Study warns against high-risk medicines in paediatric dental care
PITTSBURGH, USA: Prescribing high-risk medicines in children’s dentistry, while relatively uncommon, carries significant safety implications when it occurs, according to new research published in the December 2025 issue of the Journal of the American Dental Association (JADA).
The study highlights concerning patterns of opioid and benzodiazepine use linked to paediatric dental visits, particularly among vulnerable patient groups, reinforcing calls for strict adherence to non-opioid pain management strategies in dental care for children.
What the study examined
The research was based on a large retrospective analysis of US insurance claims data, examining paediatric dental visits over multiple years. Investigators focused on prescriptions for opioids and sedatives, medications known to increase the risk of respiratory depression, emergency department visits, hospitalisation, and longer-term dependency when used inappropriately.
Although only a small proportion of dental visits involved these medicines, the outcomes associated with their use were notable and, in some cases, serious.
Increased risk after dental visits
Children who received opioids in connection with dental treatment were more likely to require follow-up care, including emergency department attendance or hospitalisation shortly after the procedure. Importantly, a subset of patients continued opioid use beyond the immediate post-treatment period, raising concerns about early exposure and potential long-term harm.
Younger children, medically complex patients most vulnerable
Age emerged as a key risk factor. Younger children prescribed opioids appeared particularly susceptible to opioid-related adverse outcomes. The study also identified higher risks among children with complex chronic medical conditions, highlighting the need for careful medication review and multidisciplinary coordination in such cases.
These findings reinforce existing professional guidance advocating the use of non-opioid analgesics, such as paracetamol and non-steroidal anti-inflammatory drugs, for most dental pain scenarios.
Care setting influences outcomes
The analysis found differences in prescribing patterns based on care setting. Hospital-based and specialist dental services showed lower rates of adverse outcomes, potentially reflecting closer monitoring, clearer protocols, and broader use of multimodal, non-opioid pain management strategies.
In contrast, routine outpatient settings showed greater variability in prescribing practices, suggesting a need for more consistent guideline implementation.
Implications for dental practice
The study raises critical questions about the appropriateness of prescribing opioids for dental procedures associated with mild or moderate pain, where evidence supports effective relief through non-opioid combinations.
For dental professionals, the message is clear: safer paediatric prescribing depends on guideline-based decision-making, prioritising non-opioid options, thorough medical history review, and strengthened training in pain management.
As paediatric dentistry continues to evolve, standardising pain control protocols and reinforcing evidence-based prescribing may play a vital role in reducing preventable harm among young patients.
Smart dentistry starts here
Dental News App — Built for Dental Professionals
From breaking dental news to an essential Dental Drugs Index, Dental News helps you make informed clinical and professional decisions—on the go.
Get the app:
Android: CLICK HERE TO DOWNLOAD
iOS: CLICK HERE TO DOWNLOAD
