NSAIDs preferred choice for acute dental pain, review finds

A literature review has suggested that non-steroidal anti-inflammatory drugs for acute dental pain offer the best balance between risks and benefits, compared with opioid analgesics.

Teeth x-ray, dental pain concept

Use of non-steroidal anti-inflammatory drugs (NSAIDs), with or without paracetamol, can provide a better balance of benefits and risks compared with opioids for the treatment of acute dental pain, a review has revealed[1]

Researchers carried out a systematic review of existing reviews reporting efficacy and adverse events for oral acute pain relief. The review, published in the Journal of the American Dental Association (April 2018), included five papers, two of which were Cochrane reviews in adult patients.

Combinations of ibuprofen and paracetamol were associated with the greatest treatment benefit in adults. In addition, pain relief involving opioids was associated with the greatest risk of adverse events in both adults and children.

The researchers said that with increasing awareness of the potential harms of opioid medicines, dentists are likely look to other forms of analgesia.

They added: β€œThe best available data suggested that the use of non-steroidal medications, with or without [paracetamol], offered the most favourable balance between benefits and harms, optimising efficacy while minimising acute adverse events.”


[1] Moore P, Ziegler K, Lipman R et al. Benefits and harms associated with analgesic medications used in the management of acute dental pain. JADA 2018;149(4):256–268. doi: 10.1016/j.adaj.2018.02.012

Last updated
Clinical Pharmacist, CP, July 2018, Vol 10, No 7;10(7)::DOI:10.1211/PJ.2018.20204907

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