Use of analgesics in oral care
To alleviate acute dental pain, dentists and dental specialists frequently prescribe analgesics to patients, either on prescription or not. In order to effectively manage dental pain, it is advisable to follow a step-by-step plan based on the WHO analgesic ladder: step 1, start with acetaminophen step 2, add an NSAID (e.g. ibuprofen, diclofenac, naproxen); step 3, add a weak opioid (e.g. tramadol) in combination with acetaminophen or an NSAID; step 4, replace a weak opioid with a strong opioid (e.g. morphine or oxycodone). A dentist in general practice or a dental specialist needs to know, the mechanism of action and the most important interactions, contraindications and adverse effects of each of these groups of medications. Attention is needed when prescribing analgesics to risk groups such as frail elderly, pregnant and lactating women, and children.