Acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are really useful as first-line treatments for managing short-term dental pain in children under age 12, in response to a recent clinical practice guideline developed by the American Dental Association Science & Research Institute (ADASRI), the University of Pittsburgh School of Dental Medicine and the Center for Integrative Global Oral Health on the University of Pennsylvania School of Dental Medicine. The rule has been endorsed by the American Dental Association.

A tenet panel determined that, when used as directed, acetaminophen alone, NSAIDs (like ibuprofen) alone or acetaminophen together with NSAIDS can effectively manage a toddler’s pain after a tooth extraction or during a toothache when dental care shouldn’t be immediately available. These and other recommendations are actually available within the September issue of The Journal of the American Dental Association.

The rule evaluated doses of acetaminophen and NSAIDs which will differ from the dosing printed on the over-the-counter packages of those medications. Based on the rule, when acetaminophen or NSAIDs are administered as directed by a dentist or other health care provider, the chance of harm to children from either medication is low.

Guideline senior writer Paul Moore, D.M.D., Ph.D., M.P.H., is professor emeritus on the University of Pittsburgh’s School of Dental Medicine. He said the recommendations align with previous guidance from the U.S. Food and Drug Administration (FDA), which contraindicated using codeine and tramadol in children under age 12 in 2017.

While prescribing opioids to children has grow to be less frequent overall, this guideline ensures that each dentists and fogeys have evidence-based recommendations to find out essentially the most appropriate treatment for dental pain. Parents and caregivers can take comfort that widely available medications that don’t have any abuse potential, comparable to acetaminophen or ibuprofen, are secure and effective for helping their children find relief from short-term dental pain.”

Dr. Paul Moore, D.M.D., Ph.D., M.P.H., professor emeritus on the University of Pittsburgh’s School of Dental Medicine

In 2020, the FDA awarded the University of Pittsburgh and ADASRI a three-year $1.5 million grant to develop a clinical practice guideline for the management of acute pain in dentistry in children, adolescents and adults. A gaggle of researchers and methodologists from ADASRI, the University of Pittsburgh School of Dental Medicine, the Center for Integrative Global Oral Health on the University of Pennsylvania School of Dental Medicine, McMaster University and the Art of Democracy worked together to develop the rule.

“This clinical prescribing guideline is a critical step in supporting appropriate treatment of pediatric acute dental pain through using acetaminophen and NSAIDs,” said Patrizia Cavazzoni, M.D., director of the FDA Center for Drug Evaluation and Research. “Not only will this recommendation allow for higher treatment of this type of pain, but it would help prevent unnecessary prescribing of medicines with abuse potential, including opioids.”

That is the primary of two guidelines on acute dental pain management. A second set of recommendations for adolescents and adults is in development. The brand new acute pediatric pain management guideline could be found at ada.org/painmanagement.

Source:

American Dental Association

Journal reference:

Carrasco-Labra, A., et al. (2023) Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children. The Journal of the American Dental Association. doi.org/10.1016/j.adaj.2023.06.014.