A randomised trial of over 1,800 patients found that a combination of ibuprofen and acetaminophen controls post-operative pain better than hydrocodone with acetaminophen following surgical removal of impacted wisdom teeth. The study, published in the Journal of the American Dental Association and conducted across five clinical sites, is one of the largest of its kind comparing opioid and non-opioid analgesia after a dental procedure. Patients in the non-opioid group reported lower pain scores during the peak-pain period in the first two days, better sleep quality on the first night, and less interference with daily activities. They were also half as likely to need additional rescue medication and reported higher satisfaction with their pain management. Dentists in the US wrote more than 8.9 million opioid prescriptions in 2022, and wisdom tooth extraction is often a young patient's first exposure to opioids. The researchers argue there is now no clinical justification for routine opioid prescribing after third-molar extractions, except in cases where ibuprofen or acetaminophen is contraindicated. The findings align with existing American Dental Association guidance recommending against opioids as first-line treatment for dental pain.