You may have heard some time in the last decade about the “opioid epidemic.” Increasing prescription rates of opioid medications have led to widespread misuse of both prescription and non-prescription pain medication in the public. This in turn has led to severe health problems for those affected as they battled both addiction and the physical side-effects of opioid use.

In the USA, 115 people die every day because of this epidemic.

Opioids certainly have their medicinal uses, but the question needs to be asked: how often are they actually necessary? Can non-opioid medications provide equal or better relief without the side-effects?

Opioids in Dentistry

Many patients who undergo oral surgeries such as complex tooth extractions or dental implants request or expect to receive narcotics to relieve pain. Often, dentists are happy to prescribe them as they do provide pain relief and work fast.

But are they the best option?

A meta-analysis conducted in 2018 revealed that combining over-the-counter medications ibuprofen and acetaminophen (more commonly known by their brand names Advil and Tylenol, respectively) can provide superior relief of dental pain.

The meta-analysis looked at over 460 published studies comparing opioids to nonsteroidal medications. They found that 400mg of ibuprofen combined with 1,000mg of acetaminophen was not only sufficient to treat pain, it also came with significantly reduced acute side-effects.

These medications are also not as likely to result in addiction and abuse in users after extended use.

Most post-surgical pain is caused by inflammation. Nonsteroidal medications such as ibuprofen are specifically anti-inflammatory and are ideal for relieving inflammation-related pain. They put less stress on the body, they are not as prone to acute side-effects such as drowsiness and nausea, and they aren’t addictive.

Should Opioids Be Avoided Completely?

While the study found that ibuprofen and acetaminophen are sufficient in most situation, there are still times when opioids are the best option for a particular situation.

The critical point of the study, however, is that they should not be the first option, and are best left as a final choice.

If over-the-counter medications are not providing sufficient relief, which can be the case after particularly difficult surgeries, it’s important for patients to communicate this with their dentist.

While every care must be taken to avoid unnecessarily prescribing opioids when they are not needed, they should never be completely shelved as an option for pain relief.