• Posted August 28, 2023

Avoid Opioids for Short-Term Dental Pain in Kids, New Guidelines Say

Children having short-term dental pain from extractions or toothache should not be prescribed opioids but rather manage those aches with over-the-counter ibuprofen and/or acetaminophen, according to new guidelines.

The guidelines detailing dental pain management strategies for kids was endorsed by the American Dental Association (ADA) after being developed by the ADA Science & Research Institute in Chicago, 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.

These guidelines apply to children under age 12.

“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," said Dr. Paul Moore, guideline senior author and professor emeritus at the University of Pittsburgh's School of Dental Medicine.

“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," Moore said in an ADA news release.

The guidelines align with U.S. Food and Drug Administration recommendations from 2017, which advised against the use of codeine and tramadol in children under age 12.

The guideline panel said that when used as directed, acetaminophen alone, NSAIDs alone or acetaminophen in combination with NSAIDs like ibuprofen, can effectively manage a child's pain after a tooth extraction or during a toothache when dental care is not immediately available.

Doses needed may differ from those suggested on the printed packaging for the medications, but when administered as directed by a dentist or other health care provider the risk of harm to children from either medication is low.

The FDA awarded the University of Pittsburgh and the ADA's Science & Research Institute with a three-year, $1.5 million grant in 2020 to develop a clinical practice guideline for acute pain in children, adolescents and adults.

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

"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," she said in the release.

The researchers are working on a second set of guidelines for adolescents and adults.

These recommendations were published in the September issue of The Journal of the American Dental Association.

More information

The American Association of Endodontists has more on tooth pain.

SOURCE: American Dental Association, news release, Aug. 25, 2023