• Posted February 6, 2024

Dentists' Group Issues New Pain-Control Guidelines for Teens, Adults

New guidelines from the American Dental Association (ADA) are cracking down on the use of opioids for tooth pain.

The guidelines say that non-steroidal anti-inflammatory drugs (NSAIDs) taken alone or alongside acetaminophen should be the first-line treatment for managing short-term dental pain in teenagers and adults.

The available medical evidence indicates that those medications can effectively manage pain from a toothache or after a tooth removal, an ADA guideline panel concluded.

The guidelines also say that opioid painkillers should be prescribed under limited circumstances, after considering any risk factors for opioid misuse. 

Dentists should avoid providing "just in case"opioid prescriptions for patients, and use extreme caution in prescribing opioids to teens and young adults, the guidelines say.

Patients also should be educated on proper storage and disposal of opioid drugs, according to the guidelines.

The guidelines were developed under a $1.5 million grant handed down by the U.S. Food and Drug Administration in 2020 to develop guidelines for handling dental pain in patients.

"We hope this clinical practice guideline will reduce the risk of opioid addiction, overdose and diversion,"Marta Sokolowska, deputy center director for substance use and behavioral health at the FDA's Center for Drug Evaluation and Research, said in an ADA news release.

A previous set of recommendations for pediatric patients was published in 2023.

Over-the-counter NSAIDs include aspirin, ibuprofen and naproxen sodium. There also are prescription-strength NSAIDs available for more severe pain.

"It's important to take special consideration when prescribing any type of pain reliever, and now dentists have a set of evidence-based recommendations to determine the best care for their patients,"said senior author and panel chair Dr. Paul Moore, a professor emeritus at the University of Pittsburgh's School of Dental Medicine.

"Patients are encouraged to discuss pain management expectations and strategies with their dentist so they can feel confident that they are receiving the safest, most effective treatment for their symptoms,"Moore said.

The new guidelines appear Feb. 5 in the Journal of the American Dental Association.

More information

The U.S. Centers for Disease Control and Prevention has more about dental pain care.

SOURCE: American Dental Association, news release, Feb. 5, 2024