This month CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine (CJEM) that addresses the use of analgesia for acute gingivostomatitis in pediatric patients.1 Currently, there is little evidence regarding the best analgesic agent for this condition, however acetaminophen and ibuprofen are often used as first-line agents.
As shown in this CanadiEM infographic, MacLellan et al. conducted a national survey of pediatric emergency physicians to determine the national practice pattern for acute gingivostomatitis. Survey items included demographic characteristics (e.g. age, sex, years of experience), clinical behaviors (e.g. preferred analgesics), factors affecting clinical practice (e.g. perceived barriers to analgesic use) and future directions for research. The results of this survey showed that most physicians preferred using acetaminophen and ibuprofen (72%) concurrently as first-line treatment of acute gingivostomatitis. The most reported second line agents were oral morphine (48%) and compounded topical agents (42%). Most physicians were unaware of the clinical evidence for treating acute gingivostomatitis (34%) or thought the evidence was “weak” (61%).
This study is the first to document analgesic use by Canadian pediatric emergency physicians for acute gingivostomatitis. However, the breadth of reported analgesics in use highlights the lack of quality evidence for the treatment of pain in this condition. Future research is needed to evaluate the efficacy, safety and ease of administration of these analgesics, in order to establish best practice guidelines.
If you would like to download the infographic as a PDF, click here.