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

Ashley, Paul; Parekh, Susan; Moles, David R; Anand, Prabhleen; Behbehani, Amal

doi:10.1002/14651858.cd008392.pub2

Cited by 22 publications

(33 citation statements)

References 27 publications

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“…In all reviews, the reporting of 8 of the 11 items was adequate (Figure 1). The weakest area was failure to report the likelihood of publication bias, in 14 reviews (38%), which did not assess publication bias [11-13,17,19,20,24-26,34,35,38,42,43]. One review did not use “grey” literature as an inclusion criterion [34] and in another, the methods used to combine the findings of studies were inappropriate [38].…”

Section: Resultsmentioning

confidence: 99%

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

2014

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BackgroundTo ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice.MethodsWe conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence).ResultsWe selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars.ConclusionsCochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence.

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Section: Resultsmentioning

confidence: 99%

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

2014

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“…3,4 Previous investigations [5][6][7][8] have primarily used visual analogue scales (VASs) to measure only pain intensity during orthodontic therapy. Other types of pain measures, such as verbal rating scales 9 and pressure algometry, 10 have seen limited employment.…”

Section: Introductionmentioning

confidence: 99%

Validation of a modified McGill Pain Questionnaire for orthodontic patients

Iwasaki

Freytag²,

Schumacher

et al. 2013

The Angle Orthodontist

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Objective: To assess better and more efficiently the aspects of pain experienced by adolescent orthodontic patients, the McGill Pain Questionnaire-Short Form (MPQ-SF) was modified (MMPQ-SF) and validated. Materials and Methods: Internal and external expert panels developed a MMPQ-SF with 15 descriptors and 4-point Likert severity scales (MMPQ-SF15). Seventy-five subjects undergoing orthodontic treatment gave informed consent. Sixty-one subjects completed the MMPQ-SF15, a visual analogue scale (VAS), and the present pain index (PPI) 24 hours after an orthodontic visit. Respondents were grouped by gender and treatment stage: initial (15 female, 7 male), middle (10 female, 7 male), and end (16 female, 6 male). MMPQ-SF, VAS, and PPI scores were compared by Spearman correlation analysis. Underlying constructs were explored by factor analyses. Construct validity of the MMPQ-SF was tested by analysis of variance. Results: MMPQ-SF15 and VAS (r 5 0.78, r 2 s 5 0.61, P , .0001), MMPQ-SF15 and PPI (r 5 0.84, r 2 s 5 0.71, P , .0001), and VAS and PPI (r 5 0.70, r 2 s 5 0.48, P , .0001) were correlated positively and significantly. A two-factor solution (localized and generalized/emotional pain; KaiserMeyer-Olkin 5 0.88) showed that 11 descriptors (MMPQ-SF11) accounted for 64% of response variability. Generalized/emotional pain values were significantly higher during the initial stage of treatment compared to the middle (P 5 .011) and end stages (P 5 .014). Conclusions: MMPQ-SF, particularly MMPQ-SF11, demonstrated utility in assessment of localized and generalized/emotional aspects of pain in adolescent orthodontic patients and correlated well with VAS and PPI. Future application of the MMPQ-SF11 to measure orthodontic pain more specifically could lead to more appropriate management of this important facet of therapy. (Angle Orthod. 2013;83:906-912.)

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“…One SR, Ashley et al (), 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.…”

Section: Resultsmentioning

confidence: 99%

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

Radman

Babić

Runjić

et al. 2019

European Journal of Pain

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Background and objective We explored how systematic reviews evaluated paracetamol and ibuprofen for treating pain in children, as these two non‐opioid analgesics are well‐established medicines included in most national essential medicines lists. Databases and data treatment We carried out an overview of systematic reviews (SRs) of randomized controlled trials (RCTs) of interventions (PROSPERO registration: 42016045367). We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR) and Database of Reviews of Effects (DARE) up to 23 August 2017. We used AMSTAR checklist to analyse methodological quality of included SRs. Results We found 17 SRs with 72 unique RCTs; the majority of those trials included under 100 children. Positive conclusive evidence was found in only one SR, regarding safety of paracetamol. Conclusions of other SRs for efficacy and safety of ibuprofen and paracetamol were inconclusive, unclear, or there was no opinion. Only one SR analysed efficacy of ibuprofen and other non‐steroidal anti‐inflammatory drugs (NSAIDs) in chronic pain and the conclusion was that there was no evidence from RCTs that NSAIDs were effective for chronic non‐cancer pain in children and adolescents. Most of the SRs addressed very narrow questions, included few trials, with few children and were of low or medium methodological quality. Conclusions Most SRs on two relevant medicines have inconsistent conclusions and doubt upon their effectiveness. Instead of focusing on very narrow questions, SRs should examine more comprehensive research topics to obtain a general sense of consistency, particularly when analysing established medicines. Significance Evidence behind two analgesics—ibuprofen and paracetamol—that are well‐established medicines for children in most countries appears limited, judging by the systematic reviews. The discrepancy between clinical use and the extensive evidence we reviewed may be a result of the selective criteria in the reviews examined. We need new, and better evidence syntheses supporting the use of these two medicines in wide indications regarding pain in children.

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

Cited by 22 publications

References 27 publications

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment

Validation of a modified McGill Pain Questionnaire for orthodontic patients

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

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