Effect of Diclofenac Mouthwash on Postoperative Pain after Periodontal SurgeryCorrespondence Address :
Dr. Ashank Mishra,
Reader, Department of Periodontics, Sri Sai College of Dental Surgery, Vikarabad, Hyderabad-501101, Telangana, India.
Introduction: Non-Steroidal Antiinflammatory Drugs (NSAIDs) are widely used drugs for the management of pain. Oral administration of NSAIDs has various adverse events like gastrointestinal alterations - nausea, dyspepsia and gastrointestinal bleeding, hepatotoxicity and blood dyscrasias. As orally given NSAIDs are associated with systemic side effects, it is preferred to alleviate pain and inflammation using topical medication. Thus, recently the focus has been on the development of topical administration of NSAIDs in the form of gels, toothpastes and rinses.
Aim: To determine if diclofenac mouthwash, would be a better alternative to its systemic administration post surgery, in terms of patient acceptance and to minimize the adverse effects of orally administered drug.
Materials and Methods: The study was designed as a single blinded, randomized, controlled clinical trial. Thirty chronic periodontitis patients scheduled for full mouth flap surgeries were randomized to receive either Diclofenac Mouthwash (MW) or Diclofenac Tablets (TB), post surgery. The MW group patients (15) were advised to rinse undiluted 15 ml solution for 30 secs, twice daily for three days. TB group (15) was advised to take 50 mg tablet twice daily for three days. A 10 point Visual Analog Scale (VAS) and Wong Baker Facial Rating Scale (FRS) was recorded to measure the pain perception by the patients. Gingival status was assessed by the Modified Gingival Index (MGI) at Baseline and seventh day. Data pertaining to pain perception were analysed using repeated measures of ANOVA (Analysis of Variance) with post-hoc LSD test.
Results: Intra group comparisons showed a significant reduction in pain, post surgery. Inter group comparisons showed a significant reduction only in the MGI scores of MW group, when compared to TB group. Intergroup comparisons showed no significant reduction in pain scores between both the groups, stating that diclofenac mouthwash is as effective as oral administration.
Conclusion: Diclofenac mouthwash is a better alternative to the systemic administration post surgery, in terms of patient acceptance and to minimize the adverse effects of orally administrated drug.
Facial rating scale, Non steroidal anti inflammatory drugs, Visual analog scale
Ashank Mishra, Jyotsna Amalakara, Haritha Avula, Krishnajaneya Reddy. EFFECT OF DICLOFENAC MOUTHWASH ON POSTOPERATIVE PAIN AFTER PERIODONTAL SURGERY. Journal of Clinical and Diagnostic Research [serial online] 2017 April [cited: 2017 May 29 ]; 11:ZC24-ZC26. Available from
Date of Submission: Jun 23, 2016
Date of Peer Review: Aug 01, 2016
Date of Acceptance: Dec 20, 2016
Date of Publishing: Apr 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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