J Kühnisch1, M Daubländer2, G Klingberg3, A Dougall4,5, M Spyridonos Loizides6, E Stratigaki7, J L Amar8, V Anttonen9,10, M Duggal11, S Gizani12. 1. Department of Operative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany. jkuehn@dent.med.uni-muenchen.de. 2. Department of Oral Surgery, University Medical Centre Mainz, Mainz, Germany. 3. Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden. 4. Department of Child and Public Dental Health, Trinity College, Dublin, Republic of Ireland. 5. Dublin Dental University Hospital, Dublin, Republic of Ireland. 6. Private Practice for Paediatric Dentistry, Nicosia, Cyprus. 7. Department of Orthodontics and Paediatric Dentistry, University of Basel, Basel, Switzerland. 8. Private Practice for Paediatric Dentistry, Geneva, Switzerland. 9. Research Unit of Oral Health Sciences, Department of Cariology, Endodontology and Paediatric Dentistry, University of Oulu, Oulu, Finland. 10. MRC of Oulu University and University Hospital, Oulu, Finland. 11. Faculty of Dentistry, National University of Singapore, Singapore, Singapore. 12. Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece.
Abstract
BACKGROUND: The European Academy of Paediatric Dentistry (EAPD) proposes this best-practice guidance to help practitioners to decide when and how to use local analgesia to control pain in children, adolescents, and medically compromised individuals during the delivery of oral health care. METHODS: A search of different databases was conducted using all terms relevant to the subject. Relevant papers were identified after a review of their titles, abstracts or full papers. Three workshops were held during the corresponding EAPD interim seminar in Torino (Italy) in 2017. Several statements were agreed upon and, furthermore, knowledge gaps were identified. RESULTS: An important outcome was that when local analgesia administered appropriately-correct choice of agent(s) and dosage, proper route of administration-it is, firstly, clinically effective for pain-control in treating children and, secondly, it carries a very low risk of morbidity including adverse or side-effects. Furthermore, several gaps in knowledge were identified during the workshop which indicates future research needs. Most importantly it remains unsatisfactory that in several European countries the most frequently used injectable local analgesic agent, articaine, is not approved for usage in children below the age of 4 years. CONCLUSION: When considering the dental demand to treat vulnerable (medically compromised) children and adolescents in a safe, painless, less-invasive and effective way, there seems to be an urgent need to close these gaps in knowledge.
BACKGROUND: The European Academy of Paediatric Dentistry (EAPD) proposes this best-practice guidance to help practitioners to decide when and how to use local analgesia to control pain in children, adolescents, and medically compromised individuals during the delivery of oral health care. METHODS: A search of different databases was conducted using all terms relevant to the subject. Relevant papers were identified after a review of their titles, abstracts or full papers. Three workshops were held during the corresponding EAPD interim seminar in Torino (Italy) in 2017. Several statements were agreed upon and, furthermore, knowledge gaps were identified. RESULTS: An important outcome was that when local analgesia administered appropriately-correct choice of agent(s) and dosage, proper route of administration-it is, firstly, clinically effective for pain-control in treating children and, secondly, it carries a very low risk of morbidity including adverse or side-effects. Furthermore, several gaps in knowledge were identified during the workshop which indicates future research needs. Most importantly it remains unsatisfactory that in several European countries the most frequently used injectable local analgesic agent, articaine, is not approved for usage in children below the age of 4 years. CONCLUSION: When considering the dental demand to treat vulnerable (medically compromised) children and adolescents in a safe, painless, less-invasive and effective way, there seems to be an urgent need to close these gaps in knowledge.
Entities:
Keywords:
Adolescents; Adverse events; Children; Clinical practice; Guideline; Local analgesia; Techniques of administration