Dr. Janet
Mifsud, 
Dept. of Clinical Pharmacology and Therapeutics,
University of Malta
Mr. Adam Bartolo,
Institute of Health Care, Malta
Dr. Anna McElhatton,
Institute of Health Care, Malta
Prof. John Portelli,
Faculty of Dentistry,
University of Malta
The surgical
extraction of mandibular wisdom teeth is by far the commonest surgical procedure
in dentistry and is associated with considerable post-operative pain. A very
large number of studies have dealt with this topic and from a preliminary review
of the literature the following points predominate: NSAIDs are the analgesics of
choice (unless contraindicated. Diclofenac is the NSAID of choice (unless
contraindicated) Additional use of a steroid significantly helps. In cases where
NSAIDs are contraindicated (e.g. asthma, peptic ulceration) paracetamol
(with/without codeine) is the analgesic of choice, but it is not as good as the
NSAIDs because although it is a very good analgesic it lacks anti-inflammatory
properties and no studies have been carried out to confirm their efficacy.
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