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Article: Volume 48 Number 10 Page 859 - November 2021

  Dental Update 494: 859-864  Read article

Oral surgery:  The opioid crisis: evaluating the safety and efficacy of opioid analgesia in the management of acute post-operative dental pain

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Abstract: The use and misuse of opioid analgesics have been highlighted in recent years. This review assesses dental opioid use, the effectiveness of opioid-containing analgesics versus non-opioid alternatives and the implications for post-operative pain management strategies in the dental practice. Guidelines for the management of acute post-operative dental pain differ from country to country. The UK has a low dental opioid use rate when compared to the US. The combination of paracetamol and ibuprofen has similar, if not better, analgesic properties compared to opioid-containing alternatives, with fewer adverse effects.

Clinical relevance: Non-opioid analgesics are both a safe and effective alternative to opioid analgesics in the management of post-operative dental pain.

Author notes: Daniel Merrick, BA, BDentSc, MFD RCSI, Junior House Officer, Dublin Dental University Hospital. Michael O’Sullivan, BA, BDentSc, MSc, FFD RCSI, FDS RCSEd, PhD, Senior Lecturer/Consultant in Restorative Dentistry (Special Needs), Head of Division of Restorative Dentistry and Periodontology, Director of Graduate Prosthodontics, Dublin Dental University Hospital. Mary Clarke, FFD RCSI, FDSRCPS, MDentCh (OS), Dip Con Sed, Specialist in Oral Surgery/Lecturer in Conscious Sedation, Dublin Dental University Hospital. email:

Objective: The reader should understand that non-opioid post-operative pain management is safer and as effective, if not more so, as opioid-containing alternatives.