Research Summary

Clinical Practice Guidelines Recommend NSAIDs for Managing Acute Dental Pain in Pediatric Patients

Jessica Ganga

In a new guideline endorsed by the American Dental Association, nonopioid medications—nonsteroidal anti-inflammatory medications (NSAIDs)—in combination with acetaminophen are recommended for acute dental pain in pediatric patients.

The guideline authors were made up of a panel of experts from the American Dental Association Council on Scientific Affairs, American Dental Association Science and Research Institute, University of Pittsburgh School of Dental Medicine, and Center for Integrative Global Oral. A systematic review was conducted by the members of the panel to determine the effect of analgesics and corticosteroids in managing acute dental pain in patients younger than 12 years of age.

Their review determined that, when used as directed, acetaminophen alone, NSAIDs alone, or acetaminophen in combination with NSAIDs manages a child’s pain after a tooth extraction or during a toothache. All three options are effective, based on the authors’ findings, but “There is a small beneficial net balance favoring the use of nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen compared with not providing analgesic therapy,” the authors wrote.

In total, the panel developed seven recommendations and five good practice statements for health care professionals to reference.

“Nonopioid medications, specifically NSAIDs like ibuprofen and naproxen alone or in combination with acetaminophen, are recommended for managing acute dental pain after 1 or more tooth extractions (that is, simple and surgical) and the temporary management of toothache in children,” the authors concluded. “According to the FDA, the use of codeine and tramadol in children for managing acute pain is contraindicated.”

 

Reference:
Carrasco-Labra A, Polk DE, Urquhart O, et al. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children. J Am Dent Assoc. 2023;154(9):814-825. doi:10.1016/j.adaj.2023.06.014