Pain

Using Bupivacaine with Wisdom Teeth Removal Results in Less Opioids Prescribed

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An interesting article titled “A Retrospective Cross-Sectional Study of the Effect of Liposomal Bupivacaine on Postoperative Opioid Prescribing After Third Molar Extraction,” written by Stuart E. Lieblich and et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 79, pp. 1401-1408, 2021). The study seeks to explore if patients who have lower wisdom teeth removed using liposomal bupivacaine need less opioids than those wo do not have liposomal bupivacaine. In the study the authors performed a retrospective study of patients who had undergone wisdom teeth extraction at 2 outpatient oral surgery centers in the United States. Patients had to have been at least 18 years of age and undergoing an elective wisdom tooth removal with 1 partial bony or full bony lower impacted wisdom tooth. A total of 600 patients who underwent wisdom teeth extracted were included in … Read more

Taking etoricoxib before Wisdom Teeth Surgery to Help Relieve Pain

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An interesting article titled “Does low dose of etoricoxib play pre-emptive analgesic efect in third molar surgery? A randomized clinical trial” written by Long Xie and et al. appears in BMC Oral Health (vol. 21, no. 462, 2021). The article discusses the results of a randomized clinical trial that explored if a preemptive low dose of the nonsteroidal anti-inflammatory drug (NSAID) etoricoxib may reduce the need for analgesics after wisdom teeth extraction. The study the authors conducted was designed as randomized, parallel, double-blinded and placebo-controlled and occurred between August 2019 and July 2020. A total of 56 patients were included in the study that met the inclusion criteria and scheduled to have impacted horizontal mandibular wisdom teeth extracted. The authors found that the mean VAS pain score in the etoricoxib group was significantly lower than that in the placebo group … Read more

FDA warns about dental problems from buprenorphine

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The U.S. Food and Drug Administration (FDA) has issued a safety concern regarding the medication buprenorphine which is a medication used to treat opioid use disorder, acute pain, and chronic pain. Buprenorphine is often used to reduce opioid withdrawal symptoms and the desire to use opioids, without causing the cycle of highs and lows associated with abusing opioid. The FDA warning issued on January 12, 2022, states that dental problems have occured when patients take medicines containing buprenorphine that are dissolved in the mouth. In the warning, the FDA said that the dental problems can include those of tooth decay, cavities, loss of teeth, and oral infections, and can occur in those without prior dental issues. As a result of this warning, the risk of dental problems occuring will be added to the prescribing information and the patient Medication Guide … Read more

Does Bromelain Impact Pain, Swelling, and Mouth Opening after Wisdom Teeth Surgery?

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An interesting article titled “Oral Bromelain for the Control of Facial Swelling, Trismus, and Pain After Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis,” appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery written by Liu et al. The article seeks to explore if bromelain reduces pain and swelling and improves mouth opening after wisdom teeth removal. Bromelain is believed to decrease swelling by returning interstitial fluid and inflammatory component cells into the bloodstream and provide an anti-inflammatory effect by decreasing pain mediators such as prostaglandin E2 and substance P. Bromelain provides for systemic proteolytic enzyme therapy and is a mixture of proteolytic enzymes found in pineapple plants. The authors state a few articles in the past have explored using bromelain after wisdom teeth removal but with inconsistent results. For example one study showed bromelain … Read more

Man Ends His Own Life Dealing with Wisdom Tooth Pain

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Recently a 38 year year old man took his own life while he was waiting to have a wisdom tooth removed. This occurred in Southampton in England in April 2019. The man had been on a waiting list on the National Health Service (NHS) to have his wisdom tooth extracted. He came down with a severe toothache in January 2019 and saw a dentist. After seeing the dentist the man began to take large amounts of painkillers. His mother began to save up money so they could afford private treatment for the extraction. At the time of the death it was estimated the mother had saved about 900 British Pounds  of the 1,500 British Pounds needed for surgery. In the weeks leading up to the death the co-workers of the man said he was always asking to work overtime. After his … Read more