Comparative Study Between the Effect of Paracetamol and Mefenamic Acid on The Relief of Pain Following Dental Extraction of Teeth: Randomized Clinical Trial

Dental extraction involves removing a tooth from its socket, often due to dental caries, periodontal disease, or orthodontic needs etc. Proper extraction techniques are essential to minimize complications, including infection and alveolar bone damage. Pain management post-extraction is crucial for patient recovery, with Acetaminophen (Paracetamol) and Mefenamic acid (Ponstan) being common analgesics. Paracetamol, an analgesic and antipyretic, is safe for patients with contraindications to NSAIDs. In contrast, Mefenamic acid effectively reduces pain and inflammation, making it a viable option for managing postoperative discomfort. Aims of study to compare the effect of paracetamol and mefenamic acid on the relief of pain following dental extraction of teeth and to detect whether the paracetamol can be used as an alternative to mefenamic acid in patients who are contraindicated to mefenamic acid and other NSAIDs. A randomized trial study was conducted at the Oral and Maxillofacial Surgery Unit, Bilad Al-Rafidain College Clinics in Baqubah City. A total of 40 participants, aged ≥18 years, were randomly assigned into two group, one group received Acetaminophen (500 mg) and another group received Mefenamic acid (500 mg) post-dental extraction. The researcher was blind to type of drugs selected by the patient pre-extraction. Assessment of pain relief was done at 5 hours post extraction using a Numerical rating scale. The result of the study showed a significant difference in pain relief between the Paracetamol and Mefenamic acid groups, with a p-value of <0.001, indicating a substantial difference in pain relief effectiveness between paracetamol and Mefenamic acid groups. Mefenamic acid group demonstrates a marked efficacy, with 95.0% of participants scoring 0 and 5.0% scored 1 while in paracetamol group 65.0% of users scored 1, and 20.0% scored 2. The data strongly suggest that Mefenamic acid is superior to paracetamol for managing post-dental extraction pain. Its dual analgesic and anti-inflammatory action, makes it a more potent choice in cases requiring robust pain management. Although the superior effect of mefenamic acid in pain reduction as compared to paracetamol, paracetamol also showed a low score of pain (65% scored 1), so paracetamol can be used as an alternative drug to mefenamic acid in patients who are contraindicated for NSAIDs.