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Current concepts in acute pain management.
Mai-Phuong Huynh1, John A Yagiela
1Division of Diagnostic and Surgical Sciences, University of California at Los Angeles School of Dentistry, 90095-1668, USA.
Journal of the California Dental Association
|July 4, 2003
Summary
For dental pain, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are most effective. If NSAIDs are not suitable, acetaminophen-opioid combinations provide a good alternative for managing moderate to severe pain.
Area of Science:
- Dental pharmacology
- Pain management
- Clinical therapeutics
Background:
- Common dental pain relief involves NSAIDs, acetaminophen, and opioid combinations.
- NSAIDs and acetaminophen inhibit prostaglandin synthesis via cyclooxygenase enzymes.
- Opioids interact with endogenous opioid receptors for analgesia.
Purpose of the Study:
- To review the efficacy of analgesics for dental pain.
- To compare NSAIDs with acetaminophen-opioid combinations.
- To provide guidance on optimal analgesic selection and administration.
Main Methods:
- Review of clinical studies on dental pain management.
- Analysis of analgesic mechanisms of action.
- Comparison of efficacy data for various analgesic regimens.
Main Results:
- NSAIDs (e.g., ibuprofen) are superior for moderate to severe dental pain compared to acetaminophen-opioid combinations.
- Acetaminophen-opioid combinations are recommended when NSAIDs are contraindicated.
- Fixed-schedule dosing is crucial for effective pain control, unlike 'as needed' (prn) administration.
Conclusions:
- Ibuprofen or equivalent NSAIDs are the preferred choice for moderate to severe dental pain.
- NSAID intolerance warrants the use of acetaminophen-opioid combinations (600-1000 mg acetaminophen).
- Consistent, scheduled analgesic intake ensures better pain management than intermittent dosing.