Tylenol and Advil Outperform Opioids for Dental Pain, Says Study

Rutgers Study Highlights Non-Opioid Pain Relief Advantages

A recent study conducted by Rutgers University’s School of Dental Medicine has found that a combination of acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) provides superior pain relief for patients recovering from wisdom tooth extractions compared to opioid-based medications such as hydrocodone. This research, which involved over 1,800 participants, offers critical insights into effective pain management strategies and could influence dental prescribing practices to reduce reliance on opioids.

According to an article published on SciTechDaily, the findings align with the American Dental Association’s (ADA) recommendations to avoid opioids as a first-line treatment. The study’s lead author, Cecile Feldman, dean of Rutgers School of Dental Medicine, emphasized, “We think this is a landmark study. The results actually came in even stronger than we thought they would.”

Reducing Opioid Prescriptions in Dentistry

Dentists are among the top prescribers of opioids in the United States, with over 8.9 million prescriptions issued in 2022. For many young adults, wisdom tooth removal often serves as their first exposure to opioid medications, raising concerns about addiction risks. Study co-investigator Janine Fredericks-Younger noted, “There are studies out there to show that when young people get introduced to opioids, there’s an increased likelihood that they’re going to eventually use them again, and then it can lead to addiction.”

The opioid crisis in the U.S. remains a significant public health issue, with over 80,000 overdose-related deaths reported annually. By highlighting the effectiveness of non-opioid alternatives, the Rutgers study provides a compelling case for revisiting dental pain management protocols to reduce exposure to these highly addictive medications.

Study Design and Results

Participants in the randomized trial underwent surgical removal of impacted wisdom teeth, a procedure often associated with moderate to severe pain. The study divided patients into two groups: one received hydrocodone combined with acetaminophen, while the other was treated with acetaminophen and ibuprofen. Patients were asked to evaluate their pain levels, sleep quality, and daily activities over a week following surgery.

The results, published in The Journal of the American Dental Association, revealed that the non-opioid combination provided better pain relief, particularly during the first two days when pain intensity typically peaks. Feldman highlighted the real-world relevance of the findings, stating, “We were looking at the effectiveness – so how does it work in real life, taking into account what people really care about.”

Key findings included:

• Patients treated with acetaminophen and ibuprofen reported less interference with daily activities and better sleep quality during recovery.
• The non-opioid group required fewer “rescue” medications for breakthrough pain.
• Overall satisfaction with pain management was higher among patients receiving the over-the-counter drug combination.

Implications for Dental Practice

The study’s size and robust methodology make it a significant contribution to dental pain management research. Feldman asserted, “We feel pretty confident in saying that opioids should not be prescribed routinely and that if dentists prescribe the non-opioid combination, their patients are going to be a lot better off.”

This shift toward non-opioid pain management could have far-reaching effects on dental education and practice. “For a while, we’ve been talking about not needing to prescribe opioids,” Feldman added. “This study’s results are such that there is no reason to be prescribing opioids unless you’ve got those special situations, like medical conditions preventing the use of ibuprofen or acetaminophen.”

Broader Research Applications

Building on these findings, the Rutgers research team plans to explore non-opioid pain relief options for other dental procedures. Additionally, other researchers at the university are investigating cannabinoids as potential alternatives for managing dental pain. “These studies not only guide us on how to improve current dental care but also on how we can better train future dentists here at Rutgers, where we constantly refine our curriculum in the light of science,” said Feldman.

Reference and Funding

The study, titled “Nonopioid vs opioid analgesics after impacted third-molar extractions,” was authored by Cecile A. Feldman and colleagues and published on January 4, 2025. It was funded by the National Institutes of Health’s National Institute of Dental and Craniofacial Research. For more details, visit SciTechDaily or refer to the study DOI: 10.1016/j.adaj.2024.10.014.