Pain relief guidance

Assess and treat the dental cause. If temporary pain relief is appropriate, paracetamol alone is the first option.

Check what has already been taken and which risk factors affect the daily limit.

If paracetamol provides insufficient relief, one suitable NSAID may be added. Check renal function, gastrointestinal and cardiovascular risk, interactions, and whether the patient already uses an NSAID.

• Paracetamol with ibuprofen · dose and interval

Two separate medicines allow independent dosing. A fixed-dose combination is an alternative if the strength and ratio are appropriate. Check over-the-counter medicines first to avoid duplicate dosing.

After a simple extraction, use non-opioid pain relief. Reassess if pain persists or worsens, including wound, swelling and bleeding.

For severe acute pain, after that assessment, tramadol may sometimes be considered if non-opioid treatment is insufficient.