• Posted November 7, 2025

Wisdom Tooth Surgery? Opioids Not Necessary, Clinical Trial Finds

Getting your wisdom teeth pulled?

You don’t need opioids to deal with the pain of the extraction, a new study says.

A combination of ibuprofen and acetaminophen provided better pain relief than hydrocodone with acetaminophen for the first two days after wisdom tooth surgery, researchers reported Nov. 6 in JAMA Network Open.

Both men and women also had greater satisfaction post-op when using over-the-counter pain medications compared to opioids, researchers said.

The sex-specific results are important because women consistently report higher pain levels after surgery, researchers said.

"We wanted to determine whether the pain medication’s effects were consistent in males and females separately," said lead researcher Dr. Janine Fredericks-Younger, an associate professor at Rutgers School of Dental Medicine in Newark, New Jersey.

"And what we found is that in both subgroups (males and females), the non-opioid was superior for that first day and night, and then no worse than the opioid for the rest of the post-op period,” Fredericks-Younger said in a news release.

For the clinical trial, researchers recruited more than 1,800 men and women slated to undergo wisdom tooth extraction, a painful procedure that requires cutting into gums and sometimes removing bone.

Such dental procedures are how many Americans are introduced to opioids, researchers said in background notes. Dentists wrote more than 8.9 million opioid prescriptions in 2022.

"There are studies out there to show that when young people get introduced to opioids, as many have via wisdom tooth extraction, there's an increased likelihood that they'll eventually use them again, and then it can lead to addiction," Fredericks-Younger said.

Roughly half of the trial participants received 400 milligrams of ibuprofen (Advil, Motrin) and 500 milligrams of acetaminophen (Tylenol) for their pain, the study says, The other half got 5 milligrams of hydrocodone with 300 milligrams of acetaminophen.

Patients tracked their pain twice a day for nine days using electronic diaries, noting not just their pain but also their sleep quality, ability to perform daily activities, and overall satisfaction.

On every measure, the over-the-counter meds matched or beat the opioid, including better sleep and less interference with daily activities, the study found.

Those prescribed opioids also were twice as likely to call back requesting additional pain meds, researchers found.

"The results actually came in even stronger than we thought they would," senior researcher Dr. Cecile Feldman said in a news release. She’s dean of the Rutgers School of Dental Medicine.

"We expected to find the non-opioid to be non-inferior, so that at least it was no worse than opioids,” she said. “We were surprised to see that it was actually superior."

These results should limit the common dental practice of writing “just in case” opioid prescriptions for patients who are told to start with over-the-counter meds, researchers said.

The American Dental Association already recommends against opioids as a first-line pain treatment, researchers noted.

"How can we now, with the evidence and the knowledge that we have, eliminate these prescriptions from being written?" Fredericks-Younger said.

Even though this study focused on wisdom tooth extractions, Feldman said the findings could apply to other dental procedures.

"We feel pretty confident in saying that opioids should not be prescribed routinely for dental procedures," she said. "Our non-opioid combination really should be the analgesic choice."

However, future studies are needed to see if the same holds true for other types of surgeries, particularly those to treat orthopedic injuries, Feldman added.

More information

The U.S. Centers for Disease Control and Prevention has more on managing dental pain.

SOURCES: Rutgers University, news release, Nov. 6, 2025; JAMA Network Open, Nov. 6, 2025

What This Means For You

Dental patients can receive effective pain relief from a combination of acetaminophen and ibuprofen.