After Tooth Pull, Opioids Don’t Relieve Pain Better Than Other Meds: Study

News Picture: After Tooth Pull, Opioids Don't Relieve Pain Better Than Other Meds: Study

FRIDAY, March 13, 2020 (HealthDay News) — Opioids are not any higher than different meds at quelling the ache of a pulled tooth, a brand new examine finds, suggesting it could be potential to considerably scale back their use in dentistry.

University of Michigan researchers requested greater than 325 individuals who had enamel pulled to charge their ache and satisfaction inside six months of their extraction.

About half of those that had surgical extraction and 39% of those that had routine extraction had been prescribed opioids, in line with the examine.

“Patient satisfaction with ache administration was no totally different between the opioid group and non-opioid group, and it did not make a distinction whether or not it was surgical or routine extraction,” examine co-author Dr. Romesh Nalliah mentioned in a college information launch. He is affiliate dean for affected person companies at Michigan’s School of Dentistry.

In truth, his group was stunned to seek out that sufferers who received opioids reported worse ache than these given non-opioid painkillers for each sorts of extractions.

The examine additionally discovered that about half of the opioids prescribed went unused.

If leftovers aren’t disposed of correctly, sufferers or individuals round them might be liable to future opioid misuse, the researchers famous.

“The real-world information from this examine reinforces the beforehand printed randomized-controlled trials displaying opioids are not any higher than acetaminophen and nonsteroidal anti-inflammatory medication for ache after dental extraction,” mentioned examine co-author Dr. Chad Brummett. He’s director of the Division of Pain Research at Michigan Medicine.

The authors mentioned their findings counsel that main modifications are wanted in dental prescribing practices in gentle of the present opioid disaster within the United States.

The American Dental Association suggests limiting opioid prescriptions to seven days’ provide, however Nalliah thinks that is an excessive amount of.

“I feel we are able to nearly eradicate opioid prescribing from dental apply,” he mentioned. “Of course, there are going to be some exceptions, like sufferers who cannot tolerate nonsteroidal anti-inflammatories. I might estimate we are able to scale back opioid prescribing to about 10% of what we at present prescribe as a career.”

The examine was printed March 13 within the journal JAMA Network Open.

— Robert Preidt

Copyright © 2020 HealthDay. All rights reserved.


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SOURCE: University of Michigan, information launch, March 13, 2020

When Do Babies Start Teething? Symptoms, Signs, Pain Remedies

Facts you must find out about teething

Teething Pain

Teething could cause vital ache in infants.

  • Teething is the method by which a child’s enamel erupt, or break by way of, the gums. Teething usually happens between 6 to 24 months of age.
  • Symptoms of teething embody irritability, tender and swollen gums, and the toddler wanting to position objects or fingers into the mouth in an try to cut back discomfort. Fever, cough, diarrhea, and chilly signs usually are not discovered when a baby is teething.
  • Oral over-the-counter ache relievers (acetaminophen [Tylenol] or ibuprofen [Children’s Advil/Motrin]) usually present reduction of signs.
  • Topical medicines containing benzocaine might trigger critical and doubtlessly deadly uncomfortable side effects and shouldn’t be used to deal with teething signs.

What Can I Do to Ease My Child’s Teething Pain?

  • Massage your kid’s gums with a clear finger or the again of a small chilly spoon.
  • Allow your little one to chew down on a calming (however by no means frozen) teething ring. A frozen teething ring can harm the gums.
  • Try an over-the-counter teething ointment to numb the gums. Ask your dentist or physician for some product suggestions.
  • Allow your little one to suck on a chilly, moist fabric.

What is teething?

Teething is the method by which an toddler’s enamel erupt, or break by way of, the gums. Teething can be known as “slicing” of the enamel. Teething is medically termed odontiasis.

When do infants begin teething?

The onset of teething signs usually precedes the eruption of a tooth by a number of days. While a child’s first tooth can seem between four and 10 months of age, the primary tooth often erupts at roughly 6 months of age. Some dentists have famous a household sample of “early,” “common,” or “late” teethers.

A comparatively uncommon situation, “natal” enamel, describes the presence of a tooth on the day of delivery. The incidence of such an occasion is one per 2,000-3,000 dwell births. Usually, this single and sometimes considerably malformed tooth is a novel occasion in an in any other case regular little one. Rarely, the presence of a natal tooth is only one of a number of uncommon bodily findings which make up a syndrome. If the opportunity of a syndrome exists, session with a pediatric dentist and/or geneticist may be useful. The natal tooth is usually free and is often eliminated previous to the new child’s hospital discharge to get rid of the danger of aspiration into the lungs.


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What are the indicators and signs of teething?

Teething is usually related to gum and jaw discomfort because the toddler’s tooth prepares to erupt by way of the gum floor. As the tooth strikes beneath the floor of the gum tissue, the realm might seem barely pink or swollen. Sometimes a fluid-filled space much like a “blood blister” could also be seen over the erupting tooth. Some enamel could also be extra delicate than others once they erupt. The bigger molars might trigger extra discomfort resulting from their bigger floor space that may’t “slice” by way of the gum tissue as an erupting incisor is able to doing. With the exception of the eruption of the third molars (knowledge enamel), eruption of everlasting enamel hardly ever trigger the discomfort related to eruption of “child” (major or deciduous) enamel.

Teething might trigger the next signs:

  • Increased drooling
  • Restless or decreased sleeping resulting from gum discomfort
  • Refusal of meals resulting from soreness of the gum area
  • Fussiness that comes and goes
  • Bringing palms to the mouth
  • Mild rash across the mouth resulting from pores and skin irritation secondary to extreme drooling
  • Rubbing the cheek or ear area as a consequence of referred ache in the course of the eruption of the molars

Importantly, teething is not related to the next signs:

Can teething trigger a fever?

Even although grandmothers might debate the findings, analysis has not proven a causal relationship between teething and growth of a fever. Viral infections, which generally happen independently simultaneous with dental eruptions, might product a fever. However, there isn’t any teething virus.

Can teething trigger vomiting?

The technique of teething will not be causally associated to vomiting. As a number of pediatric dentists have famous, “Teething doesn’t trigger fever, runny nostril, cough, or diarrhea. Teething causes enamel.”

What is the order of tooth eruption?

The following is the overall order of eruption of major enamel:

  • Central incisors: 6-12 months of age
  • Lateral incisors: 9-16 months of age
  • Canine enamel: 16-23 months of age
  • First molars: 13-19 months of age
  • Second molars: 22-24 months of age

Between 6 to 12 years of age, the roots of those 20 “child” enamel degenerate, permitting their substitute with 32 everlasting “grownup” enamel. The third molars (“knowledge enamel”) don’t have any previous “child” model and customarily erupt in mid to late adolescence. Because of their tendency to advertise crowding and crooked orientation, they’re usually eliminated.

How lengthy does teething final?

Children will generally have variable discomfort in the course of the few days earlier than tooth eruption by way of the gum line. Some infants are bothered greater than others in the course of the migration by way of the tissues deep to the gum line. Because of their form, molars usually tend to be related to teething discomfort.


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When do you have to name the pediatrician about teething ache?

Because teething is so frequent and different signs equivalent to fever, fussiness, and diarrhea are additionally frequent, each situations might usually happen on the identical time. Other diseases or issues (equivalent to viral infections) are more likely to be inflicting fever, fussiness, and/or nasal congestion with cough and diarrhea. It is essential to contact a physician if these or different signs appear regarding. Do not assume that they’re simply from teething.

What medicines are secure to make use of to deal with teething ache?

Some controversy surrounds using ache medicines.

Medicines that may be positioned on the gums

While some dad and mom endorse topical medicines, research have not persistently proven their profit. The FDA issued a warning in May 2011 urging avoidance of oral medicines containing the topical anesthetic benzocaine (equivalent to Orajel). Benzocaine is the primary ingredient of many over-the-counter teething sprays, lozenges, and gels. The FDA warning factors out an affiliation with methemoglobinemia, a uncommon however extraordinarily critical complication. This facet impact considerably limits the power of pink blood cells to move oxygen all through the physique. This growth might produce critical to deadly penalties. Individuals who develop methemoglobinemia will develop into pale, lightheaded, confused, and wanting breath. A fast coronary heart fee can be frequent. Such an opposed response might develop upon first publicity or after a number of exposures to benzocaine. Any particular person who has such signs after publicity to benzocaine ought to search fast medical consideration on the closest emergency room. A drugs can be utilized to reverse these uncomfortable side effects.

Alcohol ought to by no means be used to numb the gums.

Medicines which are taken by mouth to assist cut back the ache

Ibuprofen (Advil or Motrin) or acetaminophen (Tylenol) will help with ache. Ibuprofen should not be given to infants youthful than 6 months of age. Medications must be used just for the few occasions when different home-care strategies don’t assist. Caution must be taken to not overmedicate for teething. The medication might masks vital signs that may very well be essential to find out about. Do not give a baby merchandise containing aspirin. No prescribed drugs are routinely given for teething.

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What dwelling treatments present reduction for teething ache?

Teething infants usually really feel higher when mild stress is positioned on their gums. For this purpose, many medical doctors suggest gently rubbing the gums with a clear finger or having the kid chew down on a clear washcloth. If the ache appears to be inflicting feeding issues, typically a unique formed nipple or use of a cup might cut back discomfort and enhance feeding. Cold objects many assist cut back irritation as nicely. Veteran dad and mom have found the usefulness of frozen washcloths and ice cubes for this function. Be cautious to keep away from having extended contact of very chilly objects on the gums. Never put something in a baby’s mouth (together with teething biscuits) that may make the kid choke. Homeopathic preparations for teething must be considered with warning because the purity and focus of substances usually are not assured. Such merchandise usually are not topic to FDA (Food and Drug Administration) overview.

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How do you take care of your child’s new enamel?

Oral hygiene could also be began even earlier than eruption of the primary tooth. Twice-a-day cleansing of the gums utilizing the washrag used for cleansing the face and palms after consuming is efficient and easy. Fluoride has been proven to be extraordinarily efficient in lowering the event and severity of cavities. Since fluoride quantities fluctuate by water supply, examine with the kid’s pediatrician or dentist relating to any supplementation which may be mandatory. Fluoride suggestions shall be primarily based upon fluoride focus in water consumed and the age of the kid. An extra of fluoride might trigger fluorosis — everlasting staining of the enamel. Children’s enamel appear most susceptible in the course of the first three years of life. For this purpose, fluoridated toothpaste isn’t mandatory for kids lower than Three years of age. Maternal fluoride supplementation throughout being pregnant has not been proven to learn fetal dental integrity or defend the kid’s child or everlasting enamel from cavity formation.

Infants and youngsters ought to by no means take a bottle to their crib or mattress. Formula, breast milk, cow’s milk, soy milk, and juice all may be related to cavity formation. Ingestion of sticky fruit (equivalent to raisins) or different meals closely laden with sugar (equivalent to sweet) can be related to a rise in cavity formation.


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When ought to my child go to the dentist for the primary time?

The American Dental Association and the American Academy of Pediatrics suggest the primary dental go to be at 1 yr of age. If a delayed schedule is chosen, the most recent time for a primary dental go to is Three years of age. Trauma, oral malformations, staining of the enamel, dental ache, and strange modifications of the enamel or gums would warrant a dental go to when first famous by the father or mother.

Medically Reviewed on 3/27/2020


Karp, Jeffrey M. “Delayed Tooth Emergence.” Pediatrics in Review 32.1 Jan. 2011: e4-e17.

Lewis, Charlotte W. “Fluoride and Dental Caries Prevention in Children.” Pediatrics in Review 35.1 Jan. 2014: 3-15.

Markman, Lisa. “Teething: Facts and Fiction.” Pediatrics in Review 30 Aug. 2009: e59-e64.

United States. U.S. Food and Drug Administration. “FDA Drug Safety Communication: Reports of a Rare, however Serious and Potentially Fatal Adverse Effect With the Use of Over-the-Counter (OTC) Benzocaine Gels and Liquids Applied to the Gums or Mouth.” Apr. 7, 2011. <>.