Use and effect of opioids, nonsteroidal anti-inflammatory drugs, and over-the-counter analgesics for dental pain

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Use and effect of opioids, nonsteroidal anti-inflammatory drugs, and over-the-counter analgesics for dental pain

Management of dental pain in clinical practice is a complex part of dental care. Pharmacological treatment generally prescribed by a dentist to counter the dental pain can be non-steroidal anti-inflammatory drugs (NSAIDs), over-the-counter (OTC) analgesics and opioids, etc. This led to the possibility of overprescribing and abuse of analgesics, in particular for opioid medications. On occasion, dental pain may be severe to justify the use of opioids.

An observational study was performed with certain objectives which involved both dentist and patients for a 5-day period; patients were recruited from PEARL Network dentists site. The objective was to evaluate (1) the post procedural prescriptions pattern of analgesic (Rx and OTC) and recommendations in dental practices (2) to determine associated effectiveness and side effects of these medications as measured by patient reported outcomes (PROs).

The inclusion criteria for the patient was- 1) Permanent dentition (erupted 2nd molar teeth) 2) Following one of the seven dental procedure (extraction, endodontic therapy, pulp capping, crown preparation, periodontal surgery and abscess treatment). 3) Expected by the P-I to experience postoperative pain sufficient to require an analgesic. 4) Able to judge pain level. 5) Ability and willingness to give verbal consent.

Patients undergoing treatment for medical disorders (dementia, Parkinson's disease, depression, severe anxiety, or any other medical condition), which according to P-I, would affect the subject's judgment of postoperative pain and those who are currently participating in another dental or medical research study, were excluded from the study.
The baseline questionnaire was completed by 2765 (99.9%) of 2767 eligible patients, and 2381 (86%) patients responded to the Day 5 follow-up questionnaire.

The estimated data showed that NSAIDs, both OTC and prescribed dosages, could be an adequate analgesic to treat most postoperative dental pain. Clinical judgment for the use of opioid should involve the physiological principles related to the pharmacology of pain and inflammation and may include a central effect.

Source:

Compendium of continuing education in dentistry

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/27875056

The original title of the article:
 

Opioid, NSAID, and OTC Analgesic Medications for Dental Procedures: PEARL Network Findings

Authors:

Wong YJ , Keenan J et al.

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