Cochrane · intervention · CD008392
Preoperative analgesics for additional pain relief in children and adolescents having dental treatment
Ashley, PF, Parekh, S, Moles, DR, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
10
current version
GRADE rated
2
No studies
6
Included studies
5
as reported
No studies 6 · 60%Ungraded 2 · 20%Very low 0 · 0%Low 2 · 20%Moderate 0 · 0%High 0 · 0%
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.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents aged up to 17 years having dental treatment (including orthodontic treatment, fillings, removal of the nerve from a tooth, and extraction of a tooth); excluded children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia | Children aged from 2 to 16 years (each study a different age range); 190 children in total across five trials; four trials in the USA and one in Turkey |
| Intervention | Analgesics given before dental treatment (both intervention and control groups may include local anaesthetics) | Paracetamol (n=3 studies); Ibuprofen (n=4 studies) |
| Comparison | Placebo or no analgesics | Placebo, including lactose tablet (n=5 studies) |
| Outcomes | Primary: Postoperative pain measures (either expressed as intensity of pain or presence or absence of pain). Secondary: Intraoperative pain; Preoperative and postoperative anxiety measures; Patient satisfaction; Parental satisfaction; Cost; Completion of treatment (yes/no); Adverse events | Postoperative pain (n=5; dichotomous presence of pain-related behaviours or continuous severity on VAS); Adverse events (n=2) |
| Study designs | Randomised controlled clinical trials (RCTs), including cluster-randomised trials and cross-over trials where the order is randomised; quasi-randomised trials excluded | RCT, parallel group (n=5) |
| Timing | Not specified | Postoperative follow-up 2 hours (severity, ibuprofen); mean 6.5 hours (presence of pain behaviour, paracetamol); other time points 15 min to 7 days |
Search date: 2016-01. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE via OVID; EMBASE via OVID; LILACS via BIREME; ISI Web of Science; ClinicalTrials.gov; WHO International Clinical Trials Registry Platform
Questions and results
Show all 3 versionsPreoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics
Population: Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment, or tooth extraction), without sedation or general anaesthesia
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Intraoperative pain | None of the included studies measured intraoperative pain. PUB3: 'The [three/four] studies did not measure intraoperative pain, ... cost or completion of treatment.' | 0 studies | No studies |
Cost | None of the included studies reported cost. PUB3: 'The [three/four] studies did not measure ... cost or completion of treatment.' | 0 studies | No studies |
Preoperative and postoperative anxiety measures | None of the included studies assessed anxiety or behaviour at baseline, and none recorded baseline anxiety. PUB3: 'The [three/four] studies did not measure ... preoperative and postoperative anxiety measures ...' | 0 studies | No studies |
Completion of treatment (yes/no) | None of the included studies measured completion of treatment. PUB3: 'The [three/four] studies did not measure intraoperative pain, preoperative and postoperative anxiety measures, patient satisfaction, parental… | 0 studies | No studies |
Parental satisfaction | None of the included studies reported parental satisfaction. PUB3: 'there was no reporting of participant or parent satisfaction in any included study.' | 0 studies | No studies |
Patient satisfaction | None of the included studies reported patient satisfaction. PUB3: 'there was no reporting of participant or parent satisfaction in any included study.' | 0 studies | No studies |
Preoperative paracetamol (acetaminophen) vs Placebo
Population: Children and adolescents having dental treatment under local anaesthetic (restorative and extraction treatments)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Postoperative pain (dichotomous measure: parent report of presence of pain-related behaviours) Mean 6.5 hours | RR 0.81 [0.53, 1.22] 520 per 1000 vs 421 per 1000 | 2 studies · 100 participants | Low Downgraded: risk of bias, imprecision |
Adverse events | No adverse events were recorded in Primosch 1995. The other two studies did not mention adverse events. | 1 study | Ungraded |
Preoperative ibuprofen vs Placebo
Population: Children and adolescents having orthodontic separator placement (without local anaesthetic)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Postoperative pain (continuous measure: self report using visual analogue scale) 2 hours | MD -13.44 [-23.01, -3.88] | 2 studies · 85 participants | Low Downgraded: risk of bias, imprecision |
Adverse events | One participant from the ibuprofen group and one from the placebo group reported a lip or cheek biting injury (Bernhardt 2001). No other adverse events were recorded for Bernhardt 2001 and Law 2000. | 2 studies | Ungraded |