Volume 9 • 2022 • Issue 6

Is it time to update your post-op care sheets? When it comes to dental procedures, the patient’s adherence to the post-op instructions helps to ensure proper healing with minimal discomfort. Often, the problem is that many patients are either confused about the instructions or forget them. Properly delivered postoperative instructions have been proven to help reduce side effects that may occur after dental procedures, including pain and stress. In a study of 120 participants, patients who received both verbal and written instructions reported the least pain and greatest satisfaction.1 The Canadian Dental Association website states that ibuprofen and acetaminophen used in combination can be very effective for pain relief.2 If it is time to update your post-op care sheet, consider adding Combogesic® to it in the pain management section. Combogesic® is a non-opioid pain reliever. It combines a fixed dose of acetaminophen 325 mg and ibuprofen 97.5 mg, eliminating the need to alternate between the two pain relievers individually. If your clinic is prescribing Combogesic® to your post-op patients, it should be included as part of your post-op instruction sheet. Considering that over three-quarters of Canadians aged 18 years or older report being aware that there is an opioid issue in Canada3, it may be reassuring for patients to learn that Combogesic® is a non-opioid pain reliever. Combogesic® also has a simple dosing schedule of up to 3 tablets every 6 hours.4 When studied against comparable doses of acetaminophen or ibuprofen, the combination of acetaminophen and ibuprofen has been shown to provide greater and more rapid relief in patients experiencing moderate to severe pain after the surgical removal of at least 2 impacted third molars. The patients who received Combogesic® experienced significantly less pain within the first 6 hours and 48 hours after taking the first dose. It only took one dose for patients to report feeling significantly less pain intensity with Combogesic® compared to the individual analgesics or the placebo. Moreover, approximately 50% fewer patients taking Combogesic® needed a rescue analgesic compared to those taking a single analgesic. Efficacy is important, but so is tolerability. The combination of acetaminophen and ibuprofen did not compromise the tolerability of the individual pain relievers. There was no statistical difference in adverse events reported by the patients on Combogesic® compared to those taking acetaminophen, ibuprofen, or placebo.5 I have found that Combogesic® is not only effective for the management of pain in endodontics, extractions, and crown and bridges, but also for more invasive procedures such as bone grafting, socket preservation and soft tissue grafting, particularly where a donor site is involved. Combogesic® is a behind-the-counter pain reliever, so your patient should be instructed to ask the pharmacist for it. The dosing schedule is up to 3 tablets every 6 hours, making it easy for most patients to manage. References: 1. Gheisari R, Resalati F, Mahmoudi S, Golkari A, Mosaddad SA. Do different modes of delivering postoperative instructions to patients help reduce the side-effects of tooth extraction? A randomized clinical trial. J Oral Maxillofac Surg. 2018 Aug;76(8):1652.e1-1652.e7. 2. Canadian Dental Association. Pain Management. Available at: www.cda-adc.ca/en/oral_health/talk/complications/pain_management (accessed 2022 Oct 1) 3. Statistics Canada. Results of the Survey on Opioid Awareness, November 2017. (2018). Available at: www150.statcan.gc.ca/n1/dailyquotidien/180109/dq180109a-eng.htm (accessed 2022 Oct 1) 4. Combogesic® product monograph. BioSyent Pharma Inc. May 25, 2020. 5. Daniels SE, Atkinson HC, Stanescu I, Frampton C. Analgesic efficacy of an acetaminophen/ibuprofen fixed-dose combination in moderate to severe postoperative dental pain: a randomized, double-blind, parallel group, placebo-controlled trial. Clin Ther. 2018;40(10):1765-76. Content sponsored by BioSyent Pharma Inc. Dr. Alan Jeroff, Clinical Instructor, Faculty of Dentistry, University of British Columbia