Ibuprofen and other
nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination
with acetaminophen are better than opioids at easing dental pain, according to new research conducted with the School of Dental Medicine at Case Western
Reserve University. The study examining relief of acute pain in
dentistry -- recently featured on the cover of The Journal of theAmerican Dental Association -- evaluated the safety and efficacy of
dozens of pain-relief options.
The clear message of
this is that in dentistry, prescribing narcotics should be a last
resort. Each day, more than 115 Americans die as a result of an
opioid overdose, according to the National Institutes of Health.
Many got hooked on opioids after a doctor or dentist prescribed, or
overprescribed them.
Most patients who
come in with pain have it resolved immediately with proper dental
technique. However some conditions dentists treat leave the patient
in some pain for a short period of time after treatment. No patient
should have to endure pain from a dental procedure. That means that
opioids are sometimes the best option, but certainly they are never
my first option.
Interestingly, the
study showed that the use of nonsteroidal medications, with or
without acetaminophen, offers the most favorable balance between
benefits and harms, optimizing efficacy while minimizing acute
adverse events. The research found that, for adults, a combination
of 400 milligrams of ibuprofen (Motrin) and 1,000 milligrams of
acetaminophen (Tylenol) was superior to any opioid-containing
medications studied. The study also found that opioids or drug
combinations that included opioids accounted for the most adverse
side effects -- including drowsiness, respiratory depression,
nausea/vomiting and constipation -- in both children and adults.
This confirms my
belief, and the acetaminophen+ibuprofen combination has long been my first course
of treating dental pain issues. In fact, I haven’t prescribed
opioids in several years. With the national opioid epidemic, my
fellow health-care providers should take note of the findings.
Keep smiling,
Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut. She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121
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