Dental pain in children: pharmacological management

Abstract

BACKGROUND: The prevalence of dental pain is relatively high across the global population, primarily attributable to dental caries. School-age children and adolescents with caries, particularly those with caregivers from lower socioeconomic backgrounds, are more likely to experience dental pain. In very young children, pain modulation is not yet fully developed; thus, inadequate pain management may cause pain memory formation which can lead to altered pain responses later in life. MATERIALS: This review aims to provide an overview of the management of dental pain in children with pulpitis. To achieve this goal, a search was conducted in PubMed using relevant keywords. The literature investigation focused on the pharmacological management of paediatric pulpitis, including the treatment of associated complications. CONCLUSION: Dental pain represents a significant public health concern. Pain due to endodontic emergency is different in younger children and should to be assessed with the use of an appropriate scales and treated with NSAID and/or acetoaminophen. The combination of ibuprofen and acetaminophen at fixed doses appears to be a viable option for dental pain treatment, although further randomised controlled trials (RCTs) are needed for confirmation. Antibiotics should only be used in cases involving local and/or systemic infectious complications. Opioids are not recommended for managing dental pain. Antibiotic prophylaxis is necessary only in selected cases and should not overshadow primary prevention, which remains the only true option for reducing the development of dental complications. Antibiotic Stewardship Programs (ASPs) could play a significant role in reducing inappropriate antibiotic prescriptions.