Thursday, September 15, 2011

Best Pill for Dental Pain

Q.  Dr Hand, what is the best drug for pain relief?

A.  One Motrin and one extra strength Tylenol is the optimal combination for best pain relief after minor surgery and for tooth aches.

For a variety of reasons, a combination of products is generally more effective then only one medication by itself.

Many dentists have recently been suggesting this Motrin & Tylenol combination for our patients instead narcotics as it is safer, works better and has less side effects.

An analysis by researchers at Oxford University appeared in the September issue of The Cochrane Library and reported in the New York Times Health Section investigated the effectiveness of oral pain medications after surgery.  

These researchers found the optimal combination was 200 milligrams of ibuprofen and 500 of Tylenol because 74 % of the time this combination lessened the pain at least by 50%. This was better then a low dosage of Tylenol or even Codeine alone.

Friday, September 9, 2011

Wisdom Teeth, to extract or not extract NY Times

It has been the general consensus that people should preemptively pull their wisdom teeth to avoid any potential problems in the future. A recent article in The New York Times Health section brings to light a different perspective concerning whether extracting wisdom teeth is always necessary and if people should be so hasty with this decision.

The article sites a general lack of research about the topic while showing how the figures and estimations that are available often contradict themselves. For example, it was estimated that roughly 75% of people should get their wisdom teeth pulled but the number of people that actual do is much lower. Furthermore, if people first waited until they experienced any pain from their wisdom teeth, then half as many extractions would actually be necessary. And of the people who don’t get their wisdom teeth pulled, one study found that 80% develop complications within seven years. Yet another study found that same percentage to be in the low teens.

The decision to pull one’s wisdom teeth should be determined on a case-by-case basis. Contrary to popular belief, wisdom teeth do not lead to crooked front teeth and should not be pulled for that reason. The “article correctly states  “The general consensus among critics of routine extraction is that recurrent gum infection, or pericoronitis; irreparable tooth decay; an abscess; cysts; tumors; damage to nearby teeth and bone; or other pathological conditions justify the procedure." To this list I would add foreseeable and potential damage to near by teeth and bone along with an obvious and sever lack of space for the wisdom tooth to erupt into. An orthodontist may also suggest wisdom tooth extraction to gain addition space.

If, after consulting your dentist and getting a second opinion you conclude that you will need to get your wisdom teeth pulled, here are some recommendations:
-         Plan to take off two to three days to allow yourself to heal properly
-         Take papaya pills or supplements in the days leading up to and after the surgery

Extracting wisdom teeth is like any procedure, there is always a small chance of complications. So if such a procedure isn’t truly necessary, it would be preferable to avoid getting it done. Extracting one’s wisdom teeth should not be looked at as an inevitable inconvenience that everybody must go through, but instead as a procedure that should only be performed only if necessary.