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Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 10:39 am
by purplepetunia
Has anyone on the forum heard that non-steroidal anti-inflammatory drugs (NSAIDs) inhibit tooth movement in orthodontics? I just came across the following article http://orthocj.com/2007/09/drugs-and-or ... e-or-boon/, which states, in part, that NSAIDs "might slow down the rate of orthodontic tooth movement, which will eventually increase the total treatment duration." I found several other similar articles/studies listed on the Web that make the same conclusion.

I've heard about the effects of osteoporosis drugs like Boniva and Fosomax on orthodontic treatment, but this is the first I've come across information that suggest NSAIDs like Motrin, Alleve, and aspirin can slow down treatment.

My orthodontic progress has been at pretty much standstill the last six months. My ortho asked me if I was taking Boniva or Fosomax or anything like it (I'm not) but he never mentioned anything about NSAIDs. I just happened to come across the information myself while researching/trying to figure out what might be slowing down my tooth movement. I take Motrin regularly for a shoulder condition. I had no idea this is what could be slowing down my progress and frankly I'm astonished my ortho didn't think to ask me about it. As the article states, "Since NSAIDs are freely available over the counter, patients should be advised not to take these drugs during orthodontic treatment, without the dentist’s knowledge."

Has anyone else ever heard anything about this? The article says that acetaminophen (Tylenol) is the preferred drug for orthodontic patients. Should I call my orthodontist to talk to him about this (my next appointment isn't for another five weeks). At any rate I'm going to stop taking Motrin and switch to Tylenol when needed.

Thanks in advance for any insights/advice you can provide.

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 10:55 am
by ashesgap
I take up to four advil a day in the week after an adjustment, and then one a day almost everyday. Then other times I take aleve frequently if i'm mopping or giving the dogs baths. With all of that my teeth moved pretty fast, faster than the ortho thought they would. If we hadn't found out my roots needed to be moved I would have been done two months ago, which was around six months early. Definitely talk to your ortho, and switch pain meds to try it out, and see if anything changes.

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 11:30 am
by AM21
I have never heard that before. I usually take 2 ibuprofen every 4 hours after an adjustment and my teeth have been moving pretty fast. Keep us updated! That's really interesting!

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 12:05 pm
by Johnny B
I take NSAIDS daily for years and my teeth have moved a whole bunch since I was braced 8 months ago. My ortho seems satisfied with my progress.

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 1:41 pm
by anngie27
the ortho that i had my consult with (also the one that I will be going to once I'm braced) mentioned this to me during the consultation. He said there had been some research done in which this showed it was true. Haven't read up on it myself though.

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 2:41 pm
by Ionika
same as anngie27...i've been advised to take them only when others wont work or just half the dose...anyways i rarely took them since.. taking less pain medication is better for our bodys anyway..

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 4:50 pm
by BaliGirl
I read those studies before I was braced and asked my orthodontist's opinion. He just shrugged and said he doesn't know whether it makes a difference or not and to take ibuprofen/naproxen whenever I want to. (I am not impressed by my ortho.)

One of the studies mentioned that 1) taking anti-inflammatories before an adjustment significantly reduces pain, and 2) it takes 3 days before teeth start moving and 3) a typical OTC dose would be eliminated from the body before then, so I made the decision to take ibuprofen/naproxen the day of an adjustment and the day after, and only if I really, really, really need it between adjustments and Tylenol won't cut it. My teeth have moved much faster than my ortho was expecting so it seems as though the occasional ibuprofen/naproxen use hasn't hurt me.

Here's a link to one of the studies:

Effects of Preoperative Ibuprofen and Naproxen Sodium on Orthodontic Pain
http://angle.org/doi/full/10.1043/0003- ... istoryKey=

Re: Anti-inflammatories inhibit tooth movement?

Posted: Wed Nov 09, 2011 6:02 pm
by DrJasonKTam
As far as I know, the slowed movement has been showed in animal models but I don't know if there is a human study yet. We do let our patients know that the movement of teeth requires an inflammatory process so that the bone can be resorbed at the pressure side of the root. Theoretically, NSAIDs would slow down this process, whereby slowing down tooth movement.

I recommend Tylenol to my patients for this reason, but if they have a reason that they feel more comfortable with NSAIDs, I tell them to go ahead. In reality, the number of days any pain meds are required is very small compared to the number of days in treatment.

Re: Anti-inflammatories inhibit tooth movement?

Posted: Thu Nov 10, 2011 8:03 am
by zcenteno
nice Topic!!! i got my braces a week ago and dang! it does hella hurts. i was about to the mefanamic acid(anti in flamatory) when the "magical" question popped into my mind. i hesitated to take it, knowing its adverse and counter effect to the ortho treatment but i was not sure if i was right. i knew there was gonna my light inflamation. i decided to take it, and to my surprise it didnt do a dang thing to the pain. i had to put with it for a week, ouch.

from where i am the most common pain killers we have is ibuprofen(which i am allergic at) and mefanamic acid. so it comes down to either that "mystery drug" or to just endure the pain.

....NO PAIN, NO GAIN.

Re: Anti-inflammatories inhibit tooth movement?

Posted: Thu Nov 10, 2011 11:01 am
by purplepetunia
Thanks everyone for the replies. I've been taking Motrin several times a week for years due to a shoulder condition. I included this information in the medical history form when I started my orthodontic treatment. If there have been studies done that even suggest NSAIDs like Motrin slow down tooth movement, I'm really surprised my ortho hasn't made the connection.

Although I had been taking Motrin because I found it to be more effective than Tylenol, I'm going to stop taking the Motrin completely and just take Tylenol only when absolutely necessary. I had been trying to cut back on the amount of Motrin I take anyway because, as someone else on the board said and I agree, I'd like to be as medication-free as possible. I will mention this to my ortho on my next visit and perhaps even bring him a printout of a couple of the articles.

On a side note some of the studies I read were done on humans but one of them was done on rats. So I'm picturing a rat with braces and I'm feeling really bad for those poor lab rats!