With the way we can manage pain these days, I rarely have to prescribe pain medication to a patient anymore. We give our patients complete 24 hour access to the dentists in our office, allowing us to quickly provide treatment before the situation gets super painful. There are still those cases however that require a little extra nudge toward comfort, and Vicodin has often been a great adjunct to care without jumping into the triplicate forms of Percocet. We still would rather avoid medication if we can. For example, Vicodin caries a narcotic, hydrocodone, which has some addictive potential. It also has acetaminophen, or Tylenol, which we now know can be toxic to the liver.
Because of this second point, the FDA changed the regulations for the formulations of Vicodin last year, and we are now starting to see the drug companies catching up. Currently, Vicodin is available as Vicodin, Vicodin ES, and Vicodin HP. The highest amount of acetaminophen is in Vicodin ES, at 750 mg. The new regulations require that there be no more than 325 mg per dosage unit of Vicodin or any other combo drug. Drug companies such as Abbott are dropping all three formulations down to only 300 mg of acetaminophen. The final date of compliance is January 2014, so keep an eye out for additional changes coming from other manufacturers.
Keep in mind, if you need an extra boost of an anti-inflammatory, you can always call in a prescription for ibuprofen as well since there is no problem with taking that concurrently with Vicodin. You can get more information from the FDA on their website here