Abstract
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.