Aspirin

Aspirin

Common brand names: Bayer, Alka-Seltzer and many others.

Description: Aspirin was first marketed in 1899 and probably is the most consumed drug in the world next to alcohol. It relieves pain, reduces fever and lessens swelling and other symptoms of arthritis. Another major use of aspirin today (under the guidance of a physician) is in the prevention of heart attacks and certain types of strokes in at-risk people, due to its ability to inhibit functioning of platelets (blood-clotting cells).

Dental uses: Aspirin is used for mild to moderate dental pain, including pain from dental surgery, toothache or the temporomandibular joint. It often is used combined with narcotics.

Dosages for dental purposes: For mild to moderate dental pain, including pain from dental surgery, toothache, or the temporomandibular joint, the recommended adult dose is 650 milligrams to 1,000 milligrams every four to six hours, with a maximum daily dose of 4,000 milligrams. For more severe pain, a narcotic-combination drug (such as aspirin with codeine, hydrocodone or oxycodone) or a nonsteroidal anti-inflammatory drug (such ibuprofen, naproxen sodium or diflunisal) may have to be prescribed. The maximum dose for aspirin also applies to aspirin plus codeine (Empirin #3) and aspirin plus oxycodone (Percodan) products.

Concerns and possible side effects: Common side effects with short-term (seven days or less) use include abdominal pain, nausea and increased bleeding time.

People who are on chronic low-dose aspirin therapy to prevent heart attacks and strokes should tell their dentist, because low-dose aspirin use can increase bleeding during dental surgery. Aspirin should not be directly placed on the oral soft tissues to treat dental pain; a severe burn (ulceration) is likely to result at the site. With chronic dosing (many weeks or months) as employed in the treatment of arthritis, more serious side effects can occur, often requiring hospitalization. These may include bleeding ulcers and perforations of the stomach and small intestines (occurring in 3 percent to 5 percent of patients) and kidney function impairment. Still, under the typical dental usage scenario of a few days at most, aspirin generally is a safe and well-tolerated drug.

People allergic to aspirin should avoid all aspirin-containing products; all related nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen sodium, diflunisal, etodolac and many others; and the new COX-2 inhibitors (celecoxib and rofecoxib). Allergic reactions can range from a mild rash to life-threatening closure of the airway and a fall in blood pressure. In addition, about 5 percent to 10 percent of people with asthma cannot tolerate aspirin, related NSAIDs or COX-2 inhibitors because they will precipitate potentially life-threatening asthmatic attacks in these individuals (so-called aspirin- or NSAID-sensitive asthmatics).

Patients with ulcers of the stomach or small intestine should not take aspirin.

Patients should avoid alcohol consumption during aspirin therapy for dental pain because alcohol increases the risk of stomach ulcers and bleeding. Other drugs aspirin may interact adversely with include the manic-depression drug lithium (Eskalith); warfarin (Coumadin) and other anticoagulants, which can cause bleeding; and oral drugs for diabetes (such as Diabinase and Orinase), which can lead to low blood sugar. These interactions can be serious, so it is imperative to inform your dentist of all medications you are taking.

Parents should not give aspirin to children with flulike symptoms, chicken pox, stomach infections and, in the opinion of most pediatricians, any respiratory infection accompanied by a fever due to aspirin’s strong association with the development of Reye’s syndrome, a potentially fatal disorder.