Dental pain ranges from mild sensitivity to a throbbing toothache. Some pain can wait until a convenient time for treatment while severe pain may result in an emergency visit. Several types of dental pain relievers play a major role in treatment and pain management for various oral conditions. The effectiveness and variety of these medications has greatly improved in recent years.
Local Anesthetics
Local anesthetic is frequently the first pain reliever used for most dental pain. According to the Cleveland Clinic, dental anesthetics relieve pain from an erupting tooth, sores, blisters and toothaches. Some topical anesthetics are available over the counter such as Anbesol, Orajel and Chloraseptic. Dentists also use topical anesthetics to produce numbness in an affected area prior to injecting a local anesthetic solution.
The administration of a local anesthetic solution usually provides rapid and profound relief from a severe toothache. A dentist uses a dental syringe to deposit the anesthetic solution in the soft tissue adjacent to the painful tooth. The solution diffuses through the thin plate of bone to anesthetize the tooth. The thickness of the bone on the lower jaw prevents this type of infiltration anesthesia. Anesthetizing the mandibular nerve on the same side as the toothache will make the painful tooth numb. Lidocaine is the most common local anesthetic used in dentistry. The anesthetic solution contains epinephrine to prolong the time of effective anesthesia.
Non-narcotic Analgesics
According to the American Dental Association, non-narcotic analgesics available over-the-counter are the most frequently used medication for relief of toothache pain and pain that occurs following dental treatment. Ibuprofen, aspirin and acetaminophen are among those in this category. The medications recommended by the American Academy of Family Physicians are acetaminophen and ibuprofen for relief of acute pain. The safest and most effective dosages are 1,000mg of acetaminophen and 400mg of ibuprofen. Some pain requires higher doses for greater pain relief. Since higher doses result in more adverse side effects, treatment begins with the smallest dose. According to the American Dental Association, 1,000mg of acetaminophen is effective even for procedures such as wisdom tooth extraction.
Narcotic Analgesics
Severe dental pain requires narcotic analgesics, according to the American Dental Association. These medications require a prescription from a physician or dentist. Narcotics do not help relieve the inflammatory process. Instead, they block pain receptors in the brain and spinal cord. The most common one prescribed is acetaminophen with codeine. Several side effects exist for these analgesics including nausea, vomiting, blurred vision, constipation, nervousness and dizziness, according to the American Academy of Family Physicians. The prescribing doctor must be aware of all pre-existing medical conditions prior to prescribing narcotics. These medications require careful use because of the propensity to develop drug dependence.
Anti-anxiety Medications
Anxiety about pain increases the sensation of pain, according to the "Journal of Neuroscience." Dentists use anti-anxiety medications such as nitrous oxide and oral sedatives in conjunction with local anesthetics for treatment of dental pain. The American Dental Association encourages a clear understanding of the risks and benefits before receiving anti-anxiety medications.
References
- Cleveland Clinic: Medications Used in Dentistry
- American Dental Association: Anesthesia and Sedation
- American Dental Association: Acetaminophen Effective for Pain Relief After Wisdom Tooth Extraction
- American Academy of Family Physicians: Oral Analgesics for Acute Nonspecific Pain
- "Journal of Neuroscience": Exacerbation of Pain by Anxiety
