Nonsteroidal anti-inflammatory drugs better than opioids for pain after dental extractions

An interesting article titled “Acute Postoperative Pain Due to Dental Extraction in the Adult Population: A Systematic Review and Network Meta-analysis,” written by A. Miroshnychenko and et. al appears in the 2023 edition of the Journal of Dental Research. The article seeks to conduct a systematic review and meta-analysis to assess tto compare the effectiveness of 10 different pharmacological treatments including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and opioids, to the management of acute pain after dental tooth extractions. Further the article looked at the pain associated with pulpitis or its complications. The authors were motived to conduct the review based on the opioid crisis occuring in North America which has been discussed before on this site, see for example the posts Assessing the Impact of Three Day Opioids Limits for Dentists, Dentists Overprescribing Opioids to Adults in the U.S., and Reducing … Read more

Assessing the Impact of Three Day Opioids Limits for Dentists

An interesting article titled “Opioid Formulary Edit’s Impact on Commercial Dental Prescribers” was presented on July 23, 2021, at the virtual session of the 2021 International Association for Dental Research (IADR)/AADR/CADR General Session written by David Hamlin and et al. The research set to investigate the impact the insurance company Cigna had when it implemented its three-day quantity limit on dental opioid prescriptions. Insurance companies limiting new opioid prescriptions for dentists to three days (or another time duration) has been discussed on this site before in the post Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery. The authors speculated that by limiting opioid prescriptions to three day there would be year-over-year reductions in prescriptions greater than three days and reductions in the average total metric quantity per prescription. In the study, the authors looked at the claims of … Read more

Combining ibuprofen and acetaminophen for wisdom teeth surgery pain management

Before on this site the hazards of opioids prescribed for surgeries like wisdom teeth extraction has been discussed. Instead of taking an opioid like Vicodin which contains hydrocodone or another opioid that contains oxycodone an alternative patients may have if their oral surgeon is willing is to take a combination of ibuprofen and acetaminophen. This combination has been discussed in many articles on the past on this site such as Reducing Opioids in Oral and Maxillofacial Surgery, New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery, and Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing. Patients may have questions about the right dosage level, there side effects, and if they work as well as opioids. According to a white paper by the American Association of Oral … Read more

Intravenous Ketamine During Surgery

A review articled carried out by the Cochrane Database of Systematic Reviews titled “Perioperative intravenous ketamine for acute postoperative pain in adults” written by Brinck et al. in 2018 (no. 12, art. no. CD012033) explored the efficacy and safety of intravenous ketamine in adults for pain management while having surgery under general anesthesia. The authors sought randomized, double-blind, controlled trials for inclusion in their analysis. The main outcomes were opioid consumption and pain intensity at 24 and 48 hours after surgery. The authors included 130 studies with 8,341 participants. Types of surgery included wisdom teeth extraction and among many others like lumbar fusion surgery, anterior cruciate ligament (ACL) repair, abdominal surgery, and elective caesarean section. The researchers found by looking at 65 of these studies that perioperative intravenous ketamine reduced postoperative opioid consumption over 24 hours by 8 mg morphine … Read more

Record Numbers Predicted to Die from Opioids in the US

As has been covered on this site before, opioid abuse which can stem from wisdom teeth surgery at a young age is a major challenge in countries like the U.S. There are many stories of families where a young person in their teenage or twenty years has their wisdom teeth taken out and then are exposed to opioids to control pain. This exposure can lead to them become potentially addicted to opioids and then later die as a result of this addiction. Thus, finding alternatives to opioids for surgery like wisdom teeth removal is important to help curb a disturbing trend. See posts like Dentists Overprescribing Opioids to Adults in the U.S., New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery, and Studies and Opinions on Opioids … Read more