Pain

Hydrocortisone Shows Promise in Reducing Pain and Swelling After Wisdom Tooth Removal

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An interesting article titled “Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial” written by Faheem Ahmed and et. al. appears in Cureus published February 01, 2024. The study sought to compare the effects of three irrigating solutions, hydrocortisone, povidone-iodine, and normal saline, on pain, trismus, and edema following removal of impacted lower wisdom teeth. Wisdom tooth removal, also known as the surgical removal of impacted third molars, is a common dental procedure, often accompanied by pain, swelling (edema), and difficulty opening the mouth (trismus). Researchers have been looking for ways to alleviate these post-surgical concers. The study metnioned in this article compared the effectiveness of three irrigation solutions used during surgery. The study involved 105 patients between the ages of 18 and 40 who needed … Read more

Coated gauze may help with pain and dry socket after wisdom teeth removal

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An interesting article titled “Retrospective analysis for predictors of postsurgical complications from third molar extraction with use of oxytetracycline–hydrocortisone-coated gauze inserted in extraction socket” appears in Oral Science International, written by Sayumi Matsuda and et. al. and published on June 15, 2023. The article sought to explore a study of a technique of inserting gauze coated with oxytetracycline–hydrocortisone ointment into a wisdom tooth extraction socket and look at the occurence of dry socket and pain when compared to a those without the gauze. The researchers applied the gauze technique to 286 patients who had lower wisdom teeth removed. The authors found the incidence of dry socket after extraction was 1.05% (with a 95% confidence interval of 0.22% to 3.03%) and the incidence of post-extraction infection was 0.35% (with a 95% confidence interval of 0.01% to 1.91%). These percentages were lower … Read more

Melatonin to Reduce Pain and Swelling Following Wisdom Teeth Removal

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An interesting article titled “The Effect of Local Melatonin Application Following the Removal of an Impacted Mandibular Third Molar” appears in the Journal of Oral and Maxillofacial Surgery written by Shaimaa Mohsen Refahee and et. al. The article seeks to measure the effect of applying melatonin in the socket of an impacted lower wisdom tooth with osteogenic activity, painkilling effect, and anti-inflammatory effect. A prior article exploring the use of melatonin after wisdom teeth extraction has been discussed on this site before see Should Melatonin be Used for Wisdom Teeth Surgery?. In the current article, the authors conducted a prospective, randomized, blinded trial comprised of patients who required removal of the impacted lower wisdom tooth. Melatonin has antioxidant and anti-inflammatory properties and promotes osteoblast differentiation and bone formation, which could potentially limit problems like intrabony defects and bone loss associated … Read more

Is it Safe to Not use Suture or Stitches When Removing Wisdom Teeth?

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An interesting article titled “Sutureless socket technique after removalof third molars: a multicentric, open, randomized controlled trial” appears in BMC Oral Health written by Sarah Takadoum and et. al. (vol. 22, Article number: 256, 2022). The article conducted a clinical trial to compare pain following removal of impacted wisdom teeth with and without sutures also known as stiches. In the article the authors mentioned how questions remain regarding the best operative techniques during wisdom teeth surgery particularly the mucosal closure stage on impacted mandibular (lower) wisdom teeth. There are some who recommend suturing sockets after extraction, justfying this by saying that it limits bleeding and contamination of the postoperative site to thus improve the quality and speed of healing. There are others who prefer natural healing while the site is closed via cheek pressure. The authors set out to compare postoperative pain … Read more

Articaine versus Bupivacaine Anesthetic Effectiveness for Lower Teeth Extraction

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An interesting article titled “A Comparative Evaluation of Anesthetic Effectiveness of 4% Articaine vs 0.5% Bupivacaine for Lower Molar Tooth Extraction” appears in Cureus in December 16, 2022, written by Tenglikar P, Manas A, Sahoo A, et al. (vol. 14, no. 12, pp. e32611). The article discusses the differences in the effectiveness of two common local anesthesia agents used in dentistry to control pain. The authors set out to explore the the effectiveness of 0.5% bupivacaine with 4% articaine in lower tooth extraction based on duration of anesthesia, onset, and pain perception along with observing blood pressure and heart rate. Today lidocaine (lignocaine) is extensively used as a local anesthestic agent in dentistry to control pain. Other anesthestic agents exists including bupivacaine and articaine. The authors conducted a randomized controlled study of patients having lower teeth extracted from June 2017 to October … Read more