Deprecated: Return type of DrupalCacheArray::offsetExists($offset) should either be compatible with ArrayAccess::offsetExists(mixed $offset): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 362
Deprecated: Return type of DrupalCacheArray::offsetGet($offset) should either be compatible with ArrayAccess::offsetGet(mixed $offset): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 369
Deprecated: Return type of DrupalCacheArray::offsetSet($offset, $value) should either be compatible with ArrayAccess::offsetSet(mixed $offset, mixed $value): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 381
Deprecated: Return type of DrupalCacheArray::offsetUnset($offset) should either be compatible with ArrayAccess::offsetUnset(mixed $offset): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in /home/rprlib/prod72/www/includes/bootstrap.inc on line 388 University of Oklahoma Health Sciences Center
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_environment_initialize() (line 695 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_environment_initialize() (line 696 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_environment_initialize() (line 697 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_environment_initialize() (line 700 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_environment_initialize() (line 702 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in include_once() (line 328 of /home/rprlib/prod72/www/sites/default/settings.php).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in include_once() (line 329 of /home/rprlib/prod72/www/sites/default/settings.php).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in include_once() (line 337 of /home/rprlib/prod72/www/sites/default/settings.php).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in include_once() (line 344 of /home/rprlib/prod72/www/sites/default/settings.php).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_settings_initialize() (line 819 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: ini_set(): Session ini settings cannot be changed after headers have already been sent in drupal_settings_initialize() (line 828 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Warning: session_name(): Session name cannot be changed after headers have already been sent in drupal_settings_initialize() (line 831 of /home/rprlib/prod72/www/includes/bootstrap.inc).
Deprecated function: Return type of DatabaseStatementBase::execute($args = [], $options = []) should either be compatible with PDOStatement::execute(?array $params = null): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2244 of /home/rprlib/prod72/www/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::current() should either be compatible with Iterator::current(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::next() should either be compatible with Iterator::next(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::key() should either be compatible with Iterator::key(): mixed, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::valid() should either be compatible with Iterator::valid(): bool, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
Deprecated function: Return type of DatabaseStatementEmpty::rewind() should either be compatible with Iterator::rewind(): void, or the #[\ReturnTypeWillChange] attribute should be used to temporarily suppress the notice in require_once() (line 2346 of /home/rprlib/prod72/www/includes/database/database.inc).
Objective: In the United States, on average, every 15 s, someone visits a hospital emergency department (ED) for a dental condition. This commentary summarizes the recommendations from a 2024 clinical practice guideline for the pharmacological management of acute dental pain associated with tooth extractions and toothache applicable to ED settings, hospitals, and urgent care clinics where definitive dental treatment is not immediately available.
Methods: A guideline panel convened by the American Dental Association, the ADA Science & Research Institute, the University of Pittsburgh School of Dental Medicine, and Penn Dental Medicine examined the effect of opioid and non-opioid analgesics; local anesthetics, including blocks; corticosteroids; and topical anesthetics on acute dental pain. The GRADE approach was used to assess the certainty of the evidence; the GRADE Evidence-to-Decision Framework was used to formulate 18 recommendations and six good practice statements.
Results: A beneficial net balance favors the use of non-opioid medications compared with opioid medications. When not contraindicated, nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen likely provide superior pain relief with a more favorable safety profile compared with opioids.
Conclusion: NSAIDs with or without acetaminophen are first-line therapy for managing acute dental pain following tooth extraction(s) and temporarily managing toothache. Opioids should be reserved for clinical situations when first-line therapy is insufficient or contraindications to NSAIDs exist.
