Painkillers in dentistry: less is more

As a migraine sufferer from a young age, I can attest, 2 Advil and a cup of coffee can drag you out of skull-crushing pain, and actually induce euphoria within 1 hour.  Information having been recently reaffirmed is confirming what I’ve experienced for 30 years.  Taking any chemical for me is a last resort, but sometimes you don’t have much of a choice when pain levels are high.

About 500 studies comparing narcotics (opioids) to over the counter pain relievers like acetaminophen and ibuprofen have been recently reviewed.  The research found that, for adults, a combination of 400 milligrams of ibuprofen and 1,000 milligrams of acetaminophen was superior to any opioid-containing medications studied.  Better than Vicodin.  Better than Percocet.  Many patients who take narcotics instead of over the counter drugs report nausea, constipation and drowsiness, with the added risk of respiratory depression.

So what about coffee?!  I discovered that washing down that Advil with coffee was especially delightful. Caffeine has actually been used in medicine for over 100 years, Anacin being the first pain reliever to include it in it’s formula.  Excedrin has it too.  Or you can drink coffee!  Recent studies show a 5-10% boost in pain reduction with adding caffeine to over the counter medicine.  This is in the range of 65 to 200  mg.  No added benefit is seen above that dose.

Possible mechanisms of action of the caffeine are included in the 2nd link below.  But in short, skip the narcotics.  Pop a couple Advil if you must!  (Ask your doctor first) Go to Starbucks!  (Ask your barista) You’ll die of happiness.



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