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Dental Abstracts

Volume 60, Issue 1, January–February 2015, Page e17
Dental Abstracts

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Pain relief with third molar removal

https://doi.org/10.1016/j.denabs.2014.07.055Get rights and content

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Background

Removing the wisdom teeth is a common dental procedure, but has an immediate negative impact on the patient’s life. The process causes pain and discomfort while speaking and eating, often prompts patients to take time off work, and affects patients’ quality of life for 1 to 2 weeks. The postoperative pain is the most common concern of patients and may be severe for up to 1 week after surgery despite analgesic therapy. Paracetamol (acetaminophen) and ibuprofen are the most commonly prescribed

Methods

The search included the databases of the Cochrane Oral Health Group’s Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and the MetaRegister of Controlled Trials. All of the selected studies were randomized controlled double-blinded clinical trials. Using the data collected, the proportion of patients achieving 50% pain relief (TOTPAR) was calculated. Outcomes were evaluated for the first 2 hours and 6 hours after the medication was given. Use of a

Results

The seven studies contained data on 2241 persons and directly compared ibuprofen to paracetamol or the combination of both agents in a single drug. General anesthetic with supplemental local anesthetic was used in two studies, local anesthetic alone in one study, and local anesthetic with supplemental sedation in four studies. Only the data from the first postoperative dose were evaluated. Ibuprofen given as a 400-mg dose and paracetamol given as a 1000-mg dose were the most common agents used.

Discussion

Ibuprofen given in a dose of 400 mg is superior to paracetamol in a dose of 1000 mg for the relief of pain after third molar removal. The combined drugs that contain both agents appear promising as well.

Clinical Significance

All of the agents are considered safe and with minimal side effects. Most patients can tolerate ibuprofen and paracetamol quite well. If these two agents are given in combination, the patient may benefit from their differing pharmacological properties and achieve sufficient

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Bailey E, Worthington H, Coulthard P: Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth, a Cochrane systematic review. Br Dent J 216:451-455, 2014

Reprints available from E Bailey, Univ of Manchester, School of Dentistry, Higher Cambridge St, Manchester, M13 9PL; e-mail: [email protected]

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