New Guideline Offers Acute Pain Management Solutions for Adolescent and Adult Dental Patients

In a collaborative effort between the American Dental Association (ADA), the University of Pittsburgh School of Dental Medicine, and the Center for Integrative Global Oral Health at the University of Pennsylvania School of Dental Medicine, a new clinical practice guideline has been developed. Published in the February issue of The Journal of the American Dental Association, this guideline is endorsed by the ADA.

Drawing upon a comprehensive review of available evidence, the guideline panel has determined that NSAIDs, such as ibuprofen and naproxen, either alone or in conjunction with acetaminophen, represent the primary treatment approach for alleviating dental pain in individuals aged 12 and above. This recommendation holds true for scenarios involving tooth extractions or toothaches when immediate dental care is not feasible.

Moreover, the guideline provides practitioners with recommendations for the cautious prescription of opioid medications in specific circumstances where deemed necessary. These recommendations underscore the importance of avoiding unnecessary opioid prescriptions, engaging patients in shared decision-making processes, and exercising extreme caution when considering opioids for adolescents and young adults. Additionally, the guideline emphasizes the significance of educating patients on proper opioid storage and disposal, as well as assessing any potential risk factors for opioid misuse and adverse events.

“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,” Paul Moore, DMD, PhD, MPH, the guideline’s senior author and panel chair and professor emeritus at the University of Pittsburgh’s School of Dental Medicine, says in a press release. “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.”

The development of this guideline was made possible through a collaborative effort funded by a 3-year $1.5 million grant awarded by the U.S. Food and Drug Administration (FDA) to the University of Pittsburgh and the ADA Forsyth Institute. By providing clear prescribing guidelines for acute dental pain management across all age groups, this initiative aims to mitigate the risks associated with opioid addiction, overdose, and diversion.

“Providing prescribing guidelines for acute dental pain management is an important step towards improving patient treatment and outcomes,” Marta Sokolowska, PhD, deputy center director for substance use and behavioral health at the FDA's Center for Drug Evaluation and Research says in the press release. “We hope this clinical practice guideline will reduce the risk of opioid addiction, overdose and diversion.”

This guideline, focusing on acute dental pain management, complements a previously published set of recommendations tailored specifically for pediatric patients in 2023. Both sets of guidelines are accessible at ada.org/painmanagement.

For further insights into the ADA’s ongoing efforts to address opioid misuse while ensuring effective pain management for dental patients, visit ada.org/advocacy/opioid-crisis.

It is important to note that the views expressed in the guidelines are those of the authors and do not necessarily reflect the official stance of, nor are they endorsed by, the FDA, U.S. Department of Health and Human Services, or the U.S. government.

The ADA, a not-for-profit organization, stands as the nation's largest dental association, representing 159,000 dentist members. Since its inception in 1859, the ADA has been a steadfast advocate for public health and has played a pivotal role in advancing the art and science of dentistry. Through its state-of-the-art research facilities, the ADA continues to develop and evaluate dental products and materials, thereby enhancing dental practice and improving patient experiences.