Abstract
Data sources
Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, ISI Web of Science, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform.
Study selection
Randomised controlled clinical trials of analgesics given before dental treatment versus placebo or no analgesics in children and adolescents up to 17 years of age. Children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia were excluded.
Data extraction and synthesis
Two reviewers independently selected studies, abstracted data and assessed risk of bias. Standard Cochrane methodological approaches were used.
Results
Five trials involving 190 patients were included. None of the studies were at low risk of bias. Three trials involved dental treatment and two involved orthodontic treatment. Three of the included trials compared paracetamol with placebo. Meta-analysis of the two trials showed no evidence of a benefit in taking paracetamol preoperatively; (RR) for postoperative pain of 0.81 (95%CI; 0.53 to 1.22). Four trials compared ibuprofen with placebo. Pooled data from two studies showed a statistically significant mean difference in severity of postoperative pain of −13.44 (95%CI; −23.01 to −3.88) on a visual analogue scale (0 to 100), which indicated a probable benefit. Both trials were at high risk of bias and the quality of the evidence is low.
Conclusions
From the available evidence, we cannot determine whether or not preoperative analgesics are of benefit in paediatric dentistry for procedures under local anaesthetic. There is probably a benefit in using preoperative analgesics prior to orthodontic separator placement. The quality of the evidence is low. Further randomised clinical trials should be completed with appropriate sample sizes and well defined outcome measures.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Chapman HR, Kirby-Turner N . Visual/verbal analogue scales: examples of brief assessment methods to aid management of child and adult patients in clinical practice. Br Dent J 2002; 193:447–450.
Howard KE, Freeman R . Reliability and validity of a faces version of the Modified Child Dental Anxiety Scale. Int J Paediatr Dent 2007; 17:281–288.
Campbell C, Soldani F, Busuttil-Naudi A, Chadwick B . Update of Non-pharmacological behaviour management guideline: Clinical Guidelines in Paediatric Dentistry, Revised 2011.
Asthma UK . website. Available from https://www.asthma.org.uk/about/media/facts-and-statistics (accessed February 2017).
British National Formulary. Available at www.medicinescomplete.com/mc/bnfc/current/PHP78612-non-steroidal-anti-inflammatory-drugs.htm (Accessed February 2017).
Author information
Authors and Affiliations
Additional information
Address for correspondence: Luisa Fernandez Mauleffinch, Managing Editor, Cochrane Oral Health Group, School of Dentistry, The University of Manchester, JR Moore Building, Oxford Road, Manchester, M13 9PL, UK. E-mail: luisa.fernandez@manchester.ac.uk
Ashley PF, Parekh S, Moles DR, Anand P, MacDonald LC. Preoperative analgesics for additional pain relief in children and adolescents having dental treatment. Cochrane Database Syst Rev 2016; 8: Art. No. CD008392. DOI: 10.1002/14651858.CD008392.pub3.
This paper is based on a Cochrane Review published in the Cochrane Library 2016, issue 8 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Library should be consulted for the most recent version of the review.
Rights and permissions
About this article
Cite this article
McCann, C. Preoperative analgesia for children and adolescents to reduce pain associated with dental treatment. Evid Based Dent 18, 17–18 (2017). https://doi.org/10.1038/sj.ebd.6401220
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.ebd.6401220
