Acetaminophen eases postwisdom tooth removal pain

NEW YORK (Reuters Health) July 30 The pain killer Paracetamol, known as acetaminophen in the U.S. and sold under the trade names Tylenol in the U.S. and Panadol in the U.K., is an effective treatment for the pain following wisdom tooth extraction, according to a review of 21 studies that used the drug versus a placebo or an inactive substance.

"It could be considered more readily by dentist and patients both as a first-choice analgesic, or to be taken alternately with doses of other analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs)," Dr. Kiaran Weil of The University of Manchester, U.K., and colleagues conclude.

Paracetamol is commonly used to treat pain after wisdom tooth extraction, Weil and his team note. While the drug is frequently classified as an NSAID, they add, its anti-inflammatory effects are "relatively weak" compared to other drugs in the class. However, the drug is effective for pain relief and has few adverse effects.

The researchers conducted a review of the medical literature to gauge the effectiveness of paracetamol -- compared to a placebo -- for pain relief after removal of the lower wisdom teeth and to identify the best dosage and dosing time.

They analyzed 21 trials including 1,968 patients. Four and six hours after taking the drug, the researchers found that patients reported significantly less pain than with placebo. The optimal dosage was 1,000 mg, which the researchers determined could be taken safely every six hours.

Nineteen percent of patients on paracetamol reported adverse events, compared with 16 percent of the placebo group, not a statistically significant difference. The most serious side effect seen with the drug was a severe headache.

The researchers conclude that "Paracetamol is a safe, effective drug for the treatment of postoperative pain following the surgical removal of lower wisdom teeth."

SOURCE: Cochrane Database of Systematic Reviews, 2007, online.

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