Children - Pain

Question 1

Pain in children

Answer 1

e.g. teething

Question 2

Teething

Answer 2

• Can start as early as 3 months
• Continue for up to 3 yrs

Question 3

Symptoms of teething

Answer 3

• pain
• increased chewing, drooling
• gum rubbing
• facial rash
• decreased appetite
• irritability

Question 4

Red flag symptoms for pain

Answer 4

• Severe pain
• Pain with the presence of the following red flag symptoms:
  Abnormal drowsiness
  Loss of consciousness
  Difficulty breathing

Question 5

Referral criteria

Answer 5

• Symptoms lasting for long periods
• Recurring or worsening symptoms
• Failure to respond to treatment

Question 6

Non-pharmacological treatment for teething

Answer 6

• Teething rings cooled in the fridge are popular
• Dummies should be avoided, but if used, then it is important not to dip them or teething rings into honey, fruit juices or syrups, as this will damage developing teeth.
• Raw fruit & vegetables to chew on
• Hardened bread (avoid sugary rusk biscuits)
• Give them cool sugar-free drinks
• Comfort them by playing with them
• Frequently wipe their chin and rest of face to prevent teething rashes

Question 7

Mild to moderate pain treatment

Answer 7

Ibuprofen
Only licensed non-steroidal anti-inflammatory drug (NSAID) for children > 3 months (OTC)
useful in dental pain
Gastric irritation
Caution in asthmatics

Paracetamol
> 2 months of age
Dangerous in overdose

Anbesol teething gel

Question 8

Anbesol teething gel

Answer 8

Lidocaine
Local anaesthetic
Refer if symptoms > 7 days

• if necessary repeat dose after 3 hours
• no more than 6 times a day

NOT FOR; under 5 months