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Article: Volume 45 Number 10 Page 935 - November 2018

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  Dent Update 2018; 45: 935-946

Oral surgery:  Prevention and Optimal Management of Peri-Surgical Pain in Dentistry

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Abstract: It is every patient’s right to expect optimal pain management in relation to routine elective surgery. Dentistry is a profession predicated upon causing and/or managing pain in patients. Poorly managed pain, or severe pain, peri-operatively, is the predominant cause of complaints in NHS dentistry, often leading to legal or GDC scrutiny. Whether the unexpected or persistent pain initiates the patient’s suspicions about possible sub-optimal treatment, which then precipitates a complaint, is a possible hypothesis. For now, however, focusing on managing the patient holistically using up-to-date pain management should be a priority for all dental teams. Recent evidence highlights the risks of opiate and opioid dependence and mortality. In addition, the minimal benefit these medications provide for peri-operative pain management compared with other over-the-counter (OTC) analgesics is recognized. Competent patient management, optimal local anaesthetic techniques and intelligent prescription of non-steroidal anti-inflammatories and paracetamol are the mainstay for odontogenic and surgical pain management.

Clinical relevance: It is imperative that dental teams are familiar with current optimal peri-surgical pain management to optimize the patient’s experience and minimize complaint.

Author notes: Tara Renton, BDS, MDSc, PhD, FDS RCS, FRACDS(OMS) FHEA, Professor of Oral Surgery, King’s College London, King’s College London Dental Institute, King’s College Hospital, Bessemer Road, London SE5 9RS, UK.

Objective: To understand the importance of managing patient expectations in managing their pain and be up-to-date with current recommendations for optimal peri-surgical pain management.

Belmont