Serrapeptase for Post Surgical Dental Pain
Abstract
Post operative dental pain often requires use of anti-inflammatories, steroids or pain medications, which all have possible complications associated with their use. Serrapeptase has demonstrated potential in managing the side effects post dental procedures which offers promise to be an alternative treatment for patients. This mini literature review looks at two high quality studies that explore the use of Serrapeptase for management of pain, swelling and trismus in patient post-surgical molar removal.
Introduction
Post operative pain is an important area of medicine, especially with the complexity that pain medication management can bring. With most patients being on multiple medications prior to surgery and pain medication offering many other complications from impact on gastrointestinal to addiction, alternatives to conventional pain management offers clinicians safer ways to support patients post surgically. Dental extractions are an excellent model to examine the impact of medication or natural substances on pain, swelling and muscle tension/trismus. These procedures can be easily matched for double blinded studies based on length of time for extraction and type of tooth- which allows for more accurate reflection of the effectiveness of the medication.
Serrapeptase or Serratiopeptidase is a protease produced by Enterobacterium serratia and is recognized in the medical field as an effective analgesic and anti-inflammatory. 1 Two studies examined the use of this supplement in the field of dentistry, specifically managing post operative symptoms with patients after a tooth extraction.
Review
The first study was a meta-analysis reviewing impact of serrapeptase in symptoms after surgical removal of impacted molars. The study limited to randomized controlled designs using serrapeptase alone or compared to other medication or placebo and measuring various outcomes. The compared medications included paracetamol, methylprednisolone and dexamethasone. Five studies were examined and determined to be moderate to high quality. The smallest study was 24 patients, while the rest were between 90-150 patients. Doses varied between 10 to 60 mg per day. The results were compiled based on outcomes- facial swelling and trismus respectively. Remarkable findings and trends were that serrapeptase outperformed steroids for controling trismus and overall, just as effective as steroids for reducing swelling after the first post-op day. Pain was too difficult to pool the data because of how the data was reported, and was not examined in the meta-analysis.
The second robust study evaluated use of Serrapeptase 5 mg or placebo as an adjunct to paracetamol 1000 mg. Thirty patients had their third molars removed in separate operations. The two operations were randomized into one of the two groups for each surgery. Their cheek thickness, interincisal distance and pain were measured with calipers and pain scale respectively for the first week after the operation. Results found pain reduction was statistically significant for the serrapeptase group. While trismus was not found to be significant, the authors acknowledged that this was not in line with other studies. Post-surgical swelling was also statistically significant.
Conclusions
Serrapeptase was found to be effective, managing trismus symptoms, swelling and pain to various degrees across these studies alongside other medication or instead of conventional treatments.
It is important to note that no complications or side effects were reported in any of the studies examining Serrapeptase. Additionally, its use alongside standard of care medications such as antibiotics, steroids and NSAIDS suggests its safety in using them concomitantly. Further research on optimal dosing and co-administration with other medication with other agents is warranted. Given the remarkable results of these studies more research into post-operative pain management and recovery should also be explored.
References:
Gowri Sivaramakrishnan, and Kannan Sridharan. “Role of Serratiopeptidase after Surgical Removal of Impacted Molar: A Systematic Review and Meta-Analysis.” Journal of Maxillofacial and Oral Surgery, vol. 17, no. 2, 18 Jan. 2017, pp. 122–128, pubmed.ncbi.nlm.nih.gov/29618875/, https://doi.org/10.1007/s12663-017-0996-9. Accessed 11 Sept. 2023.
Taiseer Hussain Al-Khateeb, and Y.M. Nusair. “Effect of the Proteolytic Enzyme Serrapeptase on Swelling, Pain and Trismus after Surgical Extraction of Mandibular Third Molars.” International Journal of Oral and Maxillofacial Surgery, vol. 37, no. 3, 1 Mar. 2008, pp. 264–268, pubmed.ncbi.nlm.nih.gov/18272344/, https://doi.org/10.1016/j.ijom.2007.11.011. Accessed 11 Sept. 2023.
