How will my pain be controlled after my surgery?
Author : Dr. Andrew Kalin MD
Both the US Centers for Disease Control and Prevention (CDC) and the American Dental Association (ADA) have guidelines that all Health care providers including Oral surgeons follow to help manage all types of pain, including pain after oral surgery.
Post operative pain control for oral surgery actually begins before surgery even happens. Pain control is one of the major considerations taken into account during surgical planning. Both long and short acting local anesthetics are used to anesthetize the area in which the surgery is required. These local anesthetics not only provide pain relief during the surgery, but provide relief for a period of time after surgery. If sedation is required for the surgery, some pain relieving medications can be administered along with sedatives to provide additional relief during the surgery as well.
After surgery, your surgeon may prescribe some medications to further manage post operative pain. Both the CDC and ADA recommend the use of non-opioid analgesics as the FIRST line of pain control for dental procedures. These medications include non steroidal anti-inflammatory medications like Naproxen or Ibuprofen. These medications can also be combined with Acetaminophen to provide additional relief.
Based on the type of surgery, on occasion, opioid medications may also be required. If opioids are being considered, the CDC makes the following recommendations:
Clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. Three days or less will often be sufficient; more than seven days will rarely be needed.
Prescribe opioids IN COMBINATION with first-line therapy. Avoid multiple acetaminophen-containing preparations concomitantly.
For adolescents and young adults through 24 years old who are undergoing minor surgical procedures (e.g., third molar extractions), limit opioid prescriptions to 8-12 tablets.
For those patients who have chronic pain prior to surgery, it is best for those patients to consult with their Pain management providers on how to best manage their pain post operatively. In very rare cases, post operative pain may last longer than expected, and in those cases, pain will be controlled with the help of Pain management consultation with Pain management specialists.
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