In my line of work, dental hygiene, I’ve talked with several patients taking pain medication, some for short periods of time, and some for very long periods of time. Although our Doctors aren’t the ones who prescribed them the medication necessarily, they often have many questions on how they work. So here are a few of the most common questions I hear from my patients, sometimes in relation to dentistry and sometimes not!

What is a good pain medication to take?

This question is a bit tricky because different pain medications work in different manners. Depending on the type of pain you are having, is how you choose your reliever. So let’s get into some quick basics about two of the most common types of over the counter medications, and how they work.

· Acetaminophen

· Non-steroidal anti inflammatory drug (NSAIDs)

Examples of Acetaminophen are Tylenol and Excedrin PM. The way that these are believed to work is that they act on the nerve endings to block pain stimuli. The NSAID group includes aspirin, ibuprofen (Advil, Motrin) and naproxen (Naprosyn, Aleve). These medications work at the site of the injury to block pain receptors and their ability to transmit pain messages to the brain. They also have antipyretic (fever reducing), and anti inflammatory actions.

So back to the question of which one should you take? The rule of thumb that I use is, if you believe to have an injury of some sort, or are sick with aches and pains, fever, tooth aches, or dealing with menstrual cramps go for the NSAID. Often people take these medications for inflammatory diseases and illnesses like arthritis, joint inflammation, and gout just as a few examples.

Other things, like a headache with no underlying cause like muscle tension, go for the Acetaminophen. This is just a general rule I use. Although, I strongly caution you against using any of these products very regularly or for longer periods of time. This leads me to the next question.

Are There Any Side Effects Of These Medications?

Yes, as with all medications there are side effects. The problems with these medications usually arise when you take them for longer periods of time. This is unless you have an immediate allergic reaction to it of course. Acetaminophen products are primarily processed by the liver. Anyone who already has a compromised liver due to disease, have a low protein diet, have been dieting or not eating due to illness, or who consumes 3 or more alcoholic beverages a day should take extreme caution when using these types of products. The reason for this is because there is a potentially toxic byproduct that is produced by the liver when it processes acetaminophen. This byproduct is known to cause liver damage. It is really quite a complex process, but in short, if your body doesn’t have enough nutrition it will not have the proper tools to help reverse the byproduct back to a form that won’t cause the liver damage.

NSAIDs can have many different side effects. They tend to promote bleeding and have a higher risk of creating ulcers in the stomach. They can also have side effects of nausea, vomiting, diarrhea or constipation. More serious side effects can be kidney and liver damage. These are just some of the reasons why I caution against using these types of medications for prolonged periods of time.

How Long Should I Take These Types Of Medications?

It is recommended to only take these types of medications sparingly and for acute (short lasting) types of pain. The longer you take these medications, the higher risk of having undesirable side effects. Ideally, you should try to limit these types of medications to 10 days or less.

Can I Take More Than The Recommended Dose To Get More Pain Relief?

This is a common misconception. With these types of medications, a higher dose doesn’t necessarily give you more pain relief, or reduce inflammation more. It just increases your chances of having side effects. This is because these types of medications have what is called the “ceiling” effect. This means that once they have reached their maximum ability to reduce your pain or inflammation for example, the more you take will NOT give you more relief.
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