A new white paper from the American Association of Oral and Maxillofacial Surgeons (AAOMS) recommends that ibuprofen, not opioids, be used as a first-line therapy for managing a patient's acute and postsurgical pain.
The white paper also states that, if opioids are to be used, the lowest possible effective dose for the shortest duration should be used.
Other recommendations include the following:
- Dosage levels and times of administration of ibuprofen and acetaminophen taken simultaneously should be documented to prevent overdosage.
- Patients should be informed not to exceed 3,200 mg of ibuprofen per day. In addition, the maximum recommended daily dose of acetaminophen is 3,000 mg.
- The appropriate state's prescription drug monitoring program or other resources should be accessed if patient drug misuse is suspected.
- All instructions for each patient's pain relief and prescriptions should be documented.
- The reasoning for not following these recommendations or those required by state laws or institutions should be documented.
- A corticosteroid should be considered for use during surgery to limit swelling and lower postsurgical discomfort after wisdom teeth removal.
- A long-acting local anesthetic to postpone the onset and severity of postsurgical pain should be considered.
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