Postoperative pain commonly follows dental procedures, and appropriate analgesic selection plays a critical role in its management. This systematic review evaluated the efficacy and safety of tenoxicam compared with other pharmacological agents for postoperative dental pain control. Indexed databases, including PubMed, EMBASE, Ovid, Scopus, Web of Science, and the Cochrane Library, were searched through August 2025. Risk of bias was assessed using the Cochrane Risk of Bias tool for interventions. Nine randomized controlled trials met the inclusion criteria and covered a range of dental procedures, including third molar extraction, endodontic treatment, orthodontic adjustment, and implant surgery. Comparators included placebo, ibuprofen, diclofenac, flurbiprofen, meloxicam, methylprednisolone, and rofecoxib. Pain outcomes were measured primarily with the Visual Analogue Scale at multiple postoperative time points. Across studies, tenoxicam showed analgesic efficacy that was generally superior or comparable to other agents, with several trials reporting statistically significant reductions in pain scores at both early and later postoperative intervals. Most studies had low overall risk of bias, although some raised concerns related to allocation concealment and outcome reporting. Tenoxicam appears to be an effective and well-tolerated option for postoperative dental pain management. Study heterogeneity and domain-level bias concerns indicate a need for additional high-quality trials to confirm these findings and support routine clinical use.