Harnessing Placebo Analgesia: Another Avenue to Opioid Reduction in Oral Surgery

Abstract

Although encouraging early signs suggest the US opioid epidemic might have peaked, our eyes have been opened to the tremendous risks of the subsequent abuse and addiction for young patients exposed to opioids. Thus, avoiding the use of opioids is especially important for the typical high school- or college-age patient undergoing third molar removal. The 2017 American Association of Oral and Maxillofacial Surgeons White Paper on opioid prescribing and pain management encouraged a multimodal approach to pain management, recommending nonsteroidal anti-inflammatory drugs (NSAIDs) for first-line analgesic therapy. In early 2019, the Journal of Oral and Maxillofacial Surgery described numerous adjuncts for treating postoperative third molar pain, with the goal of reducing the need for opioids, including a homeopathic recovery kit, intrasocket bupivacaine, preemptive intravenous ibuprofen or acetaminophen, oral bromelain, and submucosal tramadol.