• Dr Thor Conner

The Wisdom Tooth dilemma and alternatives for pain control

Updated: May 4, 2019



Opiate use and abuse (and accidental death) have become a serious issue for Americans in the last decade with over 70,000 deaths in 2017 alone. We are now more likely to die from an opiate overdose than in a car accident. Part of the problem that they actually are pretty effective pain control agents in the short term, but they aren’t all that good at control of chronic pain. They are, however, exceedingly good at making the brain desire more of the chemical. Obviously, keeping impressionable brains from exposure at vulnerable times could be a solution. In searching for answers, researchers from Stanford School of medicine performed a cohort study.

The study published in December by JAMA Internal Medicine takes a look at opiate addiction rates among insured patients and found significant increases in addiction rates among teens and young adults who were given a single dose opiates to control pain after a dental procedure (the individuals who are opiate naive). Specifically the procedure in of removing the third molar, the wisdom teeth, which millions of people do a year. This mostly elective or cosmetic operation involves more pain than a regular dental because the teeth are often removed from deeper places in the bone. This one procedure is the largest reason that kids 10-19 years old are prescribed opiates, and dentists are by far the largest prescribers for first time users in said demographic.

The question that I ponder from this study is are there good alternatives for short and long term pain management? The answer is a decided yes. There are many effective alternatives for pain management. Here are a few options:

  1. Ice (hydrotherapy), used immediately following a procedure, will reduce local inflammation and reduce pain. The analgesic properties of ice are well studied, safe, and predictable, and, more importantly, since a resistance to the therapy never develops, it can be used liberally without fear of complications.

  2. Acupuncture is widely recognized as an alleviator of pain for many conditions. Acupuncture can stimulate the release of endorphins, which also reduces pain.

  3. Homeopathy uses ultra-dilute substances to stimulate the body’s natural response to disease. Homeopathic remedies can be prescribed very precisely based on the patient’s current symptoms. These are commonly used remedies for dental procedures and their indications:

  • Arnica to speed healing and reduce the effects of trauma.

  • Hypericum to reduce nerve based pain and desensitize teeth.

  • Aconite for fear and anxiety.

  • Camomillia for teething pain in kids.

  1. Botanical medicine can be used both to decrease pain and to reduce inflammation.

  • Sedative and nervine herbs like passionflower, lemon balm, willow bark, and California poppy offer safe alternatives to painkillers.

  • Other herbs like turmeric can be used to reduce the inflammatory response. Zyflamend is one of the best.

  • Herbal extracts in mouthwashes to treat gingivitis with effective combinations of Echinacea, myrrh, licorice, gingko, and green tea.

  • Clove and peppermint essential oils can be used directly on around teeth to provide temporary pain relief.

  1. Mind-body approaches like meditation and mental imagery can confer a powerful mental framework for understanding and influencing how the brain deals with pain, with the combination of deep breathing and mental focus.

  • Devices (such as the Muse Headband) bring the additional power of bio-feedback into common and accessible use. Monitoring the progress of meditative techniques with quantifiable measures increases the learning curve for effectively using these practices in the novice and helps to

focus them in the proficient.

  1. Hypnosis is another technique that harnesses the power of altered states of consciousness and is very effective for pain control and a host of other uses. The downside to hypnotherapy is that it seems that only about 20% of people are good candidates for the hypnotic state.

  2. Body work techniques are a fantastic therapeutic tool for pain management. Manipulation of the spine and joints and massage therapy encourage the release of endorphins and dopamine which help the patient deal with pain and especially the suffering associated with unremitting pain.

  3. Energetic therapies like Qi Gong, Reiki and therapeutic touch are also good methods for managing pain and encouraging healing.

  4. Lower impact pharmaceuticals like steroids, local analgesics (lidocaine), NSAIDS and Acetaminophen may be sufficient to provide relief with less risk.

One factor to keep in mind with alternative methods of pain management is that every technique does not work for every patient. Consulting with a practitioner who knows your health history well may yield better results than simple trial and error.

Finally, consider the timing of the procedure. If the child is asymptomatic putting off extraction past age twenty will significantly reduce the chance of an addiction developing. The study found that there is a statistically significant increase in subsequent treatment for opiate dependency among those naive patients who received the pain killers (hydrocodone-acetaminophen AKA Vicodin, a relatively low potency opiate). Patients who took their first opioid at a younger age (15-18) had a higher rate of addiction treatment than those who had the same treatment a bit later in life (in their 20s). In part due to the 2018 JAMA study, dentists and the American Dental Association have been re-examining and changing their standards of care concerning timing, necessity of procedures and pain medications.

As with any health care issue, the doctors of World Tree Natural Medicine are at your service to help guide you in the use of alternative therapies.


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