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A guideline panel evaluated opioid and non-opioid analgesics, local anesthetics (including blocks), corticosteroids, and topical anesthetics using the GRADE approach to support 18 recommendations and six good practice statements.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/evidence-based-clinical-practice-guidelines-for-the-management-of-acute-dental-pain-related-commentary/406881/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/evidence-based-clinical-practice-guidelines-for-the-management-of-acute-dental-pain-related-commentary/406881.png","ImageObject",300,407,{"name":92,"@type":93},"SANS","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical settings and scenarios do these recommendations target?","Question",{"text":113,"@type":114},"The recommendations apply to EDs, hospitals, and urgent care clinics when definitive dental treatment is not immediately available, including pain related to tooth extractions and toothache.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How were the recommendations developed?",{"text":118,"@type":114},"A guideline panel assessed opioid and non-opioid analgesics, local anesthetics, corticosteroids, and topical anesthetics, using the GRADE approach and the GRADE Evidence-to-Decision Framework to generate 18 recommendations and six good practice statements.",{"name":120,"@type":111,"acceptedAnswer":121},"What is the recommended first-line therapy for acute dental pain?",{"text":122,"@type":114},"NSAIDs with or without acetaminophen are recommended as first-line therapy after tooth extraction(s) and for temporarily managing toothache, while opioids should be reserved for situations where first-line therapy is insufficient or NSAIDs are contraindicated.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},406881,1790718411,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},962090760505,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Author Manuscript Author Manuscript Author Manuscript Author Manuscript  \n\n| | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Am J Emerg Med. Author manuscript; available in PMC 2025 December 31. |\n| --- | --- |\n\nPublished in final edited form as:  \nAm J Emerg Med. 2025 March ; 89: 247–253. doi:10.1016/j.ajem.2024.12.054 .  \nEvidence-based clinical practice guidelines for the management of acute dental pain  \nVictoria G. Green, RDH, MPHa, Deborah E. Polk, PhDb,* , Michael A. Turturro, MDc, Paul A. Moore, DMD, PhDb, Alonso Carrasco-Labra, DDS, PhDd,1  \na University of Pittsburgh, Department of Dental Hygiene, School of Dental Medicine, Pittsburgh, PA, USA  \nb University of Pittsburgh, Department of Dental Public Health, School of Dental Medicine, Pittsburgh, PA, USA  \nc University of Pittsburgh, Department of Emergency Medicine, School of Medicine, Pittsburgh, PA, USA  \ndCenter for Integrative Global Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA  \nAbstract  \nObjective: In the United States, on average, every 15 s, someone visits a hospital emergency department (ED) for a dental condition. This commentary summarizes the recommendations from a 2024 clinical practice guideline for the pharmacological management of acute dental pain associated with tooth extractions and toothache applicable to ED settings, hospitals, and urgent care clinics where definitive dental treatment is not immediately available.  \nMethods: A guideline panel convened by the American Dental Association, the ADA Science & Research Institute, the University of Pittsburgh School of Dental Medicine, and Penn Dental Medicine examined the effect of opioid and non-opioid analgesics; local anesthetics, including blocks; corticosteroids; and topical anesthetics on acute dental pain. The GRADE approach was used to assess the certainty of the evidence; the GRADE Evidence-to-Decision Framework was used to formulate 18 recommendations and six good practice statements.  \nThis is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)).  \n*Corresponding author at: University of Pittsburgh, School of Dental Medicine, 3501 Terrace Street, Suite 6620, Pittsburgh, PA 16260, USA1 DrC., porra-pLtb.edura wa(Dst.Ehe. Polksenio)r. director, Department of Evidence Synthesis and Translation Research, American Dental Association Science and Research Institute, Chicago, IL, when part of the work described in this article was conducted.  \nDeclaration of competing interest  \nThe authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Deborah Polk reports financial support was provided by US Food and Drug Administration. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.  \nCRediT authorship contribution statement  \nVictoria G. Green: Writing – original draft. Deborah E. Polk: Writing – review & editing, Supervision, Project administration, Funding acquisition, Conceptualization. Michael A. Turturro: Writing – review & editing, Formal analysis. Paul A. Moore: Writing – review & editing, Formal analysis. Alonso Carrasco-Labra: Writing – review & editing, Funding acquisition, Conceptualization.  \nAuthor Manuscript Author Manuscript Author Manuscript Author Manuscript  \nGreen et al. Page 2  \nResults: A beneficial net balance favors the use of non-opioid medications compared with opioid medications. When not contraindicated, nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen likely provide superior pain relief with a more favorable safety profile compared with opioids.  \nConclusion: NSAIDs with or without acetaminophen are first-line therapy for managing acute dental pain following tooth extraction(s) and te","cbCaihlUROs45Ujv","https://ap.wps.com/l/cbCaihlUROs45Ujv","pdf",985511,15,"English","# Abstract\n## Objective\n## Methods\n## Results\n## Conclusion\n# Introduction","[{\"question\":\"What clinical settings and scenarios do these recommendations target?\",\"answer\":\"The recommendations apply to EDs, hospitals, and urgent care clinics when definitive dental treatment is not immediately available, including pain related to tooth extractions and toothache.\"},{\"question\":\"How were the recommendations developed?\",\"answer\":\"A guideline panel assessed opioid and non-opioid analgesics, local anesthetics, corticosteroids, and topical anesthetics, using the GRADE approach and the GRADE Evidence-to-Decision Framework to generate 18 recommendations and six good practice statements.\"},{\"question\":\"What is the recommended first-line therapy for acute dental pain?\",\"answer\":\"NSAIDs with or without acetaminophen are recommended as first-line therapy after tooth extraction(s) and for temporarily managing toothache, while opioids should be reserved for situations where first-line therapy is insufficient or NSAIDs are contraindicated.\"}]","Evidence-based clinical practice guidelines for the management of acute dental pain - related commentary | PDF",1790568707,38]