From the Guidelines
Ibuprofen is the most recommended NSAID after dental surgery, due to its effective pain and inflammation reduction, as well as its good safety profile when used as directed for short periods. The most recent and highest quality study, 1, provides dosage suggestions for systemic analgesia, including ibuprofen, which can be used to guide treatment. Typically, ibuprofen is taken at a dose of 400-600mg every 6-8 hours as needed for pain, not exceeding 3200mg per day. Some key points to consider when using ibuprofen after dental surgery include:
- Starting the medication before the local anesthetic wears off to stay ahead of the pain
- Alternating ibuprofen with acetaminophen (Tylenol) for more severe pain, to provide enhanced relief without increasing side effects
- Avoiding NSAIDs if you have kidney problems, stomach ulcers, or are taking blood thinners
- Taking ibuprofen with food to minimize stomach irritation
- Contacting your dentist if pain persists beyond 3-5 days, as this could indicate complications like infection or dry socket that require additional treatment. As noted in 1, the basic analgesic regimen should include paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) administered pre-operatively or intra-operatively and continued postoperatively, which supports the use of ibuprofen in this context.
From the FDA Drug Label
In clinical studies in patients with rheumatoid arthritis, ibuprofen tablets have been shown to be comparable to indomethacin in controlling the signs and symptoms of disease activity and to be associated with a statistically significant reduction of the milder gastrointestinal [see ADVERSE REACTIONS] and CNS side effects Ibuprofen tablets may be used in combination with gold salts and/or corticosteroids. Controlled studies have demonstrated that ibuprofen tablets are a more effective analgesic than propoxyphene for the relief of episiotomy pain, pain following dental extraction procedures, and for the relief of the symptoms of primary dysmenorrhea
The best NSAID after dental surgery is ibuprofen, as it has been shown to be effective in relieving pain following dental extraction procedures 2.
- Key benefits of ibuprofen include:
- Effective analgesic properties
- Comparable to indomethacin in controlling disease activity
- Associated with a reduction in milder gastrointestinal and CNS side effects
- Important consideration: ibuprofen may be used safely in combination with gold salts and/or corticosteroids, but its use in combination with salicylates is not recommended due to potential increased frequency of adverse events.
From the Research
NSAID Options After Dental Surgery
- Ibuprofen is a commonly used NSAID for pain relief after dental surgery, and it can be used in combination with acetaminophen for enhanced pain relief 3.
- The WHO analgesic ladder recommends starting with acetaminophen and adding an NSAID, such as ibuprofen, diclofenac, or naproxen, as needed 4.
Combination Therapy
- A study found that combining acetaminophen and ibuprofen (Maxigesic) provided superior pain relief after oral surgery compared to using either drug alone 3.
- There was no pharmacokinetic interaction between acetaminophen and ibuprofen when administered together 3.
Gastrointestinal Risks
- NSAIDs can cause gastrointestinal adverse effects, and co-administering proton-pump inhibitors (PPIs) can help reduce these risks 5, 6.
- However, recent evidence suggests that PPIs may potentiate the gastrointestinal risks associated with NSAIDs 5.
- Guidelines recommend prescribing gastroprotective agents, such as PPIs, to older patients taking NSAIDs to prevent gastrointestinal ulcers 7.