As in adults, pediatric patients may require pharmacologic relief of pain as a result of infection, treatment or trauma. When infection is present, treatment of the infection will eventually alleviate the pain. However, the lag in time for the antibiotic to take effect will, in many cases, require the use of an analgesic to provide a temporary reduction or elimination of pain. Subsequent dental treatment and trauma to the surrounding tissues can result in pain and inflammation that can be controlled by the judicious use of analgesics.
Drugs prescribed to relieve pain are termed analgesics. In the majority of cases prescribed analgesics should relieve pain without significantly altering consciousness. Analgesics can act via two mechanisms. Non-narcotic analgesics act directly on the peripheral nerve endings (the site from which the pain originates). Narcotic analgesics act in the central nervous system, where pain perception is altered. Specific pain levels (mild, moderate, severe) may be assigned for specific situations and procedures and the dentist should judiciously use his or her knowledge of analgesics to prescribe the most effective drug and appropriate dose to alleviate pain while avoiding overmedication.
Non-narcotic analgesics are useful in the management of mild to moderate pain which includes the majority of dental pain. Non-narcotic analgesics differ from narcotic analgesics in their site of action, lesser degree of toxicity and side affects and absence of drug dependency. Drugs in this class include acetaminophen, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs).