A randomized trial from Rutgers Health found that combining ibuprofen and acetaminophen controls post-surgical pain better than the opioid hydrocodone with acetaminophen following impacted wisdom tooth removal. The study, published in The Journal of the American Dental Association, enrolled more than 1,800 patients across five clinical sites, making it one of the largest trials of its kind.

Patients taking the non-opioid combination reported less pain during the peak-pain period in the two days after surgery, better sleep quality on the first night, and less interference with daily activities. They were also half as likely to need additional rescue pain medication and reported higher overall satisfaction with their treatment.

Dentists in the United States wrote more than 8.9 million opioid prescriptions in 2022, and wisdom tooth extraction is often a young adult's first exposure to opioids. Study co-investigator Janine Fredericks-Younger noted that opioid overdoses kill more than 80,000 Americans each year. Lead author Cecile Feldman, dean of Rutgers School of Dental Medicine, said the results support a straightforward shift in prescribing: opioids should not be routinely prescribed after dental surgery unless a patient has a medical condition preventing use of ibuprofen or acetaminophen. The findings align with existing American Dental Association guidance recommending non-opioid options as first-line treatment.