Non-opioid alternatives for dental pain

26 August 2022

A study from the University of Rochester compared two groups of patients who had dental extractions at in a local dental care clinic to find an alternative to opioid painkillers.

Dental extracts are often painful procedures for the patients. Following extraction many patients will request painkillers to alleviate symptoms while they are healing.

Prescriptions of opioid painkillers can have negative effects on the patient as they require a weaning off period to avoid withdrawal. In some cases, patients may become dependence on the opioid.

Dr Yanfang Ren, professor and clinical chief at Howitt Urgent Dental Care explained, “We hypothesized that using a combination of the non-opioid pain medications and adding gabapentin to the mix for pain would be an effective strategy to minimize or eliminate opioids for dental pain.”

Patients in the first group of 3,300 patients in 2012 received ibuprofen or acetaminophen. Higher doses of ibuprofen or opioid combinations including hydrocodone, oxycodone or codeine were prescribed to patients with moderate to severe pain.

The second group of 3,300 patients were prescribed no opioids whatsoever.

For patients with mild pain, acetaminophen or ibuprofen was prescribed. In instances of moderate to severe pain, patients received higher doses of ibuprofen or an ibuprofen and acetaminophen combination.

Due to health issues or potential interactions with existing medications, some patients were unable to take ibuprofen or acetaminophen. In these cases, patients were prescribed an opioid combination in 2012. In 2022, a gabapentin combination was used a non-opioid alternative.

The results of the study suggested that the trial had been promising when evaluates against a real-world measure of proportion of patients returning for pain relief.

“This study represents continued efforts by our team and other dentists to minimize the use of opioids for dental pain,” said Dr Eli Eliav, the director of Eastman Institute for Oral health and a pain expert.  “Additional studies, preferably randomized controlled clinical trials, are needed to confirm the safety and effectiveness of this approach. It is our duty to continuously seek safe and effective treatment for our patients in pain.”