Dental treatment can result in varying degrees of postoperative pain depending on the nature and extent of the treatment, the anatomical site involved and the individual patient’s pain threshold and coping behaviour. Routine dental treatment may result in mild pain while more invasive treatment, such as dentoalveolar surgery, can result in moderate to severe postoperative pain.

It is important to determine that the pain is a sequel to dental treatment. Other causes, such as incomplete treatment or other untreated dental pathology, should be excluded.

Recommendations for pain management following dental treatment have been published.1 In general, this involves drugs taken orally. Mild pain is usually managed with ibuprofen or aspirin or, if non-steroidal anti-inflammatory drugs (NSAIDs) are contraindicated, paracetamol. For moderate to severe pain, a combined dosing protocol of ibuprofen and paracetamol is recommended or, if NSAIDs are contraindicated, paracetamol plus codeine.

Comparisons of oral analgesic drugs are found on the Oxford league table of analgesic efficacy.2 The information has been obtained from systematic reviews of randomised, double-blind, single-dose studies in patients with moderate to severe pain and the results have been validated.

Conflict of interest: none declared

References

  1. Oral and Dental Expert Group. eTG complete [internet]. Melbourne: Therapeutic Guidelines Limited; 2012.
  2. Bandolier. Oxford league table of analgesics in acute pain. 2007. www.medicine.ox.ac.uk/bandolier/booth/painpag/Acutrev/Analgesics/Leagtab.html [cited 2013 Nov 7]