Cochrane Summaries

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Paracetamol for pain relief after surgical removal of lower wisdom teeth

Weil K, Hooper L, Afzal Z, Esposito M, Worthington HV, van Wijk A, Coulthard P
Published Online: 
18 April 2012

The surgical removal of wisdom teeth (third molars) is the most commonly performed surgical procedure undertaken in oral surgery practice. Postoperative complications may include swelling, bruising and limited mouth opening but patients are most often concerned about postoperative pain, which may be severe. Paracetamol is effective in relieving pain with a low incidence of adverse effects. It is one of the most commonly used analgesics and is widely available without prescription around the world. In this review we investigated the optimal dose of paracetamol and the optimal time for drug administration to provide pain relief after the surgical removal of wisdom teeth. The side effects of different doses of the drug were also explored.

Twenty-one trials (with over 2000 participants) were included. Paracetamol provided a statistically significant benefit when compared with placebo for pain relief at both 4 and 6 hours after taking the drug. It is most effective at 1000 mg dose, and can be taken at six hourly intervals without compromising safety. There was no statistically significant difference between the number of patients who reported adverse events, overall this being 19% in the paracetamol group and 16% in the placebo group. It should be noted that most of the studies were found to have some limitations mainly due to poor reporting of information. However the review concludes that paracetamol is a safe, effective drug for the treatment of postoperative pain following the surgical removal of lower wisdom teeth.

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