PijnvizierPain relief in dental care
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Situations

Pain around a wisdom tooth

Pericoronitis around a partially erupted molar.

Prescription options

Local treatment

Assess the tissues around the partially erupted tooth and the extent of involvement. SDCEP recommends starting with local rinsing and professional cleaning.

Pain relief alongside local care

For mild to moderate pain due to local pericoronitis, paracetamol is a first option. If pain relief is inadequate, adults may consider ibuprofen if an NSAID is appropriate.

If swelling increases or there is difficulty swallowing, follow the pathway for Swelling and infection.

Prescription options

Drafts for adults. Check the indication, contraindications and current medicines before prescribing.

Paracetamol aloneFirst option in mild to moderate pain in addition to local care

First option for acute nociceptive pain. This example applies to adults weighing more than 55 kg without risk factors for hepatotoxicity.

Checks before prescribing

Include all paracetamol from over-the-counter and combination products. Adjust the dose if there are risk factors.

  • R/ Paracetamol 500 mg tablet

    Per dose
    1,000 mg by mouth (2 tablets)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Maximum per 24 hours
    3,000 mg (6 tablets)
    Quantity in this draft
    Maximum 12 tablets

Duration in this example: 2 days. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

Ibuprofen aloneIf paracetamol is not effective, if NSAID is appropriate

Adults with toothache, if an NSAID is appropriate

Checks before prescribing

KIMO advises against NSAID use after a dental procedure that causes bleeding in patients taking antithrombotics, even if antithrombotic therapy has been temporarily interrupted. Discuss over-the-counter NSAIDs as well. See When taking antithrombotics. Check gastrointestinal, renal and cardiovascular risk factors, pregnancy, hypersensitivity and interactions. Do not combine two NSAIDs. See Frailty, kidney or liver impairment.

  • R/ Ibuprofen 400 mg film-coated tablet (Spidifen)

    Per dose
    400 mg by mouth (1 tablet)
    Frequency and interval in this example
    If necessary up to 3 times a day, approximately 8 hours between intakes
    Spidifen SmPC §4.2: every 4 to 6 hours if necessary.
    Maximum per 24 hours
    1,200 mg (3 tablets)
    Quantity in this draft
    Maximum 6 tablets

Duration in this example: 2 days. Stop earlier if the medicine is no longer needed. Reassess if pain relief is inadequate or pain worsens.

Sources for this topic

Reference for dentists on acute dental pain and pain after treatment.