New guidelines recommend avoiding opioids for short-term dental pain in children.

New guidelines recommend avoiding opioids for short-term dental pain in children.

Managing Dental Pain in Children: Guidelines for a Safer Approach

Children experiencing short-term dental pain from extractions or toothaches should not be prescribed opioids, according to new guidelines endorsed by the American Dental Association (ADA). Instead, over-the-counter options such as ibuprofen and acetaminophen should be used to manage the pain effectively.

The development of these guidelines was a collaborative effort by the ADA Science & Research Institute in Chicago, the University of Pittsburgh School of Dental Medicine, and the Center for Integrative Global Oral Health at the University of Pennsylvania School of Dental Medicine. The guidelines specifically focus on children under the age of 12.

Dr. Paul Moore, the senior author of the guidelines and a professor emeritus at the University of Pittsburgh’s School of Dental Medicine, emphasized the importance of evidence-based recommendations for determining the most appropriate treatment for dental pain in children. He stated, “While prescribing opioids to children has become less frequent overall, this guideline ensures that both dentists and parents have evidence-based recommendations to determine the most appropriate treatment for dental pain.”

The guidelines align with the U.S. Food and Drug Administration’s (FDA) 2017 recommendations, which advised against the use of codeine and tramadol in children under the age of 12. This helps establish a consistent approach to pain management across healthcare disciplines.

According to the guideline panel, when used as directed, acetaminophen alone, nonsteroidal anti-inflammatory drugs (NSAIDs) alone, or a combination of acetaminophen and NSAIDs like ibuprofen can effectively manage a child’s pain after a tooth extraction or during a toothache when dental care is not immediately available. It is important to note that the doses of these medications for children may differ from those suggested on the packaging, but when administered as directed by a dentist or healthcare provider, the risk of harm is minimal.

Dr. Patrizia Cavazzoni, the director of the FDA Center for Drug Evaluation and Research, commended the clinical prescribing guideline as a critical step in supporting appropriate treatment of pediatric acute dental pain. She stated, “Not only will this advice allow for better treatment of this kind of pain, but it will help prevent unnecessary prescribing of medications with abuse potential, including opioids.”

The FDA awarded the University of Pittsburgh and the ADA’s Science & Research Institute a three-year, $1.5 million grant in 2020 to develop a clinical practice guideline for acute pain in children, adolescents, and adults. This work highlights the importance of evidence-based approaches for pain management across different age groups.

It is worth mentioning that this set of guidelines solely focuses on children under the age of 12. However, the researchers are also working on developing a second set of guidelines specifically tailored to adolescents and adults. This comprehensive approach to pain management will provide clinicians and parents with the necessary tools to ensure safe and effective treatment for patients of all ages.

The guidelines, published in The Journal of the American Dental Association, serve as a valuable resource for dental professionals and caregivers, helping them make informed decisions regarding the appropriate management of dental pain.

In conclusion, these guidelines emphasize the use of over-the-counter medications like acetaminophen and ibuprofen for managing dental pain in children. By avoiding the unnecessary use of opioids, both dentists and parents can ensure the well-being and safety of children while effectively addressing their short-term dental pain complications.

Tooth Pain

More information

Refer to the American Association of Endodontists for additional information on tooth pain.

Source: American Dental Association, news release, Aug. 25, 2023

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