Post-Extraction Analgesia — ORE Part 1 MCQ

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EasyPharmacology & TherapeuticsPost-Extraction AnalgesiaORE Part 1

An adult requires analgesia after a surgical tooth extraction. They have previously tolerated ibuprofen and paracetamol, have no contraindication to either drug, and do not have ongoing socket bleeding. They report an allergy to codeine. Which analgesic regimen is most appropriate?

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Correct answer: C — Ibuprofen 400 mg with paracetamol 1 g

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

A is correct. In an adult who can take both medicines and has no ongoing bleeding, ibuprofen with paracetamol is an appropriate non-opioid regimen for post-extraction dental pain. SDCEP advises ibuprofen and/or paracetamol for dental pain, and its emergency dental-care guidance includes ibuprofen 400 mg and paracetamol 1 g as adult analgesic options. This also avoids codeine in a patient reporting codeine allergy. C and D contain codeine-related opioids, so are unsuitable. Tramadol is an opioid and is not first-line when effective non-opioid analgesia is available. Aspirin is not preferred after extraction because it may worsen bleeding; SDCEP specifically advises avoiding aspirin when bleeding is present. The non-opioid approach is also supported by postoperative dental-pain evidence favouring NSAIDs over opioid combinations.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Acute Dental Problems: Analgesia, 2026. https://www.acutedentalproblems.sdcep.org.uk/supporting-tools/analgesia/