Best clinical practice guidance for local analgesia in paediatric dentistry: an EAPD policy document

Abstract

When considering the dental demand to treat vulnerable (medically compromised) children and adolescents in a safe, painless, less-invasive and effective way, there seems to be an urgent need to close these gaps in knowledge.

Dentists’ self-perceived stress and difficulties when performing restorative treatment in children

“…The EAPD strongly suggests to focus on knowledge gaps regarding information on the use of LA in children aged <4 years. The EAPD further supports the statement that LA, when administered appropriately, is a safe procedure in children and adolescents with low risks of morbidity and side effects (55,131).…”

Children’s and Adolescents’ Pain, Discomfort, Fear, Cooperation, and Parental Presence During Dental Extractions

“…Within the extraction procedure, the injection was most frequently reported responsible for the negative experiences. During decades, pain has been connected with dental extractions and concerned children and adolescents [17]. It could be reasoned that the injection techniques have not developed sufficiently, despite alternative anesthesia delivery methods,…”

Evaluation of intraosseous computerized injection system (QuickSleeper™) vs conventional infiltration anaesthesia in paediatric oral health care: A multicentre, single‐blind, combined split‐mouth and parallel‐arm randomized controlled trial

“…To our best knowledge, IOA studies of pain felt by children have been only observational or non‐randomized comparative studies. Moreover, a recent systematic review and Evidence‐Based Clinical Practice Guidelines showed insufficient evidence supporting the injection technique as superior to others and concluded that more rigorous and high‐quality studies are needed …”

“…Local anaesthesia is frequently indicated in paediatric oral health care. 1 Two types of anaesthesia exist as follows: conventional intra-mucosal infiltration anaesthesia (CIA), frequently used by practitioners, and intraosseous anaesthesia (IOA), which delivers the local anaesthetic within the spongy bone adjacent to the tooth to anaesthetize. Needle-and injection-related fears are common sources of dental anxiety in children in case of CIA.…”

“…Moreover, a recent systematic review and Evidence-Based Clinical Practice Guidelines showed insufficient evidence supporting the injection technique as superior to others and concluded that more rigorous and high-quality studies are needed. 1,4 The randomized controlled trial (RCT) is the gold standard for evaluating the effectiveness of interventions. 5 The design most frequently used is the parallel-arm RCT, 6 but the split-mouth RCT is also commonly used in dental clinical trials.…”