According to the report from Department of Health and Human Services, dental caries is the most common chronic condition in childhood. But the prevalence of tooth decay is high in the adult population as well. Ultimately, untreated non-restorable decayed teeth require oral surgery. Additionally, surgical removal of impacted third molars (wisdom teeth) is a routinely performed procedure on a younger patient population. Approximately, 5 million people undergo extraction of third molars annually in the United States. Post-operative pain is common sequelae of oral surgery and limits function, thereby affecting the quality of life. Therefore, control of post-surgical pain is an essential component of patient management after oral surgery. The intensity of pain after surgery is usually moderate to severe and lasts for at least 3 days post-operatively. Local anesthetics are vital to post-operative multi-modal pain regimen. But due to its limited duration of action, prescription medications including opioids have been heavily relied upon.
According to the study conducted by the University of Michigan, Institute of Social Research, the use of opioids before high school graduation is linked with an increased risk of future opioid use by 33%. Considering, adverse effects of opioids and current opioid crisis, a need to use long acting local anesthetics prevails. One such example is, a single dose administration of liposomal bupivacaine (LB), the drug that is released over a period of 72 to 96 hours after its infiltration at the surgical site. The aim of this paper is to review the current literature on the use of LB after oral surgery, its formulation, and safety profile, and discuss future directions.