A pain management clinical practice guideline developed by Penn Dental Medicine’s Center for Integrative Global Oral Health (CIGOH) is among The Journal of the American Dental Association (JADA)‘s top five trending articles for 2024, according to JADA. Originally published in the September 2023 issue of JADA, the guideline for managing acute dental pain in children was developed by CIGOH, the American Dental Association Science and Research Institute (ADASRI), and the University of Pittsburgh School of Dental Medicine. Dr. Alonso Carrasco-Labra, associate professor and director of the Cochrane Oral Health Collaborating Center at Penn Dental Medicine, and Olivia Urquhart, an epidemiologist and instructor within CIGOH, co-led its development.
Endorsed by the ADA, the guideline notes that acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are recommended as first-line treatments for managing short-term dental pain in children under age 12. A guideline panel determined that, when used as directed, acetaminophen alone, NSAIDs (like ibuprofen) alone or acetaminophen in combination with NSAIDS can effectively manage a child’s pain after a tooth extraction or during a toothache when dental care is not immediately available.
According to the guideline, when acetaminophen or NSAIDs are administered as directed by a dentist or other health care provider, the risk of harm to children from either medication is low.
These recommendations align with previous guidance from the U.S. Food and Drug Administration (FDA) in 2017, which contraindicated the use of codeine and tramadol in children under age 12. In 2020, the FDA awarded the University of Pittsburgh and ADASRI a $1.5 million grant to develop a clinical practice guideline for the management of acute pain in dentistry in children, adolescents and adults. A group of researchers and methodologists from ADASRI, the University of Pittsburgh School of Dental Medicine, CIGOH, McMaster University and the Art of Democracy worked together to develop this pediatric patient guideline as well as one for adolescents, adults, and older adults, which published in February 2024.
Both guidelines can be found at ada.org/painmanagement.
