Dental News - Nonsteroidal anti-inflammatory drugs provide more effective dental pain relief

Dental Tribune International

Wed. 25. April 2018

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CLEVELAND, U.S.: Safe and effective pain management is an important topic for dental practitioners. Opioid and nonopioid analgesic agents are among the medications commonly prescribed to dental patients to manage pain. However, according to a new examination of the results of 460 published studies, opioids are not among the most effective or longest-lasting options for relief from acute dental pain.

Researchers at the Case Western Reserve University School of Dental Medicine in the U.S. recently found that ibuprofen and other nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen are more effective than opioids in easing dental pain.

The study sought to summarize the available evidence on the safety and efficacy of analgesic agents for the relief of acute pain in dentistry, obtained through pre-existing systematic reviews. The researchers found that, for adults, a combination of 400 mg of ibuprofen and 1 g of acetaminophen was superior to any opioid-containing medications included in the studies reviewed. In addition, it was shown 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.

“Our aim was to create a compendium detailing both the benefits and harms of these medications as a resource for dentists to use in their clinical decision-making. The best available data suggests 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,” said co-author Dr Anita Aminoshariae, an associate professor in the school’s Department of Endodontics.

Furthermore, Aminoshariae cited the national opioid epidemic as one of many reasons that health care providers should take note of the findings. Each day, more than 115 Americans die as a result of opioid overdose, according to the National Institutes of Health. “No patient should go home in pain. That means that opioids are sometimes the best option, but certainly should not be the first option,” she stated.

The study, titled “Benefits and harms associated with analgesic medications used in the management of acute dental pain,” was published in the April 2018 issue of the Journal of the American Dental Association.

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