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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
342 questions in 11 reviews · Pain control and patient management
current versionsNo studies 158 · 46.2%Ungraded 53 · 15.5%Very low 87 · 25.4%Low 30 · 8.8%Moderate 10 · 2.9%High 4 · 1.2%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Infiltration injection local anaesthetic vs No treatment or placebo Participant satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on patient or child satisfaction | 0 studies | No studies |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Intraoperative or postoperative bleeding · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Elhakim 1993 reported prolonged postoperative bleeding in the no-treatment group; Andrzejowski 2002 reported no difference in bleeding (nurse-assessed 'mild' in both groups) | 2 studies · 160 participants | Very low |
Infiltration injection local anaesthetic vs No treatment or placebo Intraoperative or postoperative bleeding · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Because of substantial clinical and methodological heterogeneity in the studies, we were unable to determine an estimate of effect | 2 studies · 174 participants | Very low |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Lip or cheek biting, numbness or allergy · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | The study did not report on lip or cheek biting | 0 studies | No studies |
Intraligamental injection local anaesthetic vs No treatment Postoperative pain · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… · On regaining consciousness, up to 1 hour (1 study to 48 hours) Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Because of substantial clinical and methodological heterogeneity in the studies, we were unable to determine an estimate of effect | 2 studies · 115 participants | Very low |
Infiltration injection local anaesthetic vs No treatment or placebo Postoperative pain or distress · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… · Postoperatively, typically up to discharge Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Because of substantial clinical and methodological heterogeneity in the studies, we were unable to determine an estimate of effect | 6 studies · 542 participants | Very low |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Parental satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | No study reported parental satisfaction | 0 studies | No studies |
Intraligamental injection local anaesthetic vs No treatment Physiological parameters (cardiac/respiratory events; type and volume of GA drug) · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on this outcome | 0 studies | No studies |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Participant satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on patient or child satisfaction | 0 studies | No studies |
Infiltration injection local anaesthetic vs No treatment or placebo Postoperative anxiety · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on postoperative anxiety | 0 studies | No studies |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Postoperative anxiety · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Postoperative anxiety (Venham Picture Test) measured in 52 children; not statistically significantly different among the three groups (P=0.23) | 1 study · 52 participants | Ungraded |
Intraligamental injection local anaesthetic vs No treatment Parental satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | No study reported parental satisfaction | 0 studies | No studies |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Postoperative anxiety · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on postoperative anxiety | 0 studies | No studies |
Infiltration injection local anaesthetic vs No treatment or placebo Physiological parameters (cardiac/respiratory events; type and volume of GA drug) · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Because of substantial clinical and methodological heterogeneity in the studies, we were unable to determine an estimate of effect | 2 studies · 148 participants | Very low |
Intraligamental injection local anaesthetic vs No treatment Participant satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | The studies did not report on patient or child satisfaction | 0 studies | No studies |
Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs Paracetamol (acetaminophen) (single postoperative oral dose; 600 mg to 1000 mg) Proportion of patients with >50% maximum pain relief (TOTPAR) over 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 6 hours postdosing, Ibuprofen 400 mg vs paracetamol 1000 mg Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 1.47 [1.28, 1.69] | 5 studies · 646 participants | High |
Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg) Proportion of patients with >50% maximum pain relief (TOTPAR) over 2 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 2 hours postdosing, Paracetamol 1000 mg/ibuprofen 400 mg vs paracetamol 1000 mg or ibuprofen 400 mg Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 1.29 [0.91, 1.85] | 1 study · 170 participants | Moderate |
Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg) Adverse events · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · Study period (immediate postoperative) Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | The majority of adverse events were minor in nature and usually included nausea, vomiting, headaches and dizziness. Side effect profiles have not been included in a meta-analysis as multiple adverse events were… | 2 studies | Ungraded |
Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg) Proportion of patients with >50% maximum pain relief (TOTPAR) over 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 6 hours postdosing, Paracetamol 1000 mg/ibuprofen 400 mg vs paracetamol 1000 mg or ibuprofen 400 mg Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 1.77 [1.32, 2.39] | 1 study · 170 participants | Moderate |
Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs Paracetamol (acetaminophen) (single postoperative oral dose; 600 mg to 1000 mg) Proportion of patients with >50% maximum pain relief (TOTPAR) over 2 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 2 hours postdosing, Ibuprofen 400 mg vs paracetamol 1000 mg Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 1.30 [1.09, 1.55] | 5 studies · 645 participants | High |
Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs Paracetamol (acetaminophen) (single postoperative oral dose; 600 mg to 1000 mg) Patients not using rescue medication at 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 6 hours postdosing, Ibuprofen 400 mg vs paracetamol 1000 mg Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 1.50 [1.25, 1.79] | 4 studies · 542 participants | High |
Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs Paracetamol (acetaminophen) (single postoperative oral dose; 600 mg to 1000 mg) Patients using rescue medication at 8 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 8 hours postdosing Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 2.02 [1.57, 2.60] | 2 studies | Ungraded |
Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg) Patients not using rescue medication at 8 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · 8 hours postdosing, Paracetamol 1000/500 mg/ibuprofen 400/200 mg vs single constituent drugs Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | RR 1.60 [1.36, 1.88] | 2 studies · 467 participants | High |
Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs Paracetamol (acetaminophen) (single postoperative oral dose; 600 mg to 1000 mg) Adverse events · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline… · Study period (immediate postoperative) Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth (2013) · Cochrane | The majority of adverse events were minor in nature and usually included nausea, vomiting, headaches and dizziness. Side effect profiles have not been included in a meta-analysis as multiple adverse events were… | 7 studies | Ungraded |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen Completion of treatment (yes/no) · Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005) Hypnosis for children undergoing dental treatment (2010) · Cochrane | Completion of treatment (yes/no) was a protocol-planned primary outcome but was not reported by the included study for this comparison (Braithwaite 2005); one participant in the sedation arm was withdrawn during… | NR | No studies |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen Anxiety control and overall response to treatment during tooth extraction · Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005) Hypnosis for children undergoing dental treatment (2010) · Cochrane | Hypnosis did not provide sufficient anxiety control during tooth extraction, and overall response to treatment remained statistically lower than response to inhalation sedation with nitrous oxide and oxygen (i.e. the… | 1 study · 10 participants | Ungraded |
Hypnosis vs No hypnosis (no hypnotic intervention) Completion of treatment (yes/no) · Children and adolescents up to 16 years of age undergoing dental treatment Hypnosis for children undergoing dental treatment (2010) · Cochrane | Completion of treatment was a protocol-planned primary outcome but was not reported as an outcome by any of the three included studies; statistical analysis and meta-analysis were not possible due to the insufficient… | NR | No studies |
Hypnosis vs No hypnosis (no hypnotic intervention) Physiological measures during local anaesthesia (pulse rate and oxygen saturation) · Children aged 4 to 13 years with no previous dental experience undergoing restorative treatment with local anaesthesia… Hypnosis for children undergoing dental treatment (2010) · Cochrane | With regard to oxygen saturation and pulse rate, only pulse rate was significantly lower in the hypnosis group (P = 0.005); oxygen saturation did not differ significantly. (Gokli 1994; cross-over, 29 children.) | 1 study · 29 participants | Ungraded |
Hypnosis vs No hypnosis (no hypnotic intervention) Adverse events · Children undergoing dental and orthodontic treatment (Gokli 1994; Trakyali 2008) Hypnosis for children undergoing dental treatment (2010) · Cochrane | None of the studies mentioned any adverse effects regarding hypnosis. (Gokli 1994; Trakyali 2008.) | 2 studies · 59 participants | Ungraded |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen Patient preference / acceptance of treatment · Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005) Hypnosis for children undergoing dental treatment (2010) · Cochrane | The majority of patients preferred inhalation sedation over hypnosis. (Braithwaite 2005; 10 patients.) | 1 study · 10 participants | Ungraded |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen Total treatment time · Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005) Hypnosis for children undergoing dental treatment (2010) · Cochrane | No significant difference in total treatment time between inhalation sedation and hypnorelaxation; hypnorelaxation demanded little additional time to complete care. (Braithwaite 2005.) | 1 study · 10 participants | Ungraded |
Hypnosis vs No hypnosis (no hypnotic intervention) Difference in post-operative anxiety between test and control groups · Children and adolescents up to 16 years of age undergoing dental treatment Hypnosis for children undergoing dental treatment (2010) · Cochrane | Difference in post-operative anxiety was a protocol-planned outcome but was not measured or reported by any included study (no post-operative anxiety scale was reported). | NR | No studies |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen Adverse events · Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005) Hypnosis for children undergoing dental treatment (2010) · Cochrane | None of the studies mentioned any adverse effects regarding hypnosis. (Braithwaite 2005.) | 1 study · 10 participants | Ungraded |
Hypnosis combined with a sedative agent vs Sedation alone (sedative agent only) Outcome NR · Children and adolescents up to 16 years of age undergoing dental treatment Hypnosis for children undergoing dental treatment (2010) · Cochrane | No randomised or quasi-randomised trials comparing hypnosis combined with sedation versus sedation alone met the inclusion criteria; this planned comparison had no eligible studies. | 0 studies | No studies |
Hypnosis vs No hypnosis (no hypnotic intervention) Measures of behaviour during local anaesthesia administration (undesirable behaviours: crying, hand movement, physical resistance, leg movement) · Children aged 4 to 13 years with no previous dental experience undergoing restorative treatment with local anaesthesia… Hypnosis for children undergoing dental treatment (2010) · Cochrane | Patients who were hypnotised demonstrated fewer undesirable behaviours (crying, hand movement, physical resistance and leg movement) than those who did not undergo hypnosis. Decreased crying with hypnosis was the only… | 1 study · 29 participants | Ungraded |
Hypnosis vs Inhalation sedation with nitrous oxide and oxygen Measures of behaviour / negative responses during local anaesthesia administration · Children aged 10 to 16 years undergoing orthodontic extractions (Braithwaite 2005) Hypnosis for children undergoing dental treatment (2010) · Cochrane | Hypnosis can control some of the patient's negative responses to dental treatment, such as movement and behaviour, during administration of local anaesthesia. (Braithwaite 2005; single-blind cross-over, 10 patients… | 1 study · 10 participants | Ungraded |
Hypnosis vs No hypnosis (no hypnotic intervention) Orthodontic appliance (headgear) wearing time and patient co-operation · Children (mean age approximately 10 years) with skeletal Class II division 1 malocclusion undergoing orthodontic… · 6 months Hypnosis for children undergoing dental treatment (2010) · Cochrane | A statistically significant decrease (P < 0.05) in headgear wear was observed in the control (verbal motivation) group from the first to the sixth month; the difference in the hypnosis group was not significant,… | 1 study · 30 participants | Ungraded |
Paracetamol (single oral dose, any dose or formulation; subgroups up to 1000 mg and 1000 mg or more) vs Placebo Achieving at least 50% pain relief at 4 hours (using pain intensity measurements / SPID) · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery… · 4 hours Paracetamol for pain relief after surgical removal of lower wisdom teeth (2007) · Cochrane | RR 4.87 [2.83, 8.37] | 17 studies · 1658 participants | Ungraded |
Paracetamol (single oral dose, any dose or formulation; subgroups up to 1000 mg and 1000 mg or more) vs Placebo Achieving at least 50% pain relief at 6 hours (using pain intensity measurements / SPID) · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery… · 6 hours Paracetamol for pain relief after surgical removal of lower wisdom teeth (2007) · Cochrane | RR 3.41 [2.34, 4.97] | 13 studies · 1184 participants | Ungraded |
Paracetamol (single oral dose, any dose or formulation; subgroups up to 1000 mg and 1000 mg or more) vs Placebo Patients with one or more adverse events · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery… · up to 7 days Paracetamol for pain relief after surgical removal of lower wisdom teeth (2007) · Cochrane | RR 1.19 [0.90, 1.57] | 17 studies · 1645 participants | Ungraded |
Paracetamol (single oral dose, any dose or formulation; subgroups up to 1000 mg and 1000 mg or more) vs Placebo Achieving at least 50% pain relief at 6 hours (using pain relief measurements / TOTPAR) · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery… · 6 hours Paracetamol for pain relief after surgical removal of lower wisdom teeth (2007) · Cochrane | RR 3.32 [1.88, 5.87] | 13 studies · 1155 participants | Ungraded |
Paracetamol (single oral dose, any dose or formulation; subgroups up to 1000 mg and 1000 mg or more) vs Placebo Achieving at least 50% pain relief at 4 hours (using pain relief measurements / TOTPAR) · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery… · 4 hours Paracetamol for pain relief after surgical removal of lower wisdom teeth (2007) · Cochrane | RR 2.85 [1.89, 4.29] | 16 studies · 1498 participants | Ungraded |