ADA recommends NSAIDS for pediatric pain management

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New ADA guideline recommends acetaminophen and NSAIDs for paediatric dental pain

New guidelines from the American Dental Association recommend using non-steroidal anti-inflammatory drugs and acetaminophen first in treating dental pain in children in no small part because of the opioid epidemic. (Image: Harbucks/Shutterstock)

CHICAGO, US: The American Dental Association (ADA) Science and Research Institute and the University of Pittsburgh School of Dental Medicine in the US have released a comprehensive new clinical practice guideline for management of acute dental pain in children, in which paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are recommended over tramadol and codeine for first-line treatment in children under 12. The guideline development was funded by a US Food and Drug Administration (FDA) grant of US$1.5 million.

In 2018, the ADA released a policy on opioid use emphasising mandatory continuing education and prescription limits. In a recent press release, Dr Paul Moore, senior author of the present guideline and professor emeritus at the University of Pittsburgh School of Dental Medicine, said: “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. Parents and caregivers can take comfort that widely available medications that have no abuse potential, such as acetaminophen or ibuprofen, are safe and effective for helping their children find relief from short-term dental pain.”

Dr Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research, said of the new clinical practice guideline: “This clinical prescribing guideline is a critical step in supporting appropriate treatment of paediatric acute dental pain through the use of acetaminophen and NSAIDs. 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.”

This paediatric pain management guideline is the first of two guidelines funded by the aforementioned FDA research grant. The second is being developed and deals with recommendations on the management of acute dental pain in adolescents and adults.

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