JAMA Netw Open
Nonopioid combo outperforms opioids for wisdom tooth pain in both sexes, study shows
A subgroup analysis of the OARS randomized trial (N = 1,815) compared nonopioid analgesia (ibuprofen 400 mg + acetaminophen 500 mg) vs. hydrocodone 5 mg with acetaminophen 300 mg after impacted mandibular third molar extraction. The study enrolled equal numbers of male and female patients. Researchers found that in both sexes, the nonopioid combo was superior during the first 24 hours and noninferior thereafter for pain control, sleep, functional recovery, and patient satisfaction. Opioid recipients were twice as likely to request additional medication.
Clinical takeaway: For postop pain after third molar extraction, ibuprofen and acetaminophen provide superior early pain relief and comparable overall outcomes to opioids in both sexes, supporting nonopioid regimens as first-line therapy.
Source:
Fredericks-Younger J, et al. (2025, November 3). JAMA Netw Open. Analgesic Differences in Males and Females After Third Molar Surgery: A Subgroup Analysis of the OARS Randomized Clinical Trial. https://pubmed.ncbi.nlm.nih.gov/41196600/