One of the most common fears of patients who are set to undergo wisdom tooth extractions is “will it hurt?” or “will recovery be painful?” Though Dr. Polyakov and his team practice the latest in technology to lessen discomfort both during and after the procedure, it is, non-the-less, a surgical procedure. Therefore, for years, the standard procedure has been for oral surgeons to prescribe opioid medications such as hydrocodone to decrease initial discomfort in the first few days following a wisdom tooth extraction, making the recovery much more manageable.1
However, with the rise in misuse of opioids due to their addictive properties, potential side effects as a result of opioids and the subsequent additional systemic health concerns that accompany them, hesitation among both patients and doctors alike to prescribe these pain management options has increased while the nature of wisdom tooth recovery has remained unchanged.1 How, then, can oral surgeons and patients ensure a comfortable recovery while mitigating the risk of opioid addiction and complications?
A solution may exist in the form of over the counter medications we all are very familiar with: ibuprofen (Motrin) and acetaminophen (Tylenol). New studies and trials indicate that, when used in a combination regimen, ibuprofen and acetaminophen may actually be better at controlling pain than their opioid counterparts, all while carrying with them far fewer broader health concerns and zero addictive tendencies.1,2 A gender-based follow up analysis to a landmark clinical trial that involving over 1800 patients which found that taking 400 mg of ibuprofen with 500 mg of acetaminophen was better than taking hydrocodone with acetaminophen during the first 48 hours after surgery indicated that this was, in fact, true for both men AND women.2
With indications that exposure to opioids in the teenage years when wisdom teeth are typically extracted could lead to increase incidence of dependence through futher use later in life, studies like these could be groundbreaking for dental practice and the long term health of patients. Though side effects could potentially exist with both treatment options, Dr. Daniel Atkinson, clinical lead at Treated, stated “there’s a higher risk of getting more serious side effects with opiods, like depression and cardiovascular events, such as a heart attack” all while being more expensive than their over-the-counter counterparts.2
Though over-the counter medications like ibuprofen and acetaminophen should be considred first according to the ADA,1 opioid use should not be dismissed out of hand and may still be useful in certain situations.2 For instance, sometimes patients have pre-existing conditions, allergies, or other factors that may make them unable to take non-steroidal anti-inflammatory medication such as ibuprofen, or perhaps the patient has no extenuating factors that would put them at an increased risk when taking opioid medications such as family or personal history of substance abuse and prefers opioid medications because they feel they help make surgical procedures more tolerable.2. In such cases, according to Dr. Adkinson, patient preference should be taken into account.
Our goal at Synergy Dental Implant and Oral Surgery Center is to provide each patient with the highest level of care specific to their personal needs that will provide them the best possible outcome. We encourage you to discuss post-surgical medication options with Dr. Polyakov and our team during your consultation, and make sure to provide an honest and detailed medical history so we can help you make the best possible treatment plan for your specific case.
If you are ready to schedule your consultation, give our office a call today! We can’t wait to see you!
- Thompson D. Wisdom Tooth Surgery? Opioids Not Necessary, Clinical Trial Finds. News-Herald. Published November 7, 2025. Available at: https://www.news-herald.net/lifestyles/health/wisdom-tooth-surgery-opioids-not-necessary-clinical-trial-finds/article_982dee5c-31e9-53c5-a5e9-16863c2243df.
- Stokes V. Nonprescription Painkillers as Effective as Opioids After Tooth Extraction. Healthgrades Pro. Published November 7, 2025. Available from: https://resources.healthgrades.com/pro/nonprescription-painkillers-equal-opioids-tooth-extraction.
Pain Management FAQ
1. What is the best pain management option after wisdom teeth removal?
Studies show that combining ibuprofen (400 mg) and acetaminophen (500 mg) can provide better pain control than opioid medications such as hydrocodone during the first 48 hours after surgery. This combination is now considered a preferred first-line option for many patients.
2. Why are non-opioid medications recommended over opioids after oral surgery?
Non-opioids like ibuprofen and acetaminophen offer strong pain relief with fewer risks. They do not carry addictive potential and have a lower likelihood of serious side effects such as depression or cardiovascular complications, which can occur with opioids.
3. Are opioids ever necessary after wisdom teeth removal?
Yes. While non-opioids work well for most patients, opioids may be appropriate in certain situations—such as when a patient cannot take NSAIDs due to allergies, medical conditions, or other contraindications, or when patient preference supports their use and no additional risk factors are present.
4. Can early exposure to opioids increase the risk of dependence later in life?
Research suggests that opioid use during the teenage years—when most wisdom tooth extractions occur—may be associated with a higher risk of future dependence. This makes minimizing opioid exposure an important consideration for young patients.
5. What should patients discuss with their oral surgeon regarding pain control?
Patients should provide a complete medical history and discuss any allergies, medical conditions, or concerns about pain management. This allows the surgeon to recommend the safest and most effective medication plan tailored to the patient’s needs.
