Evaluation of the need to prescribe opioid medication to control post-surgical pain of different periodontal/oral surgeries.

Background: To determine the level of perceived pain after different types of periodontal/oral surgical procedures, and the differences in patients' selection of pain management, over the counter (OTC) versus opioid, based on procedure type.

Methods: Patients undergoing surgical procedures were asked to complete a pain questionnaire at four time points: 1) before surgery 2) first dose of analgesic at home, 3) 24 hours postoperatively, and 4) 72 hours postoperatively. The questionnaire consisted of numerical and descriptive scales to describe the perceived pain.

Results: A total of 198 patients completed the questionnaire. All surgical procedures were grouped into five major categories: bone augmentation procedures (11% BAP), teeth extractions (26% EXT), surgical implant placement (25% IP), mucogingival surgeries (21% MGS), and pocket elimination procedures (17%). IP surgery was associated with significantly less pain compared with MGS and EXT (P <0.05). There was a statistically significant difference for taking any medication based on type of surgical procedure at 24 hours (P <0.05).

Conclusions: IP is associated with significantly lower perceived pain compared with EXT and MGS surgery. Analgesic consumption was generally parallel to pain perception. A considerable number of patients elected to control the post-surgical pain using OTC medication up to 72 hours. Periodontal/oral surgery procedures vary in the amount of perceived postoperative pain. Tailoring postoperative medications to the type of periodontal/oral surgery performed will help prevent overprescribing of opioids.