Why does the doctor ask you to take ibuprofen before surgery?

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Anecdotally, I don’t have patients call me (and they get my cell number) needing extra medication after surgery and Ibuprofen 800mg preoperatively is why I believe that is so.  Mechanism is thought to be preventing prostaglandin formation leading to less pain and swelling.  My patients also rarely swell.  Ice helps that too.  I usually am asked by patients why I gave them a prescription for a narcotic since they didn’t need anything at all to manage pain after the procedure.

There are some articles that suggest little help in using Ibuprofen for General Surgery and that it might cause bleeding (aspirin does that and Tylenol is not anti-inflammatory) but I have seen no evidence of that.  Those are articles paid for by makers of Aleve (Naproxen).  However, ibuprofen is used extensively at 600-800mg preoperatively to reduce pain induced by wisdom tooth extraction, orthodontic treatment and operative dentistry.  Adult dosage is 400-600mg q4-6h or 800mg q8h.  I usually cut it back to 400mg or 600mg for children under 12 years.

I only use it for extractions and minor surgery in patients without stomach or GI disorders.  I have never heard of an ibuprofen allergy…

Look at these articles:

http://etd.fcla.edu/UF/UFE0004879/nekula_c.pdf
http://www.ajodo.org/article/S0889-5406(00)47811-X/abstract

http://jcp.sagepub.com/content/23/1/37.abstract

It is not effective long-term for in office bleaching sensitivity (which is why I don’t do in-office bleaching anyway):

http://iadr.confex.com/iadr/2008Toronto/techprogram/abstract_106126.htm

It does not effect other drugs we use for local anesthesia:

http://www.facebook.com/note.php?note_id=315130634474

Finally, here is the keystone article from back in 1978:

Evaluation of preoperative ibuprofen for postoperative pain after removal of third molars

D.D.S., M.S. Raymond A. Dionne, and D.M.D., Ph.D. Stephen A. Cooper

An evaluation of the analgesic effects of preoperatively administered iburprofen on postoperative pain after the surgical removal of impacted third molars was undertaken in 100 patients in a double-blind parallel treatment trial. The pretreatment with ibuprofen delayed the mean time of onset of postoperative pain more than 100 minutes, as compared to pretreatment with placebo. The severity of pain initially experienced postoperatively was less in the pretreated group. There was no detectable interaction between the pretreatment and the analgesics administered postoperatively. The results of this study suggest that it is possible to delay the onset and lessen the severity of postoperative pain by preoperative administration of a on-steroidal, anti inflammatory analgesic, such as ibuprofen.

As always  it is our goal to bring dentistry to you without pain, aggravation and fear.  Building a great relationship with your dental team accomplishes this as does a history of consistently good experiences.

Thank you,

Dr. Reemon Y. Ashoty, DDS

Posted by ariel on Jan 21st, 2011 7:56 pm
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