Newer Strategies for Non-Opioid Management-Newer Strategies for Non-Opioid Management of Acute Postoperative Pain

Video Transcription

Video Summary

This presentation reviewed evidence-based, non-opioid strategies for managing acute post-operative dental pain. Dr. Jeske explained why opioids such as Vicodin became common in dentistry, but emphasized that current scientific evidence supports non-opioid options that are often equally or more effective with fewer risks.<br /><br />The lecture highlighted the third molar extraction model as the gold standard for pain studies because it is standardized, produces predictable moderate-to-severe pain, and has a low placebo response. He also discussed pain after endodontic, periodontal, and implant-related procedures, noting that procedure type and severity influence the duration and intensity of analgesic needs.<br /><br />The strongest evidence supported the combination of ibuprofen 400 mg plus acetaminophen 1,000 mg as first-line therapy for moderate to severe post-operative dental pain. He noted that this combination has excellent efficacy, low adverse-event rates, and should be taken together for synergy. Diclofenac and ketoprofen were identified as effective “lone ranger” NSAIDs, and corticosteroids were found to be most useful when given preoperatively and parenterally.<br /><br />Newer agents were also introduced, including suzetrigine (Journavx), a sodium-channel blocker, and tapentadol, a Schedule II opioid-like drug. The overall conclusion: dentistry should rely primarily on evidence-based non-opioid regimens, reserving opioids only when necessary.

Asset Caption

Description The opioid epidemic necessitates reevaluation of pain control strategies in dental practice. Newer approaches to controlling acute postoperative pain include combinations of nonsteroidal analgesics as well as steroidal agents. New drugs like suzetrigine can also be used successfully. This program explores all of these from a clinical pharmacology perspective. Learning Objectives Understand scientific evidence related to drugs for acute postoperative pain. Review conventional non-opioid medications for the control of acute postoperative pain. Apply newly introduced analgesics to pain control situations encountered in dental practice. Speaker Bio Arthur H. Jeske, PhD, DMD, is professor and associate dean at the University of Texas School of Dentistry at Houston. He earned his PhD in pharmacology and DMD from the Medical College of Georgia. A fellow of both the American and International colleges of dentists, Jeske is also editor-in-chief of “Mosby’s Dental Drug Reference” and editor of “Contemporary Dental Pharmacology.” In addition to his academic and editorial work, he maintains a private general dentistry practice.

Keywords

post-operative dental pain

non-opioid analgesia

ibuprofen acetaminophen combination

third molar extraction model

dental pain management

diclofenac ketoprofen

corticosteroids

suzetrigine Journavx

opioid alternatives