The two Canadian Collaboration on Clinical Practice Guidelines in Dentistry (CCCD) discussed in this issue of Evidence-Based Dentistry recommend the use of analgesics rather than antibiotic therapy for acute apical abscess where drainage cannot be achieved immediately, or in the treatment of acute apical periodontitis. Linked to this we have reproduced the Oxford League Table of Analgesic Efficacy: this is also freely available from the Oxford Pain Group internet site (www.jr2.ox.ac.uk/bandolier/booth/painpag/index2.html)see Figure 1. Table 1 has been developed over many years by the Oxford Pain Research Group.

Figure 1
figure 1

The Oxford Pain Group site.

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Table 1 The Oxford League table of analgesic efficacy.
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The information in the table has been derived from a large number of systematic reviews of randomised, double-blind, single-dose studies in patients who had moderate to severe pain. Each of the reviews has the same outcome measure, at least 50% pain relief over 4–6 h. The pain measurements were standardised, and have been validated. Numbers-needed-to-treat are calculated for the proportion of subjects who had at least 50% pain relief over 4–6 h compared with placebo in randomised, double-blind, and single-dose studies in people with moderate to severe pain. Drugs were oral, unless specified, and doses are given in milligrams.

The relevance of this table to acute dental pain has been raised in this journal before in an editorial by Moore et al,1 when the author noted that dental pain is no different from other acute pain models.