Critical Reviews in Oral Biology & Medicine, Vol 12, 315-330, Copyright © 2001 by International & American Associations for Dental Research

ARTICLES

Therapeutic uses of non-steroidal anti-inflammatory drugs in dentistry

R. A. Dionne and C. W. Berthold
Pain & Neurosensory Mechanisms Branch, National Institute of Dental and Craniofacial Research, NIH, Bethesda, MD 20892-1258, USA. rdionne@dir.nidcr.nih.gov

The non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used classes of drugs for the management of acute and chronic pain in dentistry. Their therapeutic efficacy and toxicity are well-documented and provide evidence that NSAIDs generally provide an acceptable therapeutic ratio of pain relief with fewer adverse effects than the opioid-mild analgesic combination drugs that they have largely replaced for most dental applications. The great many studies done with the oral surgery model of acute pain indicate that a single dose of an NSAID is more effective than combinations of aspirin or acetaminophen plus an opioid, with fewer side-effects, thus making it preferable for ambulatory patients. The combination of an NSAID with an opioid generally results in marginal analgesic activity but with an increased incidence of side-effects, which limits its use to patients in whom the NSAID alone results in inadequate analgesia. The selective COX-2 inhibitors hold promise for clinical efficacy with less toxicity from chronic administration and may prove advantageous for the relief of chronic orofacial pain. The use of repeated doses of NSAIDs for chronic orofacial pain should be re-evaluated in light of a lack of documented efficacy and the potential for serious gastrointestinal and renal toxicity with repeated dosing.

This article has been cited by other articles:

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				M. SPINK, S. BAHN, and R. GLICKMAN Clinical implications of cyclo-oxygenase-2 inhibitors for acute dental pain management: Benefits and risks J Am Dent Assoc, October 1, 2005; 136(10): 1439 - 1448. [Abstract] [Full Text] [PDF]