University of Oulu

Kühnisch, J., Daubländer, M., Klingberg, G. et al. Eur Arch Paediatr Dent (2017) 18: 313.

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

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Author: Kühnisch, J.1; Daubländer, M.2; Klingberg, G.3;
Organizations: 1Department of Operative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
2Department of Oral Surgery, University Medical Centre Mainz, Mainz, Germany
3Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Swede
4Department of Child and Public Dental Health, Trinity College, Dublin, Republic of Ireland
5Dublin Dental University Hospital, Dublin, Republic of Ireland
6Private Practice for Paediatric Dentistry, Nicosia, Cyprus
7Department of Orthodontics and Paediatric Dentistry, University of Basel, Basel, Switzerland
8Private Practice for Paediatric Dentistry, Geneva, Switzerland
9Research Unit of Oral Health Sciences, Department of Cariology, Endodontology and Paediatric Dentistry, University of Oulu, Oulu, Finland
10MRC of Oulu University and University Hospital, Oulu, Finland
11Faculty of Dentistry, National University of Singapore, Singapore, Singapore
12Department of Paediatric Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Springer Nature, 2017
Publish Date: 2019-10-25


Background: The European Academy of Paediatric Dentistry (EAPD) proposes this best-practice guidance to help practitioners to decide when and how to use local analgesia to control pain in children, adolescents, and medically compromised individuals during the delivery of oral health care.

Methods: A search of different databases was conducted using all terms relevant to the subject. Relevant papers were identified after a review of their titles, abstracts or full papers. Three workshops were held during the corresponding EAPD interim seminar in Torino (Italy) in 2017. Several statements were agreed upon and, furthermore, knowledge gaps were identified.

Results: An important outcome was that when local analgesia administered appropriately—correct choice of agent(s) and dosage, proper route of administration—it is, firstly, clinically effective for pain-control in treating children and, secondly, it carries a very low risk of morbidity including adverse or side-effects. Furthermore, several gaps in knowledge were identified during the workshop which indicates future research needs. Most importantly it remains unsatisfactory that in several European countries the most frequently used injectable local analgesic agent, articaine, is not approved for usage in children below the age of 4 years.

Conclusion: 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.

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Series: European archives of paediatric dentistry
ISSN: 1818-6300
ISSN-E: 1996-9805
ISSN-L: 1818-6300
Volume: 18
Issue: 5
Pages: 313 - 321
DOI: 10.1007/s40368-017-0311-y
Type of Publication: A1 Journal article – refereed
Field of Science: 313 Dentistry
Copyright information: © European Academy of Paediatric Dentistry 2017. This is a post-peer-review, pre-copyedit version of an article published in European Archives of Paediatric Dentistry. The final authenticated version is available online at: