Dentist Questions Wisdom Teeth

Would I need to take opioids after my extraction?

I'm about to get two of my wisdom teeth removed, but I'm worried for the medications that I'm going to need after it. I heard opioids might be prescribed, but I'd rather not take them at all because I know how addictive those can be. Would it be okay to take just ibuprofen after I get them removed?

18 Answers

It will all depend on your degree of pain, and whether YOU feel like it is worth taking something stronger. Your best bet is start on the meds while you are still numb after the procedure, and alternate every 2 hours between ibuprofen and acetaminophen (Tylenol). 1 or 2 opiod pills, if needed, would have an extremely low risk of an addictive potential.
Ibuprofen can be taken up to 800 mg every 6 hours. If you don't have any problems with Ibuprofen and or Tylenol and the Ibuprofen isn't helping enough with the pain you can try alternating every 4 hours between 2 regular strength Tylenols and 800 mg of Ibuprofen. Not at the same time ie. I would take 800 mg (4 over the counter liquid gels) and 4 hours later I would take 2 regular strength Tylenol liquid gels, followed by another 4 hour wait before taking Ibuprofen again. This is a short term solution and should not be used for more than 3 or 4 days to limit potential liver/kidney damage.
We typically advise the use of Ibuprofen and Tylenol. In our experience, the vast majority of individuals adequately manage their discomfort with this combination - avoiding the potential side effects associated with narcotic medications.
Usually, extraction can cause mild to very severe pain after the procedure. Inflammation, secondary to the trauma of the procedures and the immune system reaction needed for healing, is the main reason for pain. In the case of a chronic or active infection for involved tooth, the risk of pain is higher.

More explanation is available at my website page "Ask Your Dentist" 

1-Not all extraction procedures require opioid prescriptions.
2-Opioid medication should be avoided as much as possible, because of the well-known side effects and potential consequences.

Ibuprofen is good.
This should be discussed with your surgeon beforehand. However, recent research shows that the combination of 600 mg of ibuprofen + 600-1000 mg of acetaminophen is just as effective as narcotics.
Not really. If the oral surgeon gives you a long lasting anesthetic such as marcaine, you don't need heavy duty opioids. If he does not give you marcaine, ask the surgeon to give you another dose of anesthetic before you leave and then take the prescribed pain medication as soon as you get home even while you are numb.
It would be absolutely ok to take ibuprofen. It is a great medication that can be very helpful in extraction surgery. Talk to your dentist about your feelings and even if you still get the prescription, you don't have to fill it!

Hope this helps,

Jossi Stokes, DDS
Ibuprofen is fine. You may alternate with acetaminophen. You do not have to take opioids.
As usual with questions like this, it depends on a few factors. If the wisdom teeth are impacted and under the bone, there is more of a chance for severe swelling and pain. Often, the patient needs 5-7 days of a narcotic to help with the pain. Increasingly though, dentists are trying to avoid opioids and will, in fact, prescribe higher doses of NSAIDs like ibuprofen. They work well for most pain, and have the added benefit of helping to reduce swelling and inflammation. In cases of severe pain, sometimes dentists alternate the ibuprofen with a milder
narcotic, or they may have to simply prescribe a stronger one for a short while. But the goal is to limit the use, or at least the duration, of any narcotic. If your wisdom teeth are not impacted in the bone, but are either partially below the gum or through the gum, ibuprofen should be fine. Even aspirin will be quite effective. Plain Tylenol or acetaminophen may not be as effective.

Generally speaking, the more complicated the surgery, the greater the chance for needing any narcotic prescription. In any case, if you have a higher or lower tolerance for pain, that will also help determine what is most effective for you. You certainly won't be required to use opioids.

Michael A. Conrad, DDS, PC
Several studies have shown that using ibuprofen and Tylenol after wisdom tooth extraction are as effective or more effective than using opioids for pain relief.  Talk to your oral surgeon about the dosage and timing on their use.
Dr. AL
Pain management after wisdom teeth removal varies depending on each case. If you are concerned you need to discuss this with your surgeon. You can avoid taking opioids and manage with Ibuprofen and Extra Strength Tylenol. It all depends on how complicated the procedure is, your pain tolerance and how the extraction is carried out under sedation or not.
Even if you need to use some stronger pain killers such as opioids it is a very short term and risk of dependancy is very low unless you have history of addictions. Hope this answers your question.
Most of the patients will do fine with aspirin, Tylenol, ibuprofen, etc. But some may need a stronger narcotic type medication like hydrocodone or ultram.
You don’t have to take opioids if you don’t want to. We prescribe opioids in certain cases depending on the extraction and if we think the patient is going to be in more pain than normal afterwards. You still have a choice of course and you need to mention it to the dentist who is treating you.
Taking opioids after wisdom tooth removal is NOT a requirement! Recent research has shown that the brains of young adults are more susceptible to the risk of opiate addiction than older adults and many practitioners are reducing and sometimes eliminating the prescribing of narcotics to young adults and placing the burden on parents to withhold and administer opiates only after significant failure of a combination of acetaminophen (Tylenol) and an NSAID like ibuprofen or naproxen (Motrin/Aleve respectively) and then only half a pill of hydrocodone or oxycodone at a time.

Opioids are used for the control of stronger pain that is not taken care of with NSAIDs or Tylenol. Whether or not you will need opioids is dependent upon you and your surgery. Best to discuss this with your oral surgeon.
Most patients do very well with OTC analgesics. For better pain relief, you can take a combination of 2 advil and 2 tylenol (assuming you have no allergies to either), every 6-8 hours. Take them on a regular basis for 1-2 days to stay ahead of the development of pain.
Many times you will not need to take an opioid pain medication. I do not know the specifics of your case or your medical history. With that said, most patients are able to manage their pain with 600mg ibuprofen (3 200mg Advils) + 1000mg of Tylenol taken at the same time every 4 to 6 hours for a few days after surgery.
I hope this helps.

Keep smiling,

David M. Kaffey, DDS