A combination of over-the-counter pain relievers is more effective than opioids in managing pain after wisdom tooth extractions, suggesting a new standard therapy for dental and other pain.
The study, which is the largest and most comprehensive comparing opioids and non-opioid pain medication, appears in The Journal of the American Dental Association.
More than 1800 adults who had their impacted wisdom teeth removed were given either a non-opioid combination of 400 mg ibuprofen (Advil, Motrin) and 500 mg acetaminophen (Tylenol), or an opioid combination of 5 mg hydrocodone and 300 mg acetaminophen.
Participants taking the non-opioid medications reported significantly less pain during the first two days after surgery when pain is most severe and were more satisfied with their pain management and slept better, compared to those taking opioids.
“At no time did hydrocodone outperform the nonopioid,” says Hans Malmstrom, site principal investigator at the University of Rochester’s Eastman Institute for Oral Health and chair of general dentistry.
“Fewer prescriptions for opioids mean fewer chances for people to misuse them or become addicted. If more health care providers adopt this approach, it could significantly reduce the number of opioids circulating in communities.”
Some 5 million young adults are exposed each year to opioids after wisdom teeth extractions. Young adults who receive opioid prescriptions are more likely to eventually misuse opioids, contributing to an upsurge in deaths. An estimated 81,000 deaths each year are attributed to opioid use.
Dentists are among the leading prescribers of opioid analgesics, as well as nurse practitioners, family medicine physicians, and physician assistants.
The new findings support the American Dental Association’s recommendation to use non-opioid pain relievers as the first choice for managing acute dental pain.
“By opting for non-opioid medications, patients can achieve better pain relief and reduce the risk of opioid-related side effects and potential dependency,” says Eliav.
In addition to Rutgers University and the University of Rochester, the other study sites were University of Illinois at Chicago, University of Maryland, and the University of Michigan.
Source: University of Rochester
