A Narrative Review on the Effect of Acetaminophen and Ibuprofen in Orthodontic Tooth Movement

Orthodontic force application causes an inflammatory event in the periodontium resulting in bone
resorption and subsequent orthodontic tooth movement (OTM). The release of inflammatory
mediators like prostaglandins E2 and Interleukin-1β act as potent stimulators of bone resorption.
Application of heavy force results in pain and to relieve the same non-steroidal anti-inflammatory
drugs (NSAIDs) are prescribed. These NSAIDs negate the inflammatory reactions by interfering with
the synthesis of prostaglandins (PG), thus inhibiting orthodontic tooth movement. The purpose of this
mini-review of literature was to highlight the effects of the two commonly used drugs, namely
acetaminophen and ibuprofen on their pain relieving ability and effect on OTM. It was concluded that
acetaminophen was a potent analgesic that could be used to relieve the discomfort associated with
orthodontic treatment as its effect was at the central nervous system level and not at the cell
membrane level as also since it inhibited the PG synthesis very slightly its inhibitory effect on OTM
was not a matter of concern. On the other hand, Ibuprofen served as a mild analgesic as also
inhibited OTM with its anti-inflammatory effect. Ibuprofen inhibits PGs at the peripheral level thus
affecting osteoclastic activity and resultant deceleration of orthodontic tooth movement.
Acetaminophen is the suggested drug of choice rather than ibuprofen to relive pain and discomfort
during the course of orthodontic therapy.