Publication: Prevalence of pharmacotherapy in the department of paediatric dentistry
Date
2010
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: Pharmacotherapy plays important role in the management of paediatric dental patients in the department
of paediatric dentistry. Many children at their early age suffer from different kinds of dental conditions such as acute and
chronic irreversible pulpitis, acute and chronic alveolar abscesses, dentoalveolar and vestibular abscesses, etc along with
physiological tooth movement that requires professional help for dental treatment. Treatment of such conditions most
frequently requires pharmacotherapy as an either adjunct to dental therapeutic procedure or as a monotherapy.
Objective: To assess the prescribing patterns vis-a-vis generic or trade name, generic class, dosage form, route,
frequency, duration, number of drugs per patient, cost and indication of drug therapy, patterns of dental treatment and
Frankl’s behavioral rating.
Materials and methods: Prescriptions of 200 paediatric dental patients undergoing dental treatment in the department
of paediatric dentistry were analyzed prospectively for a period of six months in a dental teaching hospital.
Results: 133 (56.5%) patients were males and 87 (43.5%) females and age group 6-10 years was the most frequent group
(70%, P=0.0000000) and all the patients received pharmacotherapy. Total numbers of 357 drugs were prescribed. Out of
them, 212 (59.4%, P=0.0000008) were analgesic agents, 133 (37.3%) antimicrobial agents (AMAs) and 12 (3.3%) other
drugs. Extended spectrum Penicllins were the most commonly prescribed (90.2%) AMA followed by Metronidazole
(9.8%). 247 drugs (69.2%, P=0.0000000) were prescribed by trade names. 60% (P=0.0000002) drugs were prescribed
in the form of tablet or capsule followed by syrup 37% and administered entirely through oral route. Percentage of
patients receiving three drugs, two drugs and one drug was 13.5%, 56.5% (P=0.0000000) and 30% respectively and
one patient received on average 1.78 medicines. 133 patients (56.5%, P=0.0000000) received both AMA and analgesic
agent. Minimum to maximum number of days for pharmacotherapy were 2 to 15 and highest frequency was up to
four times a day. Cost of medicines was in the range of 10-150 Nepalese Rupees. Chronic irreversible pulpitis was the
commonest diagnosis (28%) and extraction (92.5%) was the commonest dental procedure. Frankl’s behaviour rating
showed that 78.5% (P=0.0000000) patients had positive attitude towards the dental procedures.
Conclusion: Findings of the study suggest that pharmacotherapy is the mainstay in therapy to treat the paediatric
dental patients along with dental procedures either to control the dental pain or odontogenic infection. Age group 6-10
years, chronic irreversible pulpitis and dental extraction are the commonest age group, diagnosis and dental procedure
respectively in the department of paediatric dentistry. Analgesic (non-steroidal anti-inflammatory drugs- Nimesulide,
Ibuprofen and Paracetamol) and Amoxicillin are the most frequently prescribed drugs mostly in the solid dosage forms
in trade names via oral route. Duration of pharmacotherapy ranges from 2 to 15 days with highest frequency being up
to 4 times a day. Majority of the patients are manageable without any behavioural modification technique- physical or
pharmacological.
Key words: Dentistry, Frankl’s behaviour raring, Paediatric, Pharmacotherapy, Prescription
Description
Paudel KR1, Sah NK 2, Jaiswal AK 3
1 Lecturer, Department of Pharmacology, Kathmandu Medical College, Kathmandu, 2 Dental Surgeon, Department of Paediatric Dentistry, B P Koirala Institute of Health Sciences, Dharan, 3 Lecturer, Department of Orthodontics, Universal College of Medical Sciences, Bhairahawa, Nepal.