Summary Review | Published:

Summary Review/Paediatric dentistry

Preoperative analgesia for children and adolescents to reduce pain associated with dental treatment

Evidence-Based Dentistry volume 18, pages 1718 (2017) | Download Citation

Address for correspondence: Luisa Fernandez Mauleffinch, Managing Editor, Cochrane Oral Health Group, School of Dentistry, The University of Manchester, JR Moore Building, Oxford Road, Manchester, M13 9PL, UK. E-mail:


Data sources

Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, ISI Web of Science, and the WHO International Clinical Trials Registry Platform.

Study selection

Randomised controlled clinical trials of analgesics given before dental treatment versus placebo or no analgesics in children and adolescents up to 17 years of age. Children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia were excluded.

Data extraction and synthesis

Two reviewers independently selected studies, abstracted data and assessed risk of bias. Standard Cochrane methodological approaches were used.


Five trials involving 190 patients were included. None of the studies were at low risk of bias. Three trials involved dental treatment and two involved orthodontic treatment. Three of the included trials compared paracetamol with placebo. Meta-analysis of the two trials showed no evidence of a benefit in taking paracetamol preoperatively; (RR) for postoperative pain of 0.81 (95%CI; 0.53 to 1.22). Four trials compared ibuprofen with placebo. Pooled data from two studies showed a statistically significant mean difference in severity of postoperative pain of −13.44 (95%CI; −23.01 to −3.88) on a visual analogue scale (0 to 100), which indicated a probable benefit. Both trials were at high risk of bias and the quality of the evidence is low.


From the available evidence, we cannot determine whether or not preoperative analgesics are of benefit in paediatric dentistry for procedures under local anaesthetic. There is probably a benefit in using preoperative analgesics prior to orthodontic separator placement. The quality of the evidence is low. Further randomised clinical trials should be completed with appropriate sample sizes and well defined outcome measures.

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Author information


  1. Glasgow Dental Hospital/Royal Hospital for Children Glasgow, Scotland

    • Catherine McCann


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About this article

Publication history



This paper is based on a Cochrane Review published in the Cochrane Library 2016, issue 8 (see for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Library should be consulted for the most recent version of the review.