Acute Pain Management for Pediatric Dental Patients

Abstract

This statement summarizes current best practices in pediatric pain management for dentists and other stakeholders. Infants, children, adolescents, and individuals with special health care needs may experience pain resulting from dental/orofacial injury, infection, and dental procedures. Dental pain, an inflammatory condition, can be categorized as somatic (ie, periodontal, alveolar, mucosal) or visceral (ie, pulpal). Effective pain management begins with careful assessment for every patient, as inadequate treatment can result in significant physical and psychological consequences. Perioperative pain management approaches include preemptive pain management (eg, anesthetics), use of local anesthesia during general anesthesia for postoperative pain control, nonpharmacological anxiolytic interventions (eg, providing a calm environment, emotional support), distraction and imagery (eg, counting, video games), and pharmacological agents including non-opioid analgesics (eg, nonsteroidal anti-inflammatory drugs, acetaminophen) and opioid analgesics. Acetaminophen and nonsteroidal anti-inflammatory medications are first line pharmacologic therapies for pain management. Opioids should rarely be used in this population, and, when necessary, should be prescribed with measures to minimize misuse.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and guidance on pain management in infants, children, adolescents, and individuals with special health care needs.

_{KEYWORDS:  PAIN MANAGEMENT; ACUTE PAIN; PAIN, POSTOPERATIVE; FACIAL PAIN; TOOTHACHE; ANALGESIA}