Adults looking to relieve pain after having a tooth pulled do better with a combination of ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) than they do with drugs containing opioids, says new research published in the Journal of the American Dental Association.
Researchers from the University of Pittsburgh, Case Western Reserve University, and other institutions analyzed scientific reviews that investigated the effectiveness and safety of pain-relief options for adults after dental surgery, mostly molar extractions. Ibuprofen plus acetaminophen was superior to the opioid-containing drugs studied, including oxycodone and tramadol. Opioid users were also more likely to suffer serious adverse effects such as shallow breathing, drowsiness, dizziness, nausea, vomiting, and constipation than nonusers, who reported some drowsiness, dizziness, nausea, and headache.
While the study authors don’t suggest that dentists entirely reject the use of opioids, they do say that dentists should prescribe them only as a last resort.
What you should do
Keep in mind that the proper goal of pain control is to decrease pain to the level of easy tolerability. This is actually preferable to completely relieving pain, as it keeps you aware that “something isn’t normal” and so helps prevent you from accidentally further injuring yourself. Think twice before requesting an opioid pain reliever; ask your dentist whether it’s safer for you to take ibuprofen with or without acetaminophen instead—but be aware that adverse effects can occur with those drugs, too.
This article first appeared in the July 2018 issue of UC Berkeley Health After 50.