Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

28 questions · 34 findings · 6 reviews · All outcomes

No studies found 6 · 17.6%GRADE not reported 12 · 35.3%Very low 2 · 5.9%Low 5 · 14.7%Moderate 5 · 14.7%High 4 · 11.8%

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)

Proportion of patients with >50% maximum pain relief (TOTPAR) over 2 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

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).

1 finding from 1 review

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)

Adverse events · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…
1 finding from 1 review

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)

Participant‐reported pain relief of 50% or greater · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

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).

1 finding from 1 review

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)

Patients not using rescue medication at 8 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

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).

1 finding from 1 review

Oral paracetamol vs placebo

At least 50% reduction in pain · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery under local…

Paracetamol (single oral dose, any dose or formulation; subgroups up… led to higher achieving at least 50% pain relief at 4 hours (using pain intensity… compared with placebo; GRADE not reported.

3 findings from 1 review

Oral paracetamol vs placebo

Patients with one or more adverse events · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery under local…

Paracetamol (single oral dose, any dose or formulation; subgroups up… showed no clear difference in patients with one or more adverse events compared with placebo; GRADE not reported.

1 finding from 1 review

Oral paracetamol vs placebo

Participant‐reported pain relief of 50% or greater · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery under local…

Paracetamol (single oral dose, any dose or formulation; subgroups up… led to higher achieving at least 50% pain relief at 6 hours (using pain relief… compared with placebo; GRADE not reported.

1 finding from 1 review

Preoperative paracetamol (acetaminophen) vs placebo

Postoperative pain (dichotomous measure: parent report of presence of pain-related behaviours) · Children and adolescents having dental treatment under local anaesthetic (restorative and extraction treatments)

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

1 finding from 1 review

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) probably leads to lower pain intensity (VAS 0-100 mm) compared with control (placebo or no treatment) (moderate certainty).

3 findings from 1 review

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Quality of life or participant satisfaction · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
1 finding from 1 review

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Rescue analgesia · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Number of paracetamol (acetaminophen) with codeine tablets required · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in number of paracetamol (acetaminophen) with codeine tablets required compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of paracetamol (acetaminophen) with codeine (Tylenol) tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of paracetamol (acetaminophen) with codeine (Tylenol)… compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Participant‐reported pain relief of 50% or greater · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher proportion of patients with >50% maximum pain relief (TOTPAR) over 6… compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Proportion of patients with >50% maximum pain relief (TOTPAR) over 2 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher proportion of patients with >50% maximum pain relief (TOTPAR) over 2… compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Patients not using rescue medication at 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher patients not using rescue medication at 6 hours compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review