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Codeine for Acute Dental Pain and Acute Pain Related to Dental Procedures

Last updated: March 3, 2021
Project Number: RC1325-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of codeine for patients with acute dental pain or pain related to dental procedures?
  2. What is the clinical effectiveness of codeine with acetaminophen and/or a nonsteroidal anti-inflammatory drug for patients with acute dental pain or pain related to dental procedures?

Key Message

Two overviews of systematic reviews, 4 systematic reviews, and 9 randomized controlled trials were identified comparing codeine or codeine combination drugs with placebo and/or other drugs in the management of acute dental pain. As compared to placebo, codeine was generally shown to offer a benefit to patients experiencing acute dental pain. When compared to other drugs and/or drug combinations particularly those that were acetaminophen- or ibuprofen-based codeine generally was not found to be as clinically effective for the management of acute dental pain, with the potential exception of tooth sensitivity following dental bleaching, where 1 study reported that acetaminophen plus codeine was statistically significantly superior to ibuprofen or placebo. Increased adverse events were observed with codeine-containing drugs as compared to other drugs and/or placebo. Studies included in this review demonstrated both strengths and limitations, some of which limit the extent to which the findings from these studies were relevant to this report and/or can be generalized.