Best Drugs for Dental Pain

Best Drugs for Dental Pain

Overdose deaths linked to opioids have reached record highs, according to a new report from the Centers for Disease Control and Prevention (CDC). While the study reveals that the sharpest increase in those deaths is due to illegal drugs such as heroin, more than one-third continue to be linked to prescription opioids such as OxyContin, Percocet, and Vicodin.

One surprising source of those drugs? The dentist.

More than half of the opioids prescribed for people who have their wisdom teeth removed have leftover pills, according to a study published in the medical journal Drug and Alcohol Dependence last September. University of Pennsylvania researchers estimate that overprescribing could add an extra 100 million opioid pills to American medicine cabinets each year.

The result? Too often those leftover narcotics wind up being misused by patients or their friends and family, says Elliot Hersh, D.M.D., Ph.D., a professor in the department of oral and maxillofacial surgery and pharmacology at Penn Dental Medicine and a co-author of the study.

“We, as dentists, have to recognize that our overprescribing contributes to the prescription opioid abuse epidemic,” Hersh says.

And evidence suggests that dentists should be recommending safer dental pain relievers. A body of research shows that over-the-counter pain relievers work just as well—or better—than opioids for most people, with far fewer side effects.

Too Many Side Effects; Too Little Relief

“It’s a myth among dentists and patients alike that opioid pain relievers are strong and OTC products are weak,” Hersh says. “Really, it’s more a matter of which medication works best against your specific type of pain.”

OTC nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, and generic) and naproxen (Aleve and generic) work particularly well against dental pain because they reduce inflammation in the traumatized areas of your mouth.

Acetaminophen (Tylenol and generic) doesn’t address inflammation, but it does an excellent job of reducing your perception of pain, Hersh says.

The combination of a NSAID and acetaminophen works well against even moderate to severe pain in people who have had their wisdom teeth removed—better, in fact, than an opioid for most people. That’s according to a comprehensive research review co-authored by Hersh that was published in the Journal of the American Dental Association in 2013.

Another advantage to OTC pain relievers is that, in general, they cause far fewer side effects than narcotic pain meds. Prescription opioids commonly cause nausea, constipation, drowsiness, and a fuzzy-headed feeling. In addition, taking the drugs longer term or in higher doses carries more serious risks, including addiction, overdose, and even death.

Making a Plan for Dental-Pain Relief

People undergoing any kind of dental surgery should “make a plan up front with their dentist or oral surgeon about how they will manage pain,” says Paul Moore, D.M.D., Ph.D., a professor in the University of Pittsburgh School of Dental Medicine and co-author of the 2013 review.

Make sure you’ve provided a thorough medical history so that your doctor can recommend pain relievers that are safest for you. Most people who take blood thinners or who have advanced kidney disease should avoid NSAIDs, for example.

It’s important to know that taking too much of any kind of pain medication—even OTC products—isn’t safe. So get written instructions for how much of each type of medication to take and how often to take it.


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