JADA Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children

A collaborative effort among 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 Health at the University of Pennsylvania produced evidence-based recommendations for managing acute dental pain in children, particularly after tooth extractions and in cases where immediate dental care is unavailable. Their comprehensive review, utilizing systematic analyses and meta-analyses, yielded seven recommendations and five good practice statements. Nonsteroidal anti-inflammatory drugs (NSAIDs), specifically ibuprofen and naproxen, either alone or in combination with acetaminophen, were found to offer a slight advantage in managing post-extraction dental pain in children. However, there’s limited evidence regarding the efficacy of corticosteroids in this context. Importantly, the guidelines strongly advise against using opioids like codeine and tramadol in children due to FDA contraindications. This guideline aims to inform dental practitioners and caregivers about the use of nonopioid medications, particularly NSAIDs, for managing acute dental pain in children following tooth extractions or during temporary toothache situations when immediate definitive dental treatment is unavailable.