dental treatments including filling a baby tooth and placing a protective crown without causing bleeding or needing general anesthesia, and the child’s eating improved afterward
  • What it means for you: If your child has a vascular malformation or similar condition, gentle preventive dental care combined with careful planning can be safe and effective. Talk to your dentist about imaging and coordinated care with specialists.

The Research Details

This is a detailed case report of one child’s dental treatment journey. The doctors documented how they managed dental care for a 3.5-year-old girl with a congenital vascular malformation—a condition where abnormal blood vessels form before birth. The team used MRI (a special imaging scan) to map out exactly where the blood vessel malformation was located, which helped them plan safe treatment. They avoided doing a biopsy (taking a tissue sample) because it could cause dangerous bleeding. Instead of using general anesthesia or aggressive treatments, the dental team chose minimally invasive approaches, meaning they used the gentlest methods possible.

The child had already received some treatments abroad, including injections of bleomycin (a medication) directly into the malformation and laser therapy. When she came to Iran for dental care, the team focused on treating her teeth while protecting the malformation from injury. They successfully performed a pulpotomy (a procedure to save a baby tooth) and placed a stainless-steel crown without sedation. Over time, they also extracted two teeth that needed to come out, again without complications.

The preventive care strategy included fluoride treatments every three months, application of a special milk-based remineralizing agent (CPP-ACP), and silver diamine fluoride (SDF) to protect vulnerable teeth. The team tracked the child’s progress and noted that her eating habits improved significantly after treatment.

This approach matters because children with vascular malformations face unique challenges during dental care. These blood vessel abnormalities bleed easily and can make routine dental work dangerous. By using imaging to understand the condition, avoiding unnecessary invasive procedures, and coordinating care between dental and medical specialists, doctors can provide safe treatment. The case also shows that preventive care—rather than aggressive treatment—can be effective and may even improve a child’s overall health and quality of life.

This is a single case report, which means it describes one patient’s experience rather than comparing many patients. Case reports are useful for documenting unusual situations and teaching other doctors, but they cannot prove that a treatment works for everyone. The strength of this report is that it includes detailed documentation, imaging confirmation of the diagnosis, and long-term follow-up. However, because it’s only one child, the findings cannot be generalized to all children with similar conditions. The case is valuable for showing what’s possible and how to approach complex pediatric dental cases thoughtfully.

What the Results Show

The dental team successfully completed pulpotomy (a tooth-saving procedure) and placed a protective crown on one of the child’s baby teeth without causing bleeding or requiring general anesthesia. This was a significant achievement because the vascular malformation was very close to the treatment area and could have bled easily. Two teeth were later extracted during follow-up visits without complications, showing that even tooth removal could be done safely.

The preventive care strategy proved effective. The child received fluoride treatments every three months to strengthen her teeth, applications of a special remineralizing agent (CPP-ACP derived from milk) to repair early tooth damage, and silver diamine fluoride (SDF) to protect a vulnerable lower tooth. These gentle, non-invasive treatments helped maintain the child’s oral health without triggering bleeding from the malformation.

Perhaps most importantly, the child’s eating habits improved significantly after dental treatment. This suggests that addressing her dental problems had a positive impact on her overall nutrition and quality of life. The team noted that the child’s cooperation improved over time, indicating that the gentle approach built trust and made future dental visits easier.

The case demonstrates the value of interdisciplinary collaboration. The child had previously received treatment from medical specialists (bleomycin injections and laser therapy), and coordinating this information with dental care was crucial. The use of MRI imaging to diagnose and map the malformation without doing a biopsy was important—it provided necessary information while avoiding the bleeding risk that a tissue sample would have caused. The case also shows that general anesthesia was not necessary, which is beneficial because anesthesia carries its own risks, especially in young children with complex medical conditions.

This case aligns with current best practices in pediatric dentistry for managing children with vascular anomalies. The emphasis on minimally invasive treatment, preventive care, and interdisciplinary collaboration reflects what dental literature recommends. The use of imaging-based diagnosis rather than biopsy is consistent with modern diagnostic approaches. However, because this is a single case, it cannot be compared statistically to other treatments. The case contributes to the body of knowledge by showing a successful example of this approach in a very young child with extensive involvement.

This is a single case report describing one child’s experience, so the findings cannot be assumed to apply to all children with vascular malformations. Every child’s condition is different—the size, location, and type of malformation vary. What worked for this child may not work the same way for another. The report doesn’t include a comparison group or statistical analysis. Additionally, the follow-up period described in the case may not be long enough to know if the benefits last over many years. The child’s improved eating habits could be due to many factors, not just the dental treatment. Finally, this case was managed in Iran with specific resources and expertise available there, so the approach might need adjustment in different healthcare settings.

The Bottom Line

If your child has a vascular malformation or similar condition affecting the mouth: (1) Seek care from a pediatric dentist experienced with complex cases, ideally working with medical specialists—high confidence this improves safety. (2) Request imaging (like MRI) to diagnose and plan treatment rather than invasive biopsies—high confidence this reduces bleeding risk. (3) Prioritize preventive care including regular fluoride treatments and protective coatings—moderate to high confidence this maintains tooth health. (4) Discuss minimally invasive approaches with your dental team rather than assuming general anesthesia or aggressive treatment is necessary—moderate confidence this improves outcomes and reduces complications.

Parents of children with vascular malformations, hemangiomas, or other blood vessel abnormalities affecting the mouth should pay close attention to this case. Pediatric dentists managing complex cases will find this helpful for planning treatment. Medical specialists treating vascular conditions should understand how to coordinate with dental care. Children with bleeding disorders or conditions affecting wound healing should also consider this approach. However, this case is specifically about one child, so individual circumstances vary greatly. Always consult with your child’s healthcare team about what’s appropriate for their specific situation.

Immediate benefits: Dental treatment can be completed safely without complications, often without general anesthesia. Short-term (weeks to months): Preventive treatments like fluoride and protective coatings begin protecting teeth from decay. Medium-term (3-6 months): Improved eating habits and nutrition may develop as dental pain decreases and the child becomes more comfortable eating. Long-term (1+ years): Continued preventive care maintains oral health and may prevent the need for more invasive treatments later. However, this timeline is based on one case, and individual children may progress differently.

Want to Apply This Research?

  • Track dental visit dates and preventive treatments received (fluoride applications, protective coatings, remineralizing agent applications). Record any bleeding episodes or complications during or after dental work. Monitor eating habits by noting which foods the child can comfortably eat and any changes in appetite or nutrition intake. Take photos of the child’s mouth at regular intervals to document any changes in the malformation’s appearance.
  • Set reminders for preventive fluoride treatments every three months. Create a dental care routine that includes gentle brushing with a soft toothbrush and use of protective coatings as recommended. Keep detailed notes about any bleeding, swelling, or discomfort after dental procedures. Maintain a food diary to track improvements in eating ability and nutrition. Schedule regular follow-up appointments with both dental and medical specialists and use the app to coordinate these visits.
  • Establish a long-term tracking system that documents: (1) All dental procedures and preventive treatments with dates, (2) Any bleeding or complications with severity and duration, (3) Changes in eating ability and food preferences, (4) Imaging results and specialist recommendations, (5) Overall oral health status and tooth condition. Review this information quarterly with your dental team to adjust the care plan as needed. Use the app to share this information with all healthcare providers involved in the child’s care.

This case report describes the experience of one child and cannot be applied universally to all children with vascular malformations or similar conditions. Every child’s situation is unique, and what worked in this case may not be appropriate for your child. This information is educational and should not replace professional medical or dental advice. Always consult with your child’s pediatrician and dentist before making treatment decisions. If your child has a vascular malformation or bleeding disorder, work closely with specialists to develop an individualized care plan. Do not attempt any dental procedures at home, and seek immediate medical attention if your child experiences unusual bleeding or complications.