Harding A M
Department of Pediatric Dentistry, Case Western Reserve University, Cleveland, Ohio.
Dent Clin North Am. 1994 Oct;38(4):733-53.
The unique physical, emotional, and developmental characteristics of the growing child make dental care particularly challenging for the practitioner. Children are not simply small adults, and the principles of adult pharmacotherapeutics are not easily extrapolated to "fit" the profile and needs of the child. Unfortunately, there is a paucity of literature concerning the use of pharmacologic agents in pediatric dentistry. This has been attributed largely to the fears and difficulties associated with working with children. In the literature available, comparison of studies and compilation of information are frequently impossible because of differences in selection criteria, study populations, and drug regimens used. Despite these difficulties, when young patients appear with pain, anxiety and infection, they must depend on the skills and knowledge of the practitioner to resolve their problem. Children have difficulties in locating or expressing pain, and fear may prevent any communication at all. The diagnosis and prevention of pain, anxiety, and infection are within the jurisdiction of the dentist and the parents. A working knowledge of the current trends in pharmacologic management of pain, infection, and anxiety enables the dentist to better treat and educate the parents in effective prevention, treatments, and therapy. The use of pharmacotherapeutic agents in unskilled hands can be potentially disastrous in children. Practitioners should use only those drugs in which they have been well trained to avoid excessive risk to the patient. The manufacturer's recommended dose should be followed carefully; if in doubt, consultation with the child's pediatrician is appropriate.
成长中儿童独特的身体、情感和发育特征，使得牙科护理对从业者来说极具挑战性。儿童并非只是缩小版的成人，成人药物治疗的原则并不能轻易外推以“适配”儿童的情况和需求。不幸的是，关于儿科牙科中药物制剂使用的文献匮乏。这在很大程度上归因于与儿童打交道相关的恐惧和困难。在现有文献中，由于选择标准、研究人群和所用药物方案的差异，研究比较和信息汇编常常无法进行。尽管存在这些困难，但当年轻患者出现疼痛、焦虑和感染时，他们必须依靠从业者的技能和知识来解决问题。儿童在定位或表达疼痛方面存在困难，恐惧可能会完全阻碍任何沟通。疼痛、焦虑和感染的诊断与预防属于牙医和家长的职责范围。对疼痛、感染和焦虑的药物治疗当前趋势有实用的了解，能使牙医更好地治疗并指导家长进行有效的预防、治疗和疗法。在不熟练的人手中使用药物制剂对儿童可能有潜在的灾难性后果。从业者应仅使用他们受过良好培训的药物，以避免给患者带来过多风险。应严格遵循制造商推荐的剂量；如有疑问，向儿童的儿科医生咨询是合适的。
