Treating Dental Pain
Non-opioid drugs such as Ibuprofen, taken alone or with acetaminophen, are better at treating dental pain than opioids. This was the finding of a recent review of over 460 scientific studies. It’s important news for dental and health-care providers working to address the nation’s opioid epidemic.
The opioid epidemic affects every state in the nation. It is “the deadliest public health crisis of our lifetime,” according to The Hill. Their report states that opioid overdoses kill more Americans each year “than have ever been killed from car accidents, guns, or HIV/AIDS.”
During 2016, an average of 115 Americans died every day as the result of an opioid overdose, according to the National Safety Council (NSC). All told, more than 42,000 died of opioid overdoses that year, the NSC says.
Opioids and Dental Pain
Dentists have often prescribed opioid medications to treat dental pain. However, members of the profession are re-thinking that practice in the wake of the opioid epidemic.
New research from the School of Dental Medicine at Case Western Reserve University has points to other options. The researchers reviewed results from more than 460 published studies. Their findings suggest a new course of action dentists can use to help patients deal with dental pain.
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“Opioids are not among the most effective – or longest lasting – options available for relief from acute dental pain,” the researchers say. Instead, the review points to a combination of other drugs for dental pain relief.
A Systematic Review
The study assessed the safety and effectiveness of a large number of dental pain-relief options. The Case Western researchers systematically reviewed and summarized data on the effectiveness of oral-pain medications from five in-depth studies.
“What we know is that prescribing narcotics should be a last resort,” Anita Aminoshariae, one of the study’s authors said. “No patient should go home in pain,” she said. “That means that opioids are sometimes the best option, but certainly should not be the first option.”
“…opioids are sometimes the best option, but certainly should not be the first option.”
“The best available data,” she said, “suggests that the use of nonsteroidal medications, with or without acetaminophen, offers the most favorable balance between benefits and harms…” This option optimized efficacy and minimized “acute adverse events.”
Guidelines for treatment of dental pain
Dental pain can be excruciating. Many patients ask dentists for opioid medications without attempting to treat the pain with other medications.
However, the researchers found that adults who took opioids or drug combinations that included them experienced the most adverse side effects. The side effects included drowsiness, respiratory depression, nausea or vomiting, and constipation.
On the other hand, the researchers found “a combination of 400 milligrams of ibuprofen and 1,000 milligrams of acetaminophen” provided relief superior to the opioids studied.
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