Over-the-counter ibuprofen and acetaminophen provide better relief for dental pain than prescription opioids and are less likely to cause side effects, researchers say.
"What we know is that prescribing narcotics should be a last resort," said study co-author Anita Aminoshariae, an associate professor at Case Western Reserve University's School of Dental Medicine, in Cleveland.
In the study, Aminoshariae's team reviewed more than 460 published studies and found that a combination of 400 milligrams of ibuprofen (such as Advil or Motrin) and 1,000 milligrams of acetaminophen (Tylenol) was more effective than opioid medications (for example, Vicodin, Oxycontin) for adults.
The investigators also found that opioids or drug combinations that included opioids caused the greatest number of side effects -- including drowsiness, respiratory problems, nausea/vomiting and constipation -- in both children and adults.
"The best available data suggests that the use of nonsteroidal medications [NSAIDs], with or without acetaminophen, offers the most favorable balance between benefits and harms, optimizing efficacy [effectiveness] while minimizing acute adverse events," Aminoshariae added.
"No patient should go home in pain. That means that opioids are sometimes the best option, but certainly should not be the first option," Aminoshariae said in a Case Western news release.
The findings are important in light of the U.S. opioid epidemic, she said. Each day, more than 115 Americans die as a result of an opioid overdose, according to the U.S. National Institutes of Health.
The study was published recently in The Journal of the American Dental Association.
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