Pain Management

Author: Kimberly N. Powell, DDS, MS

According to the National Institute of Health, the wide spread use and misuse of opioid pain relievers has risen at an alarming rate, giving way to a nation-wide crisis. As of 2015 drug overdose has become the leading cause of accidental death in the United States (Viola, COHN). Since opioid analgesics may increase the risk of adverse effects, such as central nervous system depression, respiratory depression and gastrointestinal upset; combination analgesic containing non-opioid ingredients such as acetaminophen and NSAIDs are attractive alternatives as reported by Thomas Viola, Colgate Oral Health Network (COHN). A combination of acetaminophen and ibuprofen appeared to produce significantly better analgesics efficacy compared with the same drugs taken separately for acute post-operative dental pain in adolescents and adults (Viola, COHN). The same article reported that a single-tablet combination of ibuprofen 200 mg/acetaminophen 500 mg provided highly effective analgesia that was comparable with, or superior to, other combination analgesics currently indicated for strong pain. Although these medications do not require a prescription, one must not take more than the maximum recommended daily dose, schedule, and duration as indicated on the bottle/carton, 3000 mg acetaminophen, 1200-2400 mg ibuprofen. An adverse reaction to acetaminophen use is drug-induced hepatotoxicity due to an acute or chronic overdose (Viola, COHN). Communication with your dental provide is necessary to address your concerns before initiating drug therapy. In light of the misuse of prescribed opioids, evaluating each case individually, opioids maybe considered the last option to manage dental pain.