Acetaminophen
Common brand names: Tylenol, Datril and many others.
Description: Like aspirin, acetaminophen possesses analgesic (pain-relieving) and antipyretic (fever-reducing) effects. However, it lacks anti-inflammatory effects (the ability to reduce joint swelling in arthritis patients and in some patients with temporomandibular joint pain). Acetaminophen does not irritate the stomach, cause ulcers or increase bleeding time. It is the pain reliever and fever reducer of choice in children, because its use is not associated with Reyes syndrome. It also can be safely used in patients with allergies to aspirin or to nonsteroidal anti-inflammatory drugs (NSAIDs) and in most patients with aspirin or NSAID-sensitive asthma.
Dental uses: Acetaminophen is used to treat mild to moderate pain from dental surgery, toothache and the temporomandibular joint. It is often used in combination with narcotics.
Dosages for dental purposes: The recommended adult dose is 650 mg to 1000 mg every four to six hours, with a maximum daily dose of 4000 mg. For more severe pain, a narcotic-combination drug (such as acetaminophen with codeine, hydrocodone or oxycodone) or a nonsteroidal anti-inflammatory drug (such as ibuprofen, naproxen sodium or diflunisal) may be required. Maximum doses of acetaminophen also apply to acetaminophane with codeine (Tylenol #3), acetaminophen with hyrocodone (Vicodin, Lortab), and acetaminophen with oxycodone (Percocet, Tylox) preparations. Acetaminophen dosing in children is based on age and body weight.
Concerns and possible side effects: Acetaminophen is the best tolerated of all the analgesics used in dentistry, with few side effects. However, an overdose of acetaminophen can produce severe liver damage, which may require liver transplantation. Patients should avoid alcohol consumption during acetaminophen therapy because the combination may increase the risk of liver damage.
