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the chance your child will need to un- dergo a painful dental procedure. As is often the case in healthcare, preventing a problem before it starts is the best way to keep your child happy, healthy and pain-free. If your child must undergo a dental
procedure, the type of pain manage- ment required will ultimately depend on the dental procedure performed. For example, if your child has had a simple tooth extraction, filling or other less com- plex dental procedure, over-the-counter medications such as acetaminophen or ibuprofen will often suffice. You should avoid aspirin-containing
products due to the risk of Reye’s syn- drome, a rare but serious condition that causes swelling in the liver and brain. According to the American Academy
of Pediatric Dentistry, because inflamma- tion often contributes to post-procedural pain, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are considered the treatment of choice for mild-to-moderate dental pain in kids. If your child is not able to take NSAIDs due to a bleeding disorder, kidney problems or other contraindications, acetaminophen is the recommended alternative. Just remember to pay close attention to the frequency with which you give acetaminophen, as there should be at least six hours between each dose. It is no longer recommended to give acet- aminophen every four hours due to the concerns about acetaminophen toxicity and liver damage. If your child has more extensive dental
work or requires dental surgery as the result of dental trauma, your dentist or oral surgeon might prescribe opioids. Opioids provide good pain relief for
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moderate-to-severe pain, but can also have significant side effects, the most common of which is constipation. If an opioid analgesic is prescribed, it is help- ful to encourage lots of fluids, high-fiber foods and occasionally a stool softener to prevent constipation.
Opioids can also have more serious side effects, including sedation and respiratory depression. As a result, they are used with caution in pediatric patients. Rather than using an opioid analgesic alone, it is often recommended to combine it with NSAIDs in order to reduce the amount of opioid doses your child will need. Opioids are also only prescribed for a very short duration (usually for only two to three days) in order to limit side effects and the potential for physical dependence.
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