non-steroidal antiinflammatory medication contraindications, NSAID induced myocardial infarction and stroke, non-narcotic pain management


The origins of the current “opioid epidemic” sweeping America with its consequent overdose related deaths has resulted in numerous publications accusing the dental profession of excessively prescribing narcotic analgesics leading to the initial addictive episode. These allusions have prompted the national organization representing New York States’ almost 600 oral and maxillofacial surgeons to develop and promulgate in its official journal , a position paper detailing a non-narcotic pain management regimen to alleviate post operative discomfort. However, their pronouncement suggests prescribing a maximum daily dosage of ibuprofen which has previously been documented as causing myocardial infarction and stroke in vulnerable older individuals. This current publication, which is based upon our clinical experience, is simpler and more effective than a previously published plan suggested by the American Dental Association.