The Effect of Preemptive Analgesics on Third Molar Outcomes

Abstract

Control of pain following elective but necessary surgical removal of third molars for many is an afterthought, or managed with a “cookbook” management scheme of simply writing a prescription for a large number of combination analgesic tablets or capsules (acetaminophen plus an opioid). This approach spawns multiple concerns and problems including opioid overdose, dependency and addiction, liver failure, and bleeding disorders. There has been significant research addressing preemptive pain management to minimize post operative pain. Reducing or preventing pain however with current pharmacologic agents and accepted technique may have some adverse impact on the healing process. A consistent yet alterable pain management technique is obtainable for improvement of patient satisfaction with the procedure experience. Recent research regarding timing of analgesic dosing, use of modalities that effect pain control during sedation or general anesthesia, and efficacy associated with the use of local anesthesia agents will be presented.