Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen are better at easing dental pain than opioids. Opioids are not among the most effective or long-lasting options available for relief from acute dental pain, a new examination of the results from more than 460 published studies has found.
The study examining relief of acute pain in dentistry–recently featured on the cover of The Journal of the American Dental Association–evaluated the safety and efficacy of dozens of pain-relief options.
“What we know is that prescribing narcotics should be a last resort,” said Anita Aminoshariae, an associate professor in the dental school’s Department of Endodontics and one of the study’s authors.
“No patient should go home in pain,” Aminoshariae said. “That means that opioids are sometimes the best option, but certainly should not be the first option.”
Aminoshariae said the goal of the systematic review was to summarize data–using five in-depth studies–of the effectiveness of oral pain medications.
“The best available data suggest 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,” she said.
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.