Opioids for tooth pain

Published on Friday, November 10, 2023, recent research highlights a significant shift in the use of opioids during dental procedures in the United States. Compared to just a few years ago, individuals undergoing tooth extractions or similar painful dental processes are considerably less likely to receive opioid prescriptions, marking a positive turn in addressing the widespread issue of opioid misuse in the country.

However, amidst this encouraging trend, a study reveals a setback that occurred in curbing opioid use within dental care during the pandemic. The research indicates that the efforts to minimize opioid prescriptions faced challenges during the pandemic period, causing a deceleration in the reduction of opioid usage, as noted by Dr. Kao-Ping Chua, the senior study author and assistant professor of pediatrics at the University of Michigan (UM) Medical School.

The data illustrates a notable decline of 45% in dental opioid prescriptions dispensed to patients of all ages from 2016 through 2022, yet approximately 7.4 million dental patients still received opioid prescriptions in 2022. Although prescriptions for teenagers and young adults, who are particularly vulnerable to opioid-related risks, continued to decrease rapidly even during the pandemic pause, other demographic groups experienced a slower rate of decline post-June 2020.

The study suggests that if the decline had sustained its previous pace, 6.1 million fewer dental opioid prescriptions would have been issued between June 2020 and December 2022.

While acknowledging the progress made in reducing opioid prescriptions in dentistry, Dr. Romesh Nalliah, the study’s co-author and associate dean for clinical affairs at the UM School of Dentistry, emphasized the need for intensified efforts to curb unnecessary opioid prescribing within the dental profession.

The study also speculates that the pandemic might have led to dentists prescribing opioids preventatively due to concerns about patients’ follow-up accessibility during that time.

Utilizing data from IQVIA, a company tracking prescriptions from 92% of U.S. pharmacies, the researchers excluded data from March to May 2020 due to a pause in routine dental care caused by the pandemic.

The pandemic-induced changes in dental opioid prescriptions varied across different dental specialties. The study found that the decline in opioid prescribing by oral and maxillofacial surgeons, who handle complex dental procedures for individuals with advanced dental conditions, slowed to a lesser extent compared to general dentists and dental sub-specialists.

Moreover, the research highlighted a 57% increase in dental opioid prescriptions for low-income Medicaid-covered patients and a 30% rise for privately insured patients compared to predicted trends. The authors theorized that limited access to dental care among Medicaid patients might have led to more painful dental emergencies, thereby increasing the demand for opioids.

Notably, the distribution of dental opioid prescriptions in 2022 showed that nearly 56% were received by individuals residing in the Southern United States. Meanwhile, the decline in opioid prescriptions among individuals in the Northeast slowed down significantly compared to other regions. Specifically, by late 2022, dental opioid prescribing in the Northeast was 69% higher than anticipated if the pre-pandemic decline had continued, in contrast to a 23.8% increase in the Southern region.

Source: U.S.News


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