Acute pain management following dental extraction

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This review and network meta-analysis (NMA) of pharmacological treatments for the management of pain subsequent to simple and surgical tooth extraction included 85 RCTs. There was moderate- and high-certainty evidence that for surgical dental extractions that ibuprofen 200 to 400 mg plus acetaminophen 500 to 1,000 mg was the most effective for pain relief.

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Ibuprofen prior to lower third molar removal

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This review of the effect of pre-emptive ibuprofen on post-operative pain after lower third molar surgery included 5 RCTs. Only one of the included studies was at low risk of bias so there is insufficient evidence to support the routine use of pre-emptive ibuprofen to reduce post-operative pain after lower third molar removal

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Dental implants – post-operative pain management

The authors sought to review available literature relating to SSRI withdrawal syndromes

This review evaluating clinical efficacy of analgesics in mitigating orofacial pain following dental implant surgery included 9 RCTs. While the findings suggest analgesics may be beneficial the number of studies is small an additional infromation is required on which medication,, dosage, dosing schedule, administration route and adverse effects.

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Orthodontic pain: The efficacy of analgesics

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This review of the efficacy of of analgesics on the relief of pain during orthodontic treatment included 12 RCTs. The findings demonstrate that analgesics were more effective than placebo in controlling orthodontic pain

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Post-endodontic pain: Is it influenced by concentration of sodium hypochlorite irrigation?

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This large RCT involving 308 patients found that using 1.3% NaOCl was associated with less intense and less frequent post-endodontic pain than 5.25% NaOCl in mandibular molars with nonvital pulps treated in two visits.

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Guideline: Antibiotics for Dental Pain and Swelling

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This new guideline from the American Dental Association is about the the appropriate use of systemic antibiotics for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical pulpitis, pulp necrosis and symptomatic apical periodontitis and pulp necrosis and localized acute apical abscess.

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COX-2 inhibitors for pain management after third molar removal

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review comparing the efficacy of Cox-2 inhibitors with ibuprofen after third molar removal included 12 RCTs suggesting that COX-2 inhibotors and Ibuprofen provide similar pain relief at 6, 8, and 12 h after third molar removal.

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Fixed orthodontic appliances: What is the most effective debonding technique?

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This review of different methods for reducing pain and discomfort during removal of fixed orthodontic appliances included 6 RCTs providing weak evidence for pre-debonding analgesia and other approaches.

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Nonsurgical root canal therapy: What is the most effective oral premedication to reduce post treatment pain?

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This review of the most effective oral premedication in reducing pain in adults after nonsurgical root canal therapy including 16 studies. While a premedication of choice is suggested most outcomes are only supported by very low quality evidence.

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Inferior alveolar nerve block: can NSAIDs improve anaesthetic success?

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This review of the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) as premedication on the success of inferior alveolar nerve block includes 13 RCTs suggesting NSAIDs have a positive impact on success.

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