Figure 3 Effects of NSAIDs on cyclooxygenaseCreated with BioRender.com. The mechanism of action of NSAIDs is connected with the inhibition of cyclooxygenase (COX), which blocks the conversion of arachidonic acid to proinflammatory prostaglandins. NSAIDs reduce inflammation and pain in periodontitis/mucositis or after oral surgery. Although COX exists in 2 isoforms (COX-1 and COX-2), COX-2 is responsible for proinflammatory effects, while COX-1 serve mainly physiological functions. Therefore, most NSAID adverse effects are associated with COX-1 inhibition including gastrointestinal damage, liver damage or cardiovascular complications.