As a dentist, you're already aware of the profession’s link to the opioid crisis. You know that many patients, especially teens and young adults, are exposed 
to opioids for the first time following a dental procedure, such as wisdom tooth extraction or a root canal. In fact, dentists prescribe 12% of IR opioids in the U.S., behind only family physicians, who prescribe 15%, according to a study published in the Journal of the American Dental Association (JADA). Though your intentions to relieve your patients’ pain are well-intentioned, the realities of prescription drug abuse and addiction are sobering. Recent studies indicate that more needs to be done to treat postprocedural pain responsibly.
The alarming statistics at a “macro” level help to contextualize the conversation. Opioid overdoses killed more than 42,000 people in 2016, and 40% of those deaths were from prescription opioids. In 2016, the number of overdose deaths involving opioids was 5 times higher than in 1999 (CDC). There’s a significant danger to adolescents, as legitimate opioid use before high school graduation is independently associated with a 33% increase in the risk of future opioid misuse after high school (American Academy of Pediatrics).
On the “micro” level of the dental profession, statistics from studies published in the Journal of the American Dental Association start to hit home:
- Over a six-year period, approximately 68% of all opioids prescribed were during surgical dental visits and approximately 31% during nonsurgical dental visits. During nonsurgical dental visits at which dentists prescribed an opioid, most of the procedures were restorative.
- Across all age groups over the same period, opioid prescriptions increased by 17 per 1,000 dental patients.
- The largest increase in opioid prescriptions was among patients aged 11 to 18; and 11 to 18 and 19 to 25 age groups received a higher median dose than all other age groups.
But there’s a crucial takeaway from another recent study published in JADA: for adults, a combination of 400 mg of ibuprofen plus 1000 mg of acetaminophen was superior to any opioid-containing medications studied. The findings support the ADA’s 2016 policy statement that dentists “consider [NSAIDs] as the first-line therapy for acute pain management.”
In addition to supporting statutory limits on opioid dosage, the ADA supports mandatory continuing education (CE) in prescribing opioids and other controlled substances.
Dental Learning now offers an excellent opportunity to obtain CE on this crucial topic, all while learning about the new ADA policy on opioids and NSAIDs. The comprehensive course, “Analgesics in Dentistry”, reviews opioid medications before focusing on non-opioid analgesics, as both monotherapy and combination therapy “for the safe and effective management of acute postprocedural pain in dentistry.”
We want to help you give your patients a fighting chance against postprocedural pain without using opioids. Through 9/30/18, take Dental Learning’s 2 CE course “Analgesics in Dentistry” for free.