Comment on controlling dental post-operative pain and the intraoral local delivery of drugs.

The results of numerous double-blind, placebo-controlled clinical trials consistently demonstrate that nonsteroidal antiinflammatory drugs should be the first line agents in treating postsurgical dental pain. Additive and potential opioid-sparing effects have also been reported in oral surgery pain by combining an optimal dose of an NSAID with acetaminophen 500 mg. While opioid combination drugs are indicated in some dental postsurgical patients, clinicians can no longer ignore the scourge of prescription opioid abuse in the United States. Other potential opioid sparing strategies include the use of locally delivered antimicrobial/antiinflammatory agents such as Bexident Post or extended duration local anesthetic agents such as liposomal bupivacaine placed directly in or in the vicinity of the extraction socket.