Preoperative analgesics for additional pain relief in children and adolescents having dental treatment

Abstract

Three included studies related to dental treatment (fillings and tooth extractions) and two related to orthodontic treatment (braces). Three of the five included studies compared paracetamol to a placebo (sugar tablet) and four of them compared ibuprofen to a placebo. Key results From the available evidence, we could not determine whether or not painkillers before treatment are of benefit for children and adolescents having dental procedures under local anaesthetic. There is probably a benefit in giving painkillers before braces are fitted. Only one study reported an adverse event (one participant in each group had a lip or cheek biting injury). More research is needed. Quality of the evidence None of the included studies were at low risk of bias. The quality of the evidence is low. Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (Review)

Revisiting established medicines: An overview of systematic reviews about ibuprofen and paracetamol for treating pain in children

“…The 17 included SRs were published between 2004 and 2017. There were nine Cochrane SRs (Ashley, Parekh, Moles, Anand, & MacDonald, 2016;Brady-Fryer, Wiebe, & Lander, 2004;Cooper, Fisher, et al, 2017;Cooper, Heathcote, et al, 2017;Hobson, Wiffen, & Conlon, 2015;Lewis, Nicholson, Cardwell, Siviter, & Smith, 2013;Ohlsson & Shah, 2016;Sjoukes et al, 2016) and eight non-Cochrane SRs (Anand et al, 2005;Goldstein, Berlin, Berkovitch, & Kozer, 2008;Hamunen & Kontinen, 2005;Jenkins, Costello, & Hodge, 2004;Le May et al, 2016;Perrott, Piira, Goodenough, & Champion, 2004;Pierce & Voss, 2010;Southey, Soares-Weiser, & Kleijnen, 2009). Basic characteristics of included SRs are shown in Table 1 and more details about each of them in Supporting Information Table S3.…”

“…Two included Cochrane SRs have been updated; the latest version of both was published in 2016 (Ashley et al, 2016;Ohlsson & Shah, 2016) and their earlier versions were published in 2012 (Ashley, Parekh, Moles, Anand, & Behbehani, 2012) and 2015 (Ohlsson & Shah, 2015).…”

“…Seven SRs compared ibuprofen and paracetamol (Ashley et al, 2016;Lewis et al, 2013;Le May et al, 2016;Perrott et al, 2004;Pierce & Voss, 2010;Sjoukes et al, 2016;Southey et al, 2009); seven systematic reviews analysed only paracetamol (Anand et al, 2005;Brady-Fryer et al, 2004;Goldstein et al, 2008;Hamunen & Kontinen, 2005;Hobson et al, 2015;Jenkins et al, 2004;Ohlsson & Shah, 2016) and one SR analysed only ibuprofen . Three SRs analysed only safety, of paracetamol (Jenkins et al, 2004), ibuprofen (Lewis et al, 2013) or both ibuprofen and paracetamol (Southey et al, 2009).…”

“…We divided the analysed SRs into eight groups, according to the analysed indication: analgesia during invasive procedures in preterm infants and newborns (Anand et al, 2005;Brady-Fryer et al, 2004;Ohlsson & Shah, 2016), perioperative analgesia (Goldstein et al, 2008;Hamunen & Kontinen, 2005;Hobson et al, 2015;Lewis et al, 2013), analgesia in dental procedures (Ashley et al, 2016), analgesia in acute otitis media (AOM) (Sjoukes et al, 2016), analgesia in emergency department for acute musculoskeletal injuries (Le May et al, 2016), chronic non-cancer pain , cross-sensitivity of asthma caused by aspirin with non-opioid analgesics (Jenkins et al, 2004), and difference in effectiveness and safety between ibuprofen and paracetamol (Perrott et al, 2004;Pierce & Voss, 2010;Southey et al, 2009).…”

“…One SR, Ashley et al (2016), examined the effectiveness and safety of preoperative administration of ibuprofen and paracetamol for postoperative pain after dental procedures. The SR included three RCTS about paracetamol with a total of 165 children included and four RCTs about ibuprofen with a total of 209 children.…”