The trial of more than 1,800 patients found that those given a combination of ibuprofen and acetaminophen experienced less pain, better sleep and higher satisfaction, compared with those receiving the opioid hydrocodone with acetaminophen.
To compare opioid and non-opioid pain relief, the researchers conducted a randomised trial on patients undergoing surgical removal of impacted wisdom teeth, a common procedure that typically causes moderate to severe pain.
Half the patients received hydrocodone with acetaminophen. The other half got a combination of acetaminophen and ibuprofen. Patients rated their pain levels and other outcomes, such as sleep quality, over the week following surgery.
Results published in The Journal of American Dental Association showed the non-opioid combination provided superior pain relief during the peak-pain period in the two days after surgery. Patients taking the non-opioid medications also reported better sleep quality on the first night and less interference with daily activities throughout recovery.
Patients who received the over-the-counter combo were only half as likely as the opioid patients to require additional ‘rescue’ pain medication. They also reported higher overall satisfaction with their pain treatment.
Cecile Feldman, dean of Rutgers School of Dental Medicine and lead author of the study, said, “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.”
Referring to the study’s focus on sleep quality and the ability to return to work, Cecile added, “We were looking at the effectiveness – so how does it work in real life, considering what people really care about.
“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.”
Members of the research team said they hoped to expand their work to other dental procedures and pain scenarios.