Pharmacological Management of Acute Endodontic Infections in Children and Adults: A Comparative Clinical Study.

BACKGROUND: Acute endodontic infections are among the most common dental emergencies requiring prompt pharmacological intervention alongside operative treatment. Variations in host response, drug metabolism, and microbial flora between children and adults necessitate tailored pharmacological strategies. METHODS: A prospective observational study was conducted on 120 patients presenting with acute endodontic infections, divided into two groups: children (n = 60; age 6-12 years) and adults (n = 60; age 18-60 years). Patients were managed with standardized pharmacological protocols including antibiotics (amoxicillin or amoxicillin-clavulanate), analgesics (ibuprofen or paracetamol), and adjunctive therapy when required. Clinical outcomes, including pain reduction (Visual Analog Scale [VAS] score), swelling resolution, and need for antibiotic escalation, were assessed over 5 days. Statistical analysis was performed using independent t-test and Chi-square test. RESULTS: Mean baseline pain scores were compared between children (7.8 ± 1.1) and adults (8.1 ± 1.3; P = 0.18). By day 5, pain reduction was significantly greater in adults (VAS: 1.2 ± 0.6) compared to children (1.8 ± 0.9; P = 0.004). Swelling resolution occurred in 91.7% of adults and 83.3% of children (P = 0.18). Antibiotic escalation was required in 10% of children and 5% of adults (P = 0.31). Adverse drug reactions were minimal in both groups. CONCLUSION: Pharmacological management of acute endodontic infections is effective in both children and adults; however, adults demonstrate faster symptomatic relief. Tailored dosing and close monitoring are essential in pediatric populations.