Millions of people have one or more wisdom teeth (also called third molars) removed by dentists or oral surgeons each year, and opioids were once considered the standard of care for pain following wisdom tooth removal.
However, advances in analgesic (drugs that treat pain) research and the ongoing opioid addiction epidemic have highlighted efforts to establish new protocols.
Now, results from a new, large-scale study from Rutgers University in New Jersey show that a combination of over-the-counter pain relievers commonly found in the average home medicine cabinet are as effective as, or better than, opioids in treating pain following wisdom tooth removal.
“We’re not saying that opioids will never be needed,” said Cecil Feldman, dean of the Rutgers School of Dentistry. “But what we are saying is that non-opioids can replace opioids in many cases, and that patients actually benefit from doing so.”
The study, published online earlier this month in the Journal of the American Dental Association, looked at 1,815 adults who had one or more wisdom teeth removed because they were impacted and trapped in the jawbone.
When wisdom teeth are surgically removed from this location, it almost always causes a few days of intense pain, Feldman said.
Study participants were given either a combination of ibuprofen and acetaminophen or a combination of acetaminophen and hydrocodone, the most commonly used opioid in dentistry.
Neither the patients nor the researchers knew which medications each person took.
The data showed that people who took the over-the-counter medications reported less pain in the first 48 hours after surgery compared with those who took opioids.
“[The non-opioid combination] also reduced pain interference, meaning patients were able to continue their normal daily activities,” Feldman said. “It increased overall patient satisfaction; it reduced the side effects of many [opioid] medications.”
The study builds on previous research showing that over-the-counter medications can be effective in controlling pain after tooth extraction surgery, but Feldman said past studies were small and limited in scope.
The latest Rutgers study is the largest of its kind on the topic.
Feldman hopes these results will give dentists and patients more confidence in choosing non-opioids as first-line pain management options, especially given the ongoing addiction epidemic.
“Dentists have responded positively to the pandemic and have written significantly fewer prescriptions,” she said. “But from my perspective and from the perspective of the people involved in this study, we think that number could go down further.”
The next challenge, Feldman said, is educating the public and convincing patients that non-opioid pain management after wisdom tooth removal is effective.
“There’s still this misconception that opioids are always better,” she said.
Related topics:
