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On August 25, the ADA released a clinical practice guideline recommending the use of acetaminophen and NSAIDs as first-line treatments for pediatric dental patients.

ADA releases new clinical practice guideline for dental pain management in children

Aug. 25, 2023
Just-released guidelines on the use of acetaminophen and NSAIDs as first-line treatments for pediatric dental patients “help prevent unnecessary prescribing of medications with abuse potential, including opioids.”
Elizabeth S. Leaver, Digital content manager

A new clinical practice guideline endorsed by the ADA recommends acetaminophen or NSAIDs such as ibuprofen as first-line treatments for managing short-term dental pain associated with toothaches and extractions in children under age 12.

According to a press release from the ADA, the new guideline, developed by the American Dental Association Science & Research Institute (ADASRI), 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 and released on August 25, recommends that when used as directed, acetaminophen, NSAIDs, or a combination of the two can effectively manage a child’s pain after a tooth extraction or during a toothache when dental care is not immediately available.

The guideline came about from a grant awarded by the FDA to ADASRI and the University of Pittsburgh in 2020 to develop a clinical practice guideline for the management of acute pain in dentistry in children, adolescents, and adults. The new guideline for pediatric pain management is the first of two, with the second set geared toward adolescents and adults still in development, and its recommendations align with previous FDA guidance that contraindicated the use of codeine and tramadol in children under age 12 in 2017.

“This evidence-based clinical practice guideline was developed following an intense review of worldwide scientific literature on treatment of acute dental pain," guideline senior author Paul Moore, DMD, PhD, MPH, said in an email to DentistryIQ. "These findings and recommendations will help guide dentists and physicians toward safe and effective analgesics for the management of pain associated with dental extractions and toothaches in children younger than 12 years of age.”

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According to the press release, in addition to the guideline being a “critical step in supporting appropriate treatment of pediatric acute dental pain through the use of acetaminophen and NSAIDs," said Patrizia Cavazzoni, MD, director of the FDA Center for Drug Evaluation and Research, it will also “help prevent unnecessary prescribing of medications with abuse potential, including opioids.”

“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,” Moore said. “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.”

Sourced primarily from the ADA press release: New Guideline Details Dental Pain Management Strategies for Pediatric Patients

Access the full study from JADA: Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children