Comparative Study of Acetaminophen, Ibuprofen and Combination Effects for Pain Relief Following Tooth Extraction in Children under Local Anesthesia

Introduction &

It is clear that tooth extraction is painful. Different drugs with various functions have been used in order to relieve the pain after extraction. Ibuprofen is a non-narcotic analgesic and acetaminophen is considered as one of the most consumption anti-inflammatory drugs and is administrated to relieve moderate to severe pains. Our purpose is comparing the effects of acetaminophen, ibuprofen and combination of them to relieve the teeth pain due to extraction under local anesthesia.

In this randomized clinical trial, we divided 105 children (6-11 years old) referred to pediatrics ward of dental faculty of Hamadan University into 3 groups of 35 after getting their parent's consents, taking, their history and weighing them. Group1: received acetaminophen syrup with dose of 15mg/kg, group2: received ibuprofen syrup with dose of 5 mg/kg, and group3 received acetaminophen syrup with dose of 7.5mg/kg and ibuprofen syrup with dose of 2.5mg/kg.. One hour before and 15 min after tooth extraction, severity of their pain was evaluated according to table(CHEOPS).Drug effects in every group was studied by c2, t-test and Mann Whitney U test.

Age average of the children under survey in the group of acetaminophen syrup was 8.62±1.81 years old and in the group of ibuprofen syrup was 8.45±1.68 years old, and in the group of acetaminophen with ibuprofen was equal with 8.71±1.27 years old. Sex combination of the under survey children in the group of acetaminophen syrup was 51.4% / 48.6% (female/male), in the group of ibuprofen syrup was 51.4%/48.6%, and in the group of acetaminophen syrup with ibuprofen syrup was 65.7%/34.3%. Grade average of toothache immediately after extraction in the group treated with acetaminophen syrup was 33.19 and, in group treated with ibuprofen syrup equaled 37.81, and in the group treated with acetaminophen syrup with ibuprofen syrup was 47.86. Grade average of toothache 15 min after extraction in the group 1 was 35.1, in the second group was 35.9, and in the third group was 40.83.

The group received ibuprofen syrup and in the group received acetaminophen syrup in comparison with the group received acetaminophen with ibuprofen on the instant and 15 min after extraction showed much more relieved effect (P<0.05). No meaningful statistic differences were observed between the group received acetaminophen I5 mg/kg and the group received ibuprofen 5 mg/kg.