Oral pain and infection control strategies for treating children and adolescents in India

Abstract

Introduction: Oral and dental health form an integral part of complete well being of an individual and society at large. Promoting oral health and societal progression go hand in hand. Aim: To investigate dentists' attitudes about pain and infection control while treating children and adolescents by assessing their recommendations of pre- and postoperative analgesics and antibiotics, and use of local anesthesia (LA) for definitive treatment in different clinical scenarios. Materials and Method: A total of 400 dentists, both general dental practitioners (GDPS) as well as specialist dentists, were surveyed over a period of 2 months by using a pre-tested close-ended questionnaire. The data was statistically analyzed using Pearson's Chi-square test and backward logistic regression analysis for analysis of categorical variables and independent variables, respectively. Level of significance was set at 5%. Results: It was found that there was a gross overuse of antibiotics and analgesics and under use of LA by GDPs compared to specialist dentists. Postoperative antibiotics and analgesics were used more commonly than preoperative antibiotics and analgesics. These strategies were used more often in permanent teeth than primary teeth except the use of LA, which was used with equal frequency in both primary as well as permanent dentition. Conclusion: Dependence on antibiotics and analgesics for achieving pain and infection control in children has to be minimized and focus has to be shifted on judicious definitive treatment involving use of LA, aseptic techniques, and behavior management techniques.

Antibiotic Use and Misuse in Dentistry in India—A Systematic Review

“…Twenty-six studies [ 32 , 33 , 34 , 35 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ] explored the indications and reasons for antibiotic prescription/dispensing. Of these, 25 studies involved questionnaire surveys of dentists, and one study [ 38 ] involved antibiotic dispensing by pharmacists without a prescription to patients with dental complaints.…”

“…Overall, twenty studies [ 32 , 33 , 34 , 35 , 56 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 83 , 85 , 86 , 87 , 89 ] assessed therapeutic and prophylactic indications for antibiotic use in dentistry.…”

Antibiotics in Dentistry: A Narrative Review of the Evidence beyond the Myth

“…The study revealed the overuse of antibiotics and analgesics, particularly in the postoperative phase, by general dentists rather than specialists, for pain control and treatment of infections, even in children and adolescents [65].…”

“…Clinical situations requiring antibiotic therapy on an empiric basis are limited to and include oral infections associated with signs of systemic spread of infection [17,65], such as elevated body temperature, lymphadenopathy, and lockjaw [13]. Coherently, antibiotics are not indicated for all odontogenic infections and should not be used in place of eliminating the cause of infection [72].…”