26 Pain control and carious primary teeth
|Transient or short duration (minutes)||Long duration|
|Response to hot, cold, sweet||Response to pressure (chewing)|
|Doesn’t stop play or sleep||Throbbing|
|Stops play or sleep|
If a tooth is abscessed, there is often significant coronal destruction. The pulp chamber of such teeth can often be accessed by gentle excavation, and a dressing of Ledermix on some cotton wool placed within the chamber and sealed with cement will often lead to resolution of the swelling.
An acute and/or spreading infection or swelling may require the prescription of antibiotics. This is discussed in Chapter 27. Antibiotics should only be prescribed for pain in the absence of swelling for immunosuppressed patients. Analgesics may be necessary for pain (Table 26.2).
|Paracetamol||20 mg/kg initially then 15 mg/kg every 4 hours|
|Maximum 24-hour dosage 90 mg/kg|
|Ensure adequate hydration|
|Ibuprofen (Non-steroidal anti-inflammatory drug (NSAID))||5–10 mg/kg every 8 hours|
|Can be used in conjunction with paracetamol|
|Best given with food and drink|