ABSTRACT
Following extraction of third molars, it is common practice for oral and maxillofacial surgeons to provide a prescription for an opioid-containing analgesic such as hydrocodone with acetaminophen. Because the instructions for use most often indicate that these analgesics are to be taken "as needed for pain," it is unknown how many of the prescribed postoperative analgesic tablets are needed and actually taken. Therefore, an assessment of patient pain experiences and actual opioid analgesic usage was carried out using structured telephone interviews of patients performed 1 and 7 days following their thirdmolar extraction surgery. Forty-eight adolescents and young adults, ages 15 to 30 years, participated in this assessment. A review of the surgeon's notes indicated that the median number of prescribed opioid-containing analgesics (ie, Vicodin®, Norco®, Lorcet®, Percocet®) was 20 tablets (range 10 to 40). The median consumption during the first 24 hours was reported to be three tablets (range 0 to 10), and the total consumption for all 7 days was eight tablets (range 0 to 34). Four patients reported nausea or vomiting in the first 24 hours, and six patients reported nausea or vomiting during the following 6 days of recovery. The initial prescriptions provided adequate relief for 45 of the 48 patients. Higher consumption of opioid pain relievers (OPRs) was associated with a longer duration of surgery and the occurrence of postoperative infections.
Subject(s)
Analgesics, Opioid/therapeutic use , Molar, Third/surgery , Pain Management/methods , Pain, Postoperative/drug therapy , Tooth, Impacted/surgery , Adolescent , Adult , Female , Humans , Interviews as Topic , Male , Pain Measurement , Prospective Studies , Tooth Extraction , Treatment OutcomeABSTRACT
The pharmacologic agent bisphosphonate has recently received much attention in the dental literature. Bisphosphonates in oral or intravenous forms are used to treat various diseases such as certain cancers, bone- and calcium-related disorders, osteoporosis, and osteopenia. Bisphosphonates inhibit bone turnover and result in increased bone-mineral density. The most serious dental side effect of bisphosphonate treatment (particularly when it is administered intravenously) is, paradoxically, osteonecrosis of the mandible or the maxilla represented by exposed nonhealing bone. Other related complications include decreased bone healing and inhibition of orthodontic tooth movement. This article reports the orthodontic treatment of 2 patients who were taking bisphosphonates.
