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Analgesics in Dentistry

Categories: Oral Medicine and Pathology, Sleep Medicine

Author(s): Dr. Fiona M. Collins, BDS, MBA, MA

Date: 01-15-2018 13:25:04 pm

Historically, management of acute odontogenic pain in adolescents and adults has typically been accomplished through an approach that incorporated nonparenteral opioid and/or nonopioid analgesics. However, the availability of opioid analgesics has resulted in epidemic levels of opioid abuse and addiction. Alternative treatment strategies utilizing non-opioids are preferable for management of acute pain, where indicated, including moderate to severe pain. Non-opioids include NSAIDs, acetaminophen, and combination medications, and are more, or as, effective as opioids. This article reviews opioid medications before focusing on non-opioid analgesics, as both monotherapy and combination therapy, for the safe and effective management of acute postprocedural pain in dentistry.

Analgesics are prescribed and/or recommended to dental patients to relieve pain, which may be acute or longer-term chronic in nature. Pain experienced following oral maxillofacial surgery is acute pain, while an example of chronic pain would include patients with long-term temporomandibular joint pain associated with temporomandibular joint disease. Analgesics for postprocedural pain management are mainly used following oral maxillofacial surgery for extractions, implant placement, bone grafting, endodontic therapy, and periodontal surgery. However, they may also be recommended and prescribed preprocedurally for the management of postprocedural pain. The main focus of this article is the use of nonparenteral analgesics that are ingested orally or ministered nasally for the relief of acute dental pain in adults. Analgesic medications used in dentistry include opioid and non-opioid medications, typically given orally.

Educational Objectives
The overall goal of this course is to provide information on nonparenteral analgesics used in dentistry. After completing this article, the reader will be able to:
1. Describe opioid medications and aspects of the new ADA policy on opioids.
2. List and describe ingested nonsteroidal anti-inflammatory drugs (NSAIDs) used in dentistry for pain management.
3. Describe an inhaled NSAID that can be used for acute pain management.
4. Review findings from systematic reviews and trials comparing opioid and non-opioid analgesics.

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