Pharmacologic considerations in pediatric dentistry.

Abstract

The unique physical, emotional, and developmental characteristics of the growing child make dental care particularly challenging for the practitioner. Children are not simply small adults, and the principles of adult pharmacotherapeutics are not easily extrapolated to "fit" the profile and needs of the child. Unfortunately, there is a paucity of literature concerning the use of pharmacologic agents in pediatric dentistry. This has been attributed largely to the fears and difficulties associated with working with children. In the literature available, comparison of studies and compilation of information are frequently impossible because of differences in selection criteria, study populations, and drug regimens used. Despite these difficulties, when young patients appear with pain, anxiety and infection, they must depend on the skills and knowledge of the practitioner to resolve their problem. Children have difficulties in locating or expressing pain, and fear may prevent any communication at all. The diagnosis and prevention of pain, anxiety, and infection are within the jurisdiction of the dentist and the parents. A working knowledge of the current trends in pharmacologic management of pain, infection, and anxiety enables the dentist to better treat and educate the parents in effective prevention, treatments, and therapy. The use of pharmacotherapeutic agents in unskilled hands can be potentially disastrous in children. Practitioners should use only those drugs in which they have been well trained to avoid excessive risk to the patient. The manufacturer's recommended dose should be followed carefully; if in doubt, consultation with the child's pediatrician is appropriate.