Published in 2024.
This recommendation incorporates an evidence-based clinical practice guideline developed by the American Dental Association Science and Research Institute, together with the University of Pittsburgh School of Dental Medicine and the Center for Integrative Global Oral Health at the University of Pennsylvania.
The guideline has been endorsed by the International Association of Paediatric Dentistry (IAPD) and incorporated into the IAPD Foundational Articles and Recommendations framework to support global clinical practice.
Acute dental pain in children is a common clinical presentation and may arise from dental procedures, inflammatory conditions, or untreated dental disease. Effective pharmacological pain management is an important component of paediatric dental care and supports both patient comfort and successful treatment outcomes.
Evidence-based guidance is required to assist clinicians and caregivers in selecting appropriate analgesic strategies for children under the age of 12. These recommendations focus on pharmacological approaches for managing postoperative dental pain and for temporarily managing toothache when definitive dental treatment is not immediately available.
Core principles include:
These recommendations are intended to guide clinicians, patients, and caregivers in selecting safe and effective pharmacological strategies for the management of acute dental pain in children.
For children undergoing simple or surgical tooth extractions, the guideline panel suggests initiating pain management using:
These options are preferred over acetaminophen alone for postoperative pain management.
If pain control using NSAIDs alone is inadequate, the addition of acetaminophen is suggested.
When NSAIDs are contraindicated, acetaminophen alone may be used.
Due to insufficient evidence, no recommendation could be formulated regarding the use of corticosteroids for postoperative dental pain management.
When definitive dental treatment is not immediately available, the guideline panel suggests using:
These options are recommended over acetaminophen alone for temporary pain control.
If NSAIDs alone do not provide sufficient pain relief, the addition of acetaminophen may be considered.
When NSAIDs are contraindicated, acetaminophen alone may be used.
Clinicians should:
Certain medications should not be used in children, including:
Topical benzocaine in infants and young children, due to the risk of methemoglobinemia
To support clinical implementation and knowledge translation, IAPD provides additional educational materials.
🎥 IAPD Webinars
Selected IAPD webinars address pain management strategies and clinical decision-making in paediatric dentistry.
▶ Watch on the IAPD YouTube channel
🎙 IAPD Podcast Series
The IAPD podcast series explores evidence-based approaches to paediatric dental care and clinical decision-making.
▶ Listen on the Colgate Oral Health Network
International Association of Paediatric Dentistry (IAPD).
IAPD Foundational Articles and Recommendations: Pharmacological Management of Acute Dental Pain in Children Under 12 Years.
2024.
