A new study led by Rutgers Health shows that over-the-counter pain relievers like ibuprofen and acetaminophen work just as well—or even better—than opioids for pain relief after wisdom tooth removal. This was true for both men and women.
The research builds on an earlier study involving more than 1,800 people who had their wisdom teeth removed.
That first study found that people who took a combination of 400 mg of ibuprofen (Advil, Motrin) and 500 mg of acetaminophen (Tylenol) had less pain and were more satisfied than those who took 5 mg of the opioid hydrocodone combined with acetaminophen. The pain relief was better during the first two days after surgery, which is usually when the pain is the worst.
Now, a new follow-up study published in JAMA Network Open looked closely at men and women separately. The results were clear: both groups got better pain relief on the first day and night from the non-opioid combination, and afterward, their pain levels were similar to those who took opioids. In fact, on many measures, the over-the-counter meds did even better.
This finding is important because women often report higher pain levels after surgery. Researchers wondered if pain medicine might work differently for women than for men. But the results showed that the ibuprofen-acetaminophen combo worked just as well for both sexes.
The study included equal numbers of men and women and was done across five universities. For nine days after surgery, patients tracked their pain, sleep, and daily activity using electronic diaries.
Those who took the non-opioid combo said they slept better, were more active, and needed fewer follow-up pain meds. Patients who took opioids were twice as likely to call their doctors asking for stronger medication.
The researchers were surprised by how strong the results were. They expected the non-opioid combination to be “not worse” than opioids, but they found it was actually better.
This is especially important because dental work is one of the most common ways people are first introduced to opioids. In 2022 alone, dentists wrote over 8.9 million opioid prescriptions in the U.S.
Many young people receive opioids after getting their wisdom teeth removed, and this can increase the risk of future use or even addiction. Opioid overdoses kill more than 80,000 Americans each year.
Wisdom tooth removal is considered one of the most painful dental procedures because it often involves cutting into the gums and removing bone. That’s why the FDA uses this procedure to test how well pain medicines work. However, the researchers believe their results may apply to other dental treatments as well.
Still, many dentists continue to prescribe opioids “just in case.” The next step in this research will look at why this happens even when evidence shows that non-opioid options are better.
The American Dental Association recommends avoiding opioids as a first choice for dental pain. This new study strongly supports that advice. According to the lead researchers, opioids should no longer be prescribed routinely after dental work. Instead, ibuprofen and acetaminophen should be the go-to pain relief option.
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The study is published in JAMA Network Open.
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