What do systematic reviews say?

Preoperative paracetamol (acetaminophen) vs placebo

Preoperative paracetamol (acetaminophen) showed no clear difference in postoperative pain (dichotomous measure: parent report of presence… compared with placebo (low certainty).

• Preoperative analgesics for additional pain relief in children and adolescents having dental treatment 2016 · Cochrane All outcomes

  Mean 6.5 hours
  RR 0.81 [0.53, 1.22]
  2 studies · 100 participants
  Low

Preoperative paracetamol (acetaminophen) vs placebo

• Preoperative analgesics for additional pain relief in children and adolescents having dental treatment 2016 · Cochrane All outcomes
  No adverse events were recorded in Primosch 1995. The other two studies did not mention adverse events.
  1 study
  GRADE not reported

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Combined paracetamol plus ibuprofen in a single tablet (e.g.… showed no clear difference in proportion of patients with >50% maximum pain relief (TOTPAR) over 2… compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (moderate certainty).

• Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth 2013 · Cochrane All outcomes

  2 hours postdosing · Paracetamol 1000 mg/ibuprofen 400 mg vs paracetamol 1000 mg or ibuprofen 400 mg
  RR 1.29 [0.91, 1.85]
  1 study · 170 participants
  Moderate

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

• Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth 2013 · Cochrane All outcomes

  Study period (immediate postoperative)
  The majority of adverse events were minor in nature and usually included nausea, vomiting, headaches and dizziness. Side effect profiles have not been included in a meta-analysis as multiple adverse events were…
  2 studies
  GRADE not reported

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Combined paracetamol plus ibuprofen in a single tablet (e.g.… probably leads to higher proportion of patients with >50% maximum pain relief (TOTPAR) over 6… compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (moderate certainty).

• Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth 2013 · Cochrane All outcomes

  6 hours postdosing · Paracetamol 1000 mg/ibuprofen 400 mg vs paracetamol 1000 mg or ibuprofen 400 mg
  RR 1.77 [1.32, 2.39]
  1 study · 170 participants
  Moderate

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Combined paracetamol plus ibuprofen in a single tablet (e.g.… leads to higher patients not using rescue medication at 8 hours compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (high certainty).

• Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth 2013 · Cochrane All outcomes

  8 hours postdosing · Paracetamol 1000/500 mg/ibuprofen 400/200 mg vs single constituent drugs
  RR 1.60 [1.36, 1.88]
  2 studies · 467 participants
  High