Better Pain Management After Dental Procedures

What is the best way to manage pain after tooth extraction or other dental procedures? The answer to the question might surprise you.

A new study by The Journal of the American Dental Association compared the effectiveness and the side effects of OTC Pain Meds - paid - shutterstock 736488091“nearly all analgesic formulas.” Two important conclusions are:

  1. “Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for relieving postoperative pain.”
  2. “Opioid combinations are associated with high incidences of adverse effects, such as nausea, vomiting, and constipation.”

It is noteworthy that in the assessment there was no comparison of “acetyl-para-aminophenols (APAPs) and hydrocodone that found it to be more effective than some over-the-counter medications either alone or in combination. These NSAIDs, like ibuprofen and naproxen sodium, have been more effective than opioids in relieving post-operative pain.

In fact, taking two Tylenol (400 mg) with one Advil (200mg of ibuprofen) every 4 – 6 hours is as effective as taking one Tylenol with codeine and without the side effects. Please remember that staying ahead of pain is much easier than trying to relieve pain once it begins.

A previous study by the Journal of the American Dental Association linked adolescent opioid abuse to postoperative opioid prescriptions written by dentists. Specifically, “nearly 6% of almost 15,000 people between 16 and 25 years old who received initial opioid prescriptions in 2015 from dentists were diagnosed with opioid abuse within a year. In comparison, 0.4% in a similar group who didn’t get dental opioids were diagnosed with opioid abuse during the same period.”

At Complete Dental Care of Salem, VA, we have prescribed over-the-counter drugs for pain whenever possible for a number of years. We do not see value in over-medicating our patients. We are proud to be an early adopter in a movement among dentists across the country that will withhold opioid painkillers whenever possible. When we prescribe over-the-counter medications, we make a point of explaining how to use these medications for adequate pain relief. If we believe it likely that you will experience pain after a dental procedure, we may suggest that you take an NSAID before you leave the office.

People have been managing oral pain after dental procedures for centuries. Many of them used some “natural remedies” such as:

  • Hydrogen peroxide, which can heal bleeding gums, reduce swelling, and kill bacteria.
  • Vanilla extract, an antioxidant that aids healing. Because it contains alcohol, it is valued for its pain-relieving properties, as well.
  • Clove oil has been used widely for its antiseptic properties and because it reduces pain and inflammation. It can be applied directly to the gums or mixed with water to make a mouthwash.
  • Thyme essential oil can be used in the same way as clove oil.
  • Guana leaves, when chewed, have anti-inflammatory effects.
  • Wheatgrass is can relieve inflammation and prevent infection.

If you have any question about any medication that we recommend to you either for pain relief or for anti-bacterial and anti-inflammatory needs, please just ask us what we are prescribing and what your concerns are about any medication. We can work with you to find an effective non-opioid medication or combination of medications.

Eat Your (dark-colored) Berries

A recent study from the Oral Health Foundation (in the UK) reports that if you eat a handful of dark-colored berries it may reduce your risk of tooth decay. The study demonstrated that certain nutrients in cranberries and blueberries can help to prevent tooth decay. These nutrients protect the teeth from a particular strand of bacteria that accelerates the cranberries and blueberriesdecay process.

These nutrients, called polyphenols, prevent tooth decay by preventing “bad bacteria” from sticking to your teeth and gums. This effect could help us prevent tooth decay, plaque buildup, and gum disease. Dr. Nigel Carter says in the report “Cranberries seem especially good for our oral health, as their polyphenols stick around in our saliva and will continue to help our mouth, even after we’ve swallowed them.”

It is important to remember that like other fruits, cranberries and blueberries may contain large amounts of natural sugars (which may contribute to obesity and diabetes). Thus, quantities eaten should be limited. Yet dark-colored berries are one of the best sources of antioxidants, providing water, fiber, and other nutrients.

Probably the most exciting part of the study is the tooth-protecting nutrients in these fruits can be extracted sugar-free. This means they can be used in several ways and in several types of foods and products. They will dissolve in water. This means that they can be added to oral health care products, such as toothpaste and mouthwash. They can also be used to create healthy replacements for sugary drinks.

It will be interesting to see if and when manufacturers will add polyphenols to their formulas for toothpaste and mouthwash.

In the meantime, it might make sense for many of us to add dark-colored berries to our diets. The best times to do that would be for breakfast or dinner. This limits the exposure of our teeth to the sugar and acid in the fruits. Further, it is important that we limit the amount of these fruits that we consume so that we gain the benefits and do not do harm with excessive sugar.

Our suggestion is that you eat a handful of cranberries or blueberries daily, brush and floss twice daily, and see your dentist twice each year. Let’s keep your teeth and gums healthy by eating a handful of dark-colored berries each day.

Marijuana and Oral Health

13% of American adults use marijuana regularly for either medical treatment or recreational use. This is almost twice the number (7%) of adults using marijuana in 2013. Cannabis can be used in three ways: (1) smoking/inhalation, (2) drying it into a plant resin and baking it into foods, and (3) applying it topically in creams and ointments that contain THC.marijuana cigarette - paid - shutterstock 650375488

Marijuana use often has psychological and physiological effects. Our concern today is with the effects of marijuana on oral health. These effects include:

  1. dry mouth (xerostomia). Many scientists believe the marijuana associated effect is due to all or any forms of the drug and not only with smoking the drug. Xerostomia can cause a drying out of the tissue of the mouth, which significantly reduces the risk of cavities and tooth decay. Regular cannabis users have a significantly higher number of caries than people who do not use the drug.
  2. Regular cannabis use can increase the risk for periodontal disease.
  3. Because cannabis contains particular carcinogens, like tobacco. Long-term use of cannabis has been associated is some studies with chronic inflammation of mucosa and gingival enlargement. It is unclear, however, if this effect is caused by the inhaled smoke or by the cannabis itself.
  4. Several other abnormalities are associated with marijuana use, including erythroplakia, keratosis, leukoplakia. These abnormalities can, in some cases, develop into neoplasias. They should be monitored regularly and continually.

Your dentist needs to know if you use marijuana frequently. With this knowledge we can monitor your oral health more carefully and frequently. Finally, cannabis has immunosuppressive properties that are related to the human papillomavirus. The increased cancer risk in those with HPV could lead to increased risk of cancers of the head and neck. These connections are still under analysis, however.

People do not enter dentistry in order to pry into people’s secrets and sit in judgment of them. We enter the profession because we care about people, and we want to help people protect and improve their oral and general health. Nor do we enter this profession to sit in judgment of others.

When you come to Complete Dental Care of Salem, VA, you will be met with patience and understanding. We expect you to tell us if you use cannabis regularly so that we can provide you with the best possible dental care. We do not judge our patients. If you are a regular cannabis user, please come in and talk with us about the potential risks of using marijuana. Then, let’s create a workable plan to care for your oral and general health.

Smiles Go More Than Skin Deep

Smiles have amazing power in our lives. More than a factor in our appearance, our smiles have profound influence on our minds and on the minds of others. Understanding the amazing power of our smiles, it is no surprise that most of us do all that we can to protect our smiles. Here are some of the reasons Smiles go more than skin deep.

  1. Smiling makes us more dreamstimefree -  sm 6338071
  2. Smiling makes us look younger.
  3. Smiling reduces stress.
  4. Smiling sends the messages to your brain that elevate your mood.
  5. Smiling boosts your immune system.
  6. Smiling is contagious.
  7. Smiling lowers your blood pressure.
  8. A smile makes you seem more confident and more successful.
  9. Smiling helps you maintain a positive attitude.
  10. Smiling makes you feel better.
  11. Smiling makes us appear more likable and thus helps us build better relationships.
  12. People who smile a lot live longer.
  13. Smiling and laughing reduce pain.
  14. Smiling makes you seem more trustworthy.
  15. Smiling boosts productivity.
  16. Smiling makes you more creative.

Take good care of your teeth and keep smiling. We’re here to help you protect your smile and care for your oral health.

What Are Lie Bumps?

“Lie bumps” is a common name for transient lingual papillitis. The common name derives from a superstitious belief that telling a lie causes these bumps to appear on your tongue. The name is still used even though we know this is not the real cause. These bumps are typically small, red or white, and may be painful or uncomfortable. They appear suddenly and generally disappear in a few days. In most cases, no treatment is necessary. If these bumps appear anatomy of human tongue - paid - Depositphotos 95368080 s-2015alongside other symptoms, you might have “eruptive lingual papillitis," which is caused by a virus. They are most commonly found in children. If they persist for more than a week, it is wise to see your dentist or doctor. If these bumps recur in children, it is wise to see their pediatrician.

Transient Lingual Papillitis vs. Eruptive Lingual Papillitis: The bumps that appear on the tongue in either of these conditions look alike. Eruptive lingual papillitis differs in several ways”

  • It can last as long as two weeks.
  • It may be caused by a virus.
  • It is contagious.
  • It may cause swollen glands.
  • It may be accompanied by fever.
  • It is more common in children.

CAUSE: Scientific research has not been able to identify or document a definite cause of lie bumps. A number of possible causes have been advanced, including: stress, gastrointestinal upset, menstruation, acidic food, sour food, food allergies, spicy food, smoking, and local trauma (e.g., biting or burning the tongue). They are often caused by the taste buds splitting.

TREATMENT: Lie bumps typically require no treatment. To manage the symptoms, you might try:

  • Avoid acidic, sour, or spicy food.
  • Rinse the mouth with salt water.
  • Brush after every meal.
  • Use mouthwash to reduce bacteria in the mouth.
  • Use an over-the-counter topical treatment (e.g., Zilactin)

WHEN TO SEE A DOCTOR: There are several types of bumps that can appear on your tongue, each with its own cause. If you have bumps that are not caused by transient lingual papillitis (lie bumps) or eruptive lingual papillitis, you should see your dentist or doctor. Other bumps might be caused by human papillomavirus (HPV), canker sores, syphilis, scarlet fever, oral cancer, traumatic fibroma, or lymphoepithelial cysts.


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