Appropriate analgesic prescribing for the general dentist

Abstract

This article reviews dental and medical literature pertaining to the safety, efficacy, and mechanisms of action of common analgesic treatments for acute postoperative pain. MEDLINE searches were conducted for 2005 through 2009 using the terms "dental analgesia," "postoperative pain," "pain medication," "pathophysiology," "treatment," and "dentistry." Reports selected for further review included those published in peer-reviewed journals. The authors gave preference to articles reporting randomized controlled trials. Acetaminophen and NSAIDs continue to be the most appropriate choices for the treatment of mild to moderate acute dental pain. The use of selective cyclo-oxygenase (COX)-2 inhibitor NSAIDs may be considered for patients at risk of gastrointestinal sequelae or those taking blood thinners such as warfarin. Whether analgesic medications are used alone or in combination, prescribers must be aware of the potential safety concerns associated with them, especially in light of new information promoting lower doses, shorter treatment durations, and decreased maximum recommended doses.