A groundbreaking study by Rutgers Health has shown that a combination of over-the-counter pain medications—acetaminophen (Tylenol) and ibuprofen (Advil, Motrin)—outperforms opioids in controlling pain after wisdom tooth extraction. This research could shift how dentists manage post-surgical pain, potentially reducing the reliance on opioids.
The study, involving over 1,800 patients, found that those given acetaminophen and ibuprofen reported significantly lower pain levels, better sleep, and higher overall satisfaction compared to patients who were prescribed the opioid hydrocodone with acetaminophen. According to Cecile Feldman, dean of Rutgers School of Dental Medicine and the study’s lead author, “The results actually came in even stronger than we thought they would.”
Dentists and Opioid Prescriptions: A Key Opportunity for Change
Dentists are among the top prescribers of opioids in the U.S., writing over 8.9 million opioid prescriptions in 2022. Wisdom tooth extraction, often performed on young adults, frequently represents their first exposure to opioid medications. This early introduction can have serious implications, as Janine Fredericks-Younger, a co-investigator of the study, noted. “When young people get introduced to opioids, there’s an increased likelihood that they’ll use them again, potentially leading to addiction.” In the U.S., opioid overdoses result in over 80,000 deaths annually.
Real-World Results Favor Non-Opioid Options
The researchers conducted a randomized trial to compare opioid and non-opioid pain relief in patients undergoing surgical removal of impacted wisdom teeth. Half of the patients received the opioid hydrocodone with acetaminophen, while the other half were given the non-opioid combination of acetaminophen and ibuprofen.
Participants tracked their pain levels and other recovery outcomes, such as sleep quality and the impact on daily activities, over a week. The results, published in *The Journal of the American Dental Association*, were striking:
- Superior pain relief: The non-opioid combination provided better pain management during the critical two days following surgery, when pain is typically at its peak.
- Better sleep and functionality: Patients in the non-opioid group reported improved sleep on the first night and experienced fewer disruptions to daily activities throughout the recovery period.
- Reduced need for additional medication: Those using the over-the-counter combination were only half as likely to require additional “rescue” medication for breakthrough pain.
- Higher satisfaction: Overall, patients taking the non-opioid combination expressed greater satisfaction with their pain treatment compared to those on opioids.
Implications for Dental Practice
Given its size—one of the largest studies of its kind—and its real-world focus, the study’s findings are expected to have a significant impact on dental practice. “We feel pretty confident in saying that opioids should not be prescribed routinely,” Feldman concluded, emphasizing that dentists can provide better outcomes for their patients by opting for non-opioid pain relief.
By reducing opioid prescriptions, dentists can play a critical role in curbing the opioid epidemic, offering safer and more effective pain management for common dental procedures. This study highlights a path forward in addressing the opioid crisis, starting with evidence-based changes in dental care.