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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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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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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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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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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This network meta-analysis of oral premedication to improve anaesthetic success of inferior alveolar nerve block in patients with irreversible pulpitis suggest that that oral premedication with dexamethasone, NSAIDs and Tramadol increases the success rate.
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This Cochrane review of drug interventions for pain during orthodontic treatment including 32 RCTs find that analgesics were effective in reducing pain. However, low quality evidence did not show a difference in effectiveness between systemic NSAIDs compared with paracetamol, or topical NSAIDs compared with local anaesthetic.
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16 RCTs involving 1900 patients were included in this review of pre-op analgesia for patients with pulpitis . The findings suggest that premedication with analgesics improves the success rate of local anaesthesia.
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The review of NSAIDs for endodontic postoperative pain suggests that NSAIDs are effective. A combination of ibuprofen 600 mg and acetaminophen 1000 mg and Ibuprofen 600 mg were both effective. More studies are need to assess teh most effective NSAIDs dosages and does intervals.
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This Cochrane review found 5 RCTs of pre-op analgesics prior to dental treatment for children under local anaesthetic. The evidence as insufficient to determine a benefit but there may be a benefit prior to orthodontic band placement. Further high quality studies are needed.
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