Exparel®: A Safer, Longer-Lasting Option for Post-Surgical Pain Relief

Recovering from oral surgery can be uncomfortable — but modern pain management options mean you don’t have to rely solely on prescription narcotics to feel better.

At Northwest Oral & Maxillofacial Surgery, we are committed to reducing the risks associated with opioid use by offering safe, effective alternatives, including Exparel®, a long-lasting, non-opioid numbing medication that can significantly reduce or even eliminate the need for narcotics after surgery.

Why Pain Management Matters After Oral Surgery

Pain after oral surgery is a normal part of healing. Whether you’ve had your wisdom teeth removed, dental implants placed, or undergone corrective jaw surgery, your body responds to surgical trauma with inflammation and tenderness.

Effective pain control is important not just for comfort, but also for:

• Better recovery outcomes: Patients who manage pain effectively tend to eat, sleep, and move more comfortably, which supports healing.
• Reduced stress on the body: High levels of pain can raise blood pressure and heart rate, which may slow recovery.
• Lower risk of complications: If pain prevents you from following post-op care instructions, healing may be delayed.
  
  

The Risks of Opioid Pain Medications

For decades, oral surgeons have prescribed opioid medications like hydrocodone and oxycodone for post-surgical pain relief. These drugs can be effective — but they come with well-documented risks.

According to the Centers for Disease Control and Prevention (CDC):

• In 2023, nearly 8.6 million Americans 12 years and older reported misusing prescription opioids in the past year.
• From 1999 to 2023, nearly 308,000 people died from overdoses involving prescription opioids.
  
  

“Risk of opioid overdose and death increases at higher dosages and when taken for longer periods of time or more often than prescribed,” says the CDC. “It is also very dangerous to combine opioids with other drugs, especially those that cause drowsiness.”

Common side effects of opioids include:

• Tolerance—meaning you might need to take more of the medication for the same pain relief.
• Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped.
• Increased sensitivity to pain. 
• Constipation. 
• Nausea, vomiting, and dry mouth. 
• Sedation and dizziness. 
• Confusion. 
• Depression. 
• Low levels of testosterone that can result in lower sex drive, energy, and strength.
  
  

Given these concerns, the board-certified surgeons at Northwest Oral & Maxillofacial Surgery take a conservative approach to prescribing opioids and only use them when absolutely necessary.

Non-Opioid Pain Relief: The First Line of Defense

Most patients can effectively manage post-surgical discomfort without narcotics. Our preferred approach begins with:

• Ibuprofen (Advil®, Motrin®) – Reduces inflammation and relieves pain. 
• Acetaminophen (Tylenol®) – Reduces pain and fever; can be taken in combination with ibuprofen for stronger relief.
  
  

Research has shown that ibuprofen and acetaminophen together can be as effective as opioids for short-term pain relief after dental surgery — without the risks of addiction.

“The trial in more than 1,800 patients found that those given a combination of ibuprofen and acetaminophen experienced less pain, better sleep and higher satisfaction compared with those receiving the opioid hydrocodone with acetaminophen,” according to the Rutgers Health study. “Results in The Journal of American Dental Association showed the non-opioid combination provided superior pain relief during the peak-pain period in the two days after surgery."

Introducing Exparel®: Long-Lasting Local Pain Control

For patients who want to minimize or avoid opioids entirely, we offer Exparel®, a slow-release local anesthetic that is injected directly into the surgical site during your procedure.

How it works:

• Exparel® contains bupivacaine, a proven numbing medication, in a unique time-release formula.
• The medication is slowly released over up to 72 hours, providing extended pain relief during the most intense post-surgical period.
• Because it targets the surgical site directly, it reduces the need for systemic medications like opioids.
  
  

Benefits of Exparel®:

• Opioid-free pain control: Reduces or eliminates the need for narcotic prescriptions.
• Longer-lasting relief: Covers the critical first three days after surgery, when discomfort is typically highest.
• Faster return to normal activities: Less grogginess and fewer side effects than opioids.
• Improved comfort during recovery: Many patients transition straight to over-the-counter pain relievers.
  
  

When Exparel® May Be Right for You

While Exparel® can benefit many patients, it may be especially helpful for those who:

• Have a personal or family history of opioid misuse. 
• Are concerned about side effects from opioids. 
• Undergo more complex procedures with higher expected discomfort. 
• Want to reduce the risk of dependency. 

Our surgeons will discuss whether Exparel® is a good option for you during your pre-surgical consultation.

Insurance and Cost Considerations

At present, most dental insurance plans do not cover Exparel®, so it is typically an out-of-pocket expense. Exparel® can be expensive with a vial costing $350+.

However, many patients find the benefits — including avoiding narcotics and recovering more comfortably — well worth the investment.

We are happy to provide a cost estimate and help you weigh your options before surgery.

Pain Management Tips for a Smoother Recovery

Regardless of whether you choose Exparel®, there are several steps you can take to manage discomfort after oral surgery:

1. Follow your surgeon’s instructions exactly: This includes when and how to take medications.
2. Use cold compresses: Ice packs can reduce swelling and numb the area in the first 24–48 hours.
3. Rest and elevate your head: Minimizes swelling and discomfort. 
4. Eat soft foods: Smoothies, yogurt, and mashed potatoes are gentle on healing tissues.
5. Stay hydrated: Helps your body heal more efficiently. 
6. Avoid smoking or alcohol: These can slow healing and increase pain.
    

Our Commitment to Safe, Effective Pain Relief

At Northwest Oral & Maxillofacial Surgery, patient safety is our top priority. We:

• Educate every patient about the risks and benefits of all pain relief options. 
• Use the lowest effective dose of medication for the shortest necessary time. 
• Offer opioid-free alternatives like Exparel® whenever possible. 
• Provide close follow-up to ensure pain is well managed.
   

Talk to Your Surgeon About Your Options

Your comfort and safety matter. If you’re concerned about opioid use or want to explore alternatives like Exparel®, let your surgeon know during your consultation. Together, we’ll create a personalized pain management plan that supports a smooth, safe recovery.

To learn more about Exparel® or schedule a consultation, contact Northwest Oral & Maxillofacial Surgery today.