Drugs used as dental analgesics can simply be divided into two types: the narcotic and the non-narcotic analgesics. Between the two, the non-narcotic type is more often prescribed by dentists, but if the pain is severe and prolonged, narcotic analgesics can be prescribed. In some cases when redness or irritation is experienced on the mouth area, patients can be prescribed some corticosteroids.
The reason why non-narcotic dental analgesics are preferred by dentists is that they often act on the peripheral nervous system, which are the nerves located outside the brain and the spinal cord. As a result, they are safer, exhibit fewer critical side effects and reactions, and are less likely to cause the patient to become addicted. Non-narcotic analgesics also cause fewer stomach upsets.
Some common non-narcotic dental analgesics include aspirin, ibuprofen, and naproxen. In general, all three of these work by preventing certain enzymes from reacting to each other. As a result, the drugs ultimately prevent the production of prostaglandin, which are hormone-like compounds that send “pain messages” to the spinal nerves. Aside from easing the pain, these analgesics also help reduce inflammation of gums. Non-narcotic dental analgesics are often available over the counter, but patients should still consult with their dentist on what specific drug to use.
If the patient is experiencing severe pain, especially after a dental procedure like extractions and root canals, narcotic dental analgesics can be prescribed if non-narcotic analgesics do not relieve the pain. These painkillers act directly on the central nervous system, by binding themselves to receptors in the cells found in the brain and the spinal cord, slowing down the rate in which the cells send “pain messages.” They can produce, however, worse side effects such as central nervous system depression, which slows down a person’s breathing and heart rate and can lead to a coma, or even death.
Commonly prescribed narcotic analgesics are codeine and hydrocodone. Codeine is actually very similar to morphine in terms of molecular formula, while hydrocodone is a derivation from codeine. Codeine and hydrocodone may be more effective in reducing pain, but they cannot reduce inflammation as effectively as non-narcotic painkillers. In the US, narcotic analgesics are only available through a prescription because of their adverse effects.
Corticosteroids such as triamcinolone are prescribed if the patient experiences irritation on the mouth or gums after a long dental surgery. They are often available in topical creams and applied in the irritated area to reduce redness and swelling. It should be noted that patients taking corticosteroids should not be taking a non-narcotic analgesic, but can combine the medication with acetaminophen, another drug commonly used as a dental analgesic.