pharmacist or the British National Formulary (BNF).
The dosages for children can be calculated on the basis of a percentage chart (Table
4.1). Often 'average' doses are used but the prescriber has the absolute responsibility
to confirm that the dosages recommended are correct.
The common drugs used for pain control in children are paracetamol BNF and
ibuprofen BNF. The potential side-effects and the dosages should be checked with the
formulary before prescribing. Aspirin should not be used on children because of the
risk of Reye's syndrome. The increase in asthma among children requires that this be
considered before ibuprofen is prescribed. Narcotic analgesics such as codeine or
morphine can be used on children but only after less powerful analgesics have been
shown to be ineffective. As above, the dosage should be checked with the BNF.
4.5 METHODS OF PAIN CONTROL
The different methods of pain control vary from simple behaviour management to full
intubational general anaesthesia in a hospital operating theatre (Fig. 4.1). There is a
strong relationship between the perception of pain experienced and the degree of
anxiety perceived by the patient. Painful procedures cause fear and anxiety; fear and
anxiety intensify pain. This circle of cause and effect is central to the management of
all patients. Good behaviour management reduces anxiety, which in turn reduces the
perceived intensity of pain, which further reduces the experience of anxiety.
Behaviour management have been covered in detail in Chapter 2 and local anaesthetic
techniques in Chapter 5. The majority of dental procedures on children can be carried
out using a combination of these two techniques. This chapter will deal with the
methods of sedation and general anaesthesia that are applicable to dental treatment in
children.