According to a new clinical practice guideline developed by the American Dental Association, nonsteroidal anti-inflammatory drugs (NSAIDs) taken alone or with acetaminophen are recommended for the short-term management of toothache in adults and adolescents age 12 and older. (ADA), University of Pittsburgh School of Dental Medicine and Center for Integrative Global Oral Health University of Pennsylvania School of Dental Medicine. The guide has been approved by the ADA and is now available in the February issue Journal of the American Dental Association.
Based on a review of the available evidence, a guideline panel concluded that, when used as indicated, NSAIDs (such as ibuprofen and naproxen) alone or in combination with acetaminophen can effectively control pain after tooth extraction or during dental care. . Not immediately available.
The guideline also recommends clinicians prescribe opioid medications in limited circumstances where they may be appropriate. These include avoiding “just in case” prescriptions, involving patients in shared decision making, and exercising extreme caution when prescribing opioids for adolescents and young adults. When prescribing opioids, the guidelines advise patients on proper storage and disposal and consider risk factors for opioid abuse and serious adverse events.
Special considerations are important when treating any type of pain, and now, dentists have a set of evidence-based recommendations to determine the best care for their patients. Patients are encouraged to discuss pain management expectations and strategies with their dentist so they can feel confident they are receiving the safest, most effective treatment for their symptoms.”
Dr. Paul Moore, DMD, PhD, MPH, senior author of the guideline and panel chair and professor emeritus at the University of Pittsburgh School of Dental Medicine
In 2020, the US Food and Drug Administration (FDA) awarded the University of Pittsburgh and the ADA Science and Research Institute (ADASRI) – now the ADA Forsyth Institute – a three-year, $1.5 million grant to develop a clinical practice guideline for the management of children, Acute Pain in Adolescent and Adult Dentistry. A team of researchers from ADASRI, University of Pittsburgh School of Dental Medicine, Center for Integrative Global Oral Health, Pennsylvania School of Dental Medicine, McMaster University and The Art of Democracy worked together to develop the guidelines.
“Providing guidelines for the management of acute dental pain is an important step toward improving patient care and outcomes,” said Dr. Marta Sokolowska, PhD, is deputy director of the Center for Substance Use and Behavioral Health at the FDA’s Center for Drug Evaluation and Research. “We hope this clinical practice guideline will reduce the risk of opioid addiction, overdose, and diversion.”
This is the second of two guidelines for the management of acute dental pain. A previous set of recommendations for pediatric patients was published in 2023. Both guidelines can be found at ada.org/painmanagement.
Carrasco-Labra, A., etc. (2024). Evidence-based clinical practice guidelines for the pharmacologic management of acute dental pain in adolescents, adults, and the elderly. Journal of the American Dental Association. doi.org/10.1016/j.adaj.2023.10.009.