A recent study conducted by Rutgers Health reveals that a combination of acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) offers superior pain relief after wisdom tooth extraction compared to opioids, a finding that could potentially reshape post-surgical pain management practices in dentistry.
The trial, involving over 1,800 patients, demonstrated that those using the non-opioid combination experienced reduced pain, improved sleep quality, and greater overall satisfaction compared to individuals treated with hydrocodone and acetaminophen. Given that dentists prescribe millions of opioid prescriptions annually, particularly for dental procedures like wisdom tooth extractions, this discovery is significant. In fact, over 8.9 million opioid prescriptions were written by dentists in 2022 alone, with many young adults encountering opioids for the first time through such procedures.
According to study co-investigator Janine Fredericks-Younger, introducing young people to opioids increases the risk of future misuse, a worrying trend as opioid overdoses claim more than 80,000 lives annually in the U.S.
The research focused on patients undergoing the common but painful procedure of impacted wisdom tooth removal. In this randomized trial, half of the participants were given hydrocodone combined with acetaminophen, while the other half received acetaminophen and ibuprofen. Patients reported pain levels and other recovery indicators, such as sleep quality, during the week following the surgery.
Published in The Journal of the American Dental Association, the results revealed that the non-opioid combination provided more effective pain relief during the first two days after surgery, a period of peak pain. Additionally, patients taking the non-opioid combination experienced better sleep and reported less disruption to their daily routines during recovery.
Those who were given the non-opioid regimen were significantly less likely to need additional pain medication. Moreover, they expressed higher levels of satisfaction with their pain management compared to those on opioids.
Given the study’s scale and real-world design, which spanned five clinical sites and involved more than 1,800 participants, the findings offer strong evidence against routine opioid prescriptions for wisdom tooth removal. According to researcher Feldman, “Opioids should not be the go-to option for post-surgical pain, and this study underscores the benefits of using the non-opioid combination.”
These results are in line with the American Dental Association’s recent guidelines, which advocate for minimizing opioid prescriptions and prioritizing alternative pain management strategies. Feldman hopes the study’s findings will encourage broader changes in prescribing practices among dentists.
“This research shows there’s no reason to prescribe opioids unless absolutely necessary,” Feldman said, emphasizing that conditions like medical issues preventing the use of acetaminophen or ibuprofen are the only exceptions.
The team behind the study plans to extend their research to other dental procedures and explore further alternatives to opioids, including cannabinoids, for managing dental pain.
Feldman concludes, “This study not only helps improve current dental practices but also contributes to advancing the education of future dentists, reinforcing the importance of science-driven care at Rutgers.”
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