Nonsteroidal gastropathy in dentistry--issues and controversies in patient's management

Nonsteroidal anti-inflammatory drugs (NSAIDs) provide excellent analgesia for mild to moderate pain and are therefore commonly prescribed in dental practice. However, they are not without side effects, most notably upper gastrointestinal toxicity. This article reviews the issues and controversies in managing dental patients especially those who present with acute pain in the light of introduction of preventive strategies to reduce such gastrointestinal complications.

This review is primarily based on articles selected from Medline between 1997-2006 concerning upper gastrointestinal toxicity following NSAID use and introduction of preventive strategies to reduce them with particular reference to dental practice and developing countries.

Selective COX-2 inhibitors (coxibs) cause fewer gastrointestinal events than do non selective NSAIDs. However, they should be used with caution in the light of recent evidence linking them with adverse cardiovascular events.

Dental Practitioners need to be aware of notable side effects and the role of preventive strategies when prescribing NSAIDs.