New Guidelines Advise Against Opioids for Children’s Dental Pain

In a move aimed at promoting safer and more effective pain management for children, new guidelines have been endorsed by the American Dental Association (ADA). 

These guidelines, developed collaboratively 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, recommend that opioids should not be prescribed to children experiencing short-term dental pain resulting from extractions or toothaches. Instead, the guidelines advise the use of over-the-counter options such as ibuprofen and acetaminophen.

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Focused on Children Under Age 12

The endorsed guidelines are specifically tailored to children under the age of 12, aiming to ensure that both dentists and parents have access to evidence-based recommendations for the most appropriate treatment of dental pain. 

Dr. Paul Moore, the senior author of the guidelines and a professor emeritus at the University of Pittsburgh’s School of Dental Medicine, emphasised that the use of widely available, non-abusable medications like acetaminophen and ibuprofen is safe and effective in providing relief from short-term dental pain.

Aligned with FDA Recommendations

These guidelines align with recommendations from the U.S. Food and Drug Administration (FDA) dating back to 2017. The FDA had advised against the use of codeine and tramadol in children under the age of 12. 

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The panel behind these new guidelines stressed that when used as directed, acetaminophen alone, non-steroidal anti-inflammatory drugs (NSAIDs) alone, or acetaminophen in combination with NSAIDs like ibuprofen can effectively manage a child’s dental pain resulting from procedures like tooth extractions or during toothaches when immediate dental care is not available.

Ensuring Safe Administration

It’s important to note that the doses required for effective pain relief may differ from what is printed on the packaging of these medications. However, when administered under the guidance of a dentist or other healthcare provider, the risk of harm to children from either medication is considered low.

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The development of these guidelines was supported by a three-year, $1.5 million grant awarded by the FDA in 2020 to the University of Pittsburgh and the ADA’s Science & Research Institute. Dr. Patrizia Cavazzoni, director of the FDA Center for Drug Evaluation and Research, lauded the importance of these clinical prescribing guidelines. She noted that not only will these recommendations lead to better treatment of pediatric dental pain, but they will also help prevent unnecessary prescriptions of potentially addictive medications, including opioids.

Focus on the Future

While these guidelines primarily address children, the researchers are actively working on a second set of guidelines aimed at adolescents and adults. The commitment to evidence-based, safe, and effective pain management is a cornerstone of these efforts.

The detailed recommendations can be found in the September issue of The Journal of the American Dental Association, signalling a significant step forward in promoting the responsible use of pain management medications for children’s dental care.