PHARMACOLOGICAL GUIDE IN PEDIATRIC DENTISTRY

Medication selection in pediatric dentistry requires developmentally appropriate dosing, attention to comorbidity and avoidance of unnecessary prescribing. This narrative review summarizes pharmacological agents used for dental pain, local anesthesia, infection control, anxiety management and selected preventive or mucosal indications. A focused search of PubMed-indexed literature, Cochrane reviews and guidance from pediatric dental, pediatric medical and public-health organizations was undertaken through 9 October 2026. Recent guidelines and higher-level syntheses were prioritized, with earlier foundational pharmacology sources retained when relevant. Nonopioid analgesics, particularly ibuprofen and acetaminophen, remain first-line options for most acute dental pain. Local anesthetic doses should be calculated by body weight and total milligrams rather than cartridge count. For odontogenic infections, source control is essential and systemic antibiotics are generally reserved for spreading disease, systemic involvement or selected medical risks. Nitrous oxide and other sedatives require appropriate patient selection, trained personnel, monitoring and rescue capacity. Fluoride varnish and silver diamine fluoride provide additional, indication-specific non-systemic options; routine chlorhexidine for caries prevention lacks convincing evidence. Important limitations include variable national drug labeling, heterogeneous pediatric trials and limited comparative data in medically complex children. This practical synthesis supports indication-driven, weight-appropriate prescribing while emphasizing that product information and local regulations take precedence over summary doses.