Prescription Of Opioids In Dental Medicine
The United States is dealing with an opioid crisis. The number of people taking prescription opioids has never been higher, with 4.3 million people abusing them in 2014.
The Opioid Epidemic and Dental Medicine
The United States is dealing with an opioid crisis. The number of people taking prescription opioids has never been higher, with 4.3 million people abusing them in 2014. Although we frequently associate overprescribing with medical doctors, opioids are also commonly utilized in dentistry medicine.
Dental medications account for 10% of all opioid prescriptions in the United States, and their use has been continuously increasing since 1996. Dental opioid prescriptions in the United States are 37 times greater than in other developed countries.
Furthermore, up to 92% of opioids supplied to dental patients are never used. This means that there will be more prescriptions in the home, which could be abused by patients or other family members.
Dental Pain Management, Both Acute and Postoperative
These figures are even more startling when we consider that the American Dental Association (ADA) still recommends non-steroidal anti-inflammatory medicines (NSAIDs) as the first-line treatment for dental pain, rather than opioids.
Non-opioid analgesics are just as effective as opioids in treating dental pain, according to several high-quality studies. Despite this, some dentists continue to prescribe opioids without first attempting nonsteroidal anti-inflammatory drugs (NSAIDs). Even when opioids are required, the CDC recommends that they be prescribed for no more than three days.
Despite this, dental opioid prescriptions frequently exceed the three-day limit. Dentists also prescribe opioids for dental discomfort in children, increasing the risk of opioid exposure as children get older.
Following wisdom tooth removal, 3.5 million teenagers and young people were taken Vicodin, a mixture of hydrocodone and acetaminophen, which introduced them to opioids. The earlier a patient is exposed to opioids, the greater the risk of having an opioid use problem later in life.
Prescription Recommendations for Opioids
In collaboration with the American Dental Association (ADA), the Center for Disease Control and Prevention (CDC) developed guidelines for managing dental pain while still using opioids appropriately. In both the non-operative and postoperative situations, they advocate utilizing either NSAIDs or acetaminophen as first-line medication therapy, regardless of the severity of acute tooth pain.
If NSAIDs aren't working because of the risk of postoperative bleeding, there are other options before turning to opioids. Postoperative injections of long-acting anesthetics like bupivacaine, for example, can help reduce the risk of bleeding and making NSAIDs safer to take.
Opioids should only be taken for brief periods of time, according to the guidelines (three days or less). Dentists and long-term opioid prescribers should work together to manage decisions to use extra opioids prior to dental procedures or for acute dental pain in patients on chronic opioids.
Prior to prescription, dentists, like physicians, should consult state-specific Prescription Drug Monitoring Programs (PDMP). Dentists, like medical doctors, should be urged to discuss the hazards of these medications with their patients before prescribing them.
Responsible opioid prescribing in the dentistry industry is improving as a result of the implementation of national ADA standards, but we must continue to address opioid usage in both the medical and dental professions if we are to combat this epidemic.