New Guideline Recommends NSAIDs, Acetaminophen for Pediatric Dental Pain

Nonsteroidal anti-inflammatory drugs and/or acetaminophen should be used for first-line treatment of acute dental pain in pediatric patients.

Children less than 12 years of age with acute dental pain should be managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and/or acetaminophen, according to new guidelines endorsed by the American Dental Association (ADA).

The new clinical practice guideline was developed by the American Dental Association Science & Research Institute (ADASRI), the University of Pittsburgh School of Dental Medicine and the Center for Integrative Global Oral Health at the University of Pennsylvania School of Dental Medicine. The guideline aligns with recommendations from the Food and Drug Administration (FDA), which advise against the use of codeine and tramadol in children less than 12 years of age.

Findings from a systematic review and meta-analysis showed that nonopioid medications, such as ibuprofen and naproxen alone, or with acetaminophen (if pain is not adequately controlled with an NSAID), are recommended for acute dental pain after 1 or more simple and surgical tooth extractions and for the temporary management of toothache when dental care is not immediately available. Dosages provided in the recommendations were based on dosing for prescribed analgesics, which differ from those printed on the over-the-counter (OTC) packaging of these medications.

“This clinical prescribing guideline is a critical step in supporting appropriate treatment of pediatric acute dental pain through the use of acetaminophen and NSAIDs,” said Patrizia Cavazzoni, MD, director of the FDA Center for Drug Evaluation and Research. “Not only will this advice allow for better treatment of this kind of pain, but it will help prevent unnecessary prescribing of medications with abuse potential, including opioids.”

A second guideline for the management of acute dental pain in adolescents and adults is currently in the works.

This article originally appeared on MPR


  1. New guideline details dental pain management strategies for pediatric patients. News release. American Dental Association. August 25, 2023. Accessed August 31, 2023.
  2. Carrasco-Labra A, Polk DE, Urquhart O, et al. Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in children. Journal of the American Dental Association. Published online September 2023. doi:10.1016/j.adaj.2023.06.014