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It’s a rite of passage in the teen years: wisdom teeth removal. But this common surgery comes with a troubling practice. When it’s done, teens are likely to be prescribed opioids for pain relief. That may have lasting consequences.1

Oral surgeons and dentists remove wisdom teeth from millions of people per year.2 The majority are under 25. This experience could be the first time a teen uses an opioid and feels its effects. High school students who receive an opioid prescription are 33 percent more likely to later misuse opioids.3

Not only do many teens take prescription opioids after wisdom teeth removal, but many leave pills unused when their pain subsides. That can leave the pills available for non-medical misuse.

A 2016 study published in the journal Drug and Alcohol Dependence revealed a startling finding. The researchers estimated that patients leave as many as 100 million opioid pills unused from post-dental surgery prescriptions.4

Those leftover pills can be a big problem. Studies show family and friends are the source of most abused prescription drugs.5

How can dentists and oral surgeons treat their patients for pain without contributing to the opioids crisis?

  1. Understand the Centers for Disease Control and Prevention recommendations for safe opioid prescribing.6 About half of all prescriptions fell outside of the 2016 CDC guidelines. That’s according to Dr. Darshak Sanghavi, chief medical officer of OptumLabs.®
  2. Follow the American Dental Association’s (ADA) recommendations.7 Those include considering NSAIDs and/or acetaminophen first for pain. They also include talking to patients about opioids and screening them for risky substance use behaviors.
  3. Take advantage of training opportunities. The ADA’s Practical Guide to Substance Use Disorders and Safe Prescribing is one example.8

How can parents help their teens control pain and stay safe? By discussing pain relief with the oral surgeon or dentist completing the procedure.

  1. Ask about their method for controlling post-procedure pain. Find out the goal of the approach and how long a prescription will last.
  2. Ask if there are alternatives to opioids for pain relief.
  3. Share any concerns, including worries about the danger of addiction.
  4. If an opioid is considered clinically warranted, consider asking for a one- or two-day supply at most. Then request refills from the provider’s office (not the pharmacy) if needed.
  5. Ask what to do with any leftover pills.

Patients and providers should weigh all the pros and cons when considering an opioid prescription. That’s true for wisdom teeth removal or any other type of procedure.

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References

  1. General DentistryDental therapeutic practice patterns in the U.S. II. Analgesics, corticosteroids, and antibiotics. Published May 2006. Accessed Sept. 7, 2018.
  2. American Dental Association. 1999 survey of dental services rendered. Unpublished report cited in The Prophylactic Extraction of Third Molars: A Public Health Hazard. Published September 2007. Accessed Sept. 7, 2018.
  3. Pediatrics. Prescription opioids in adolescence and future opioid misuse. Published November 2015. Accessed Sept. 7, 2018.  
  4. Drug & Alcohol Dependence. Unused opioid analgesics and drug disposal following outpatient dental surgery: A randomized controlled trial. Published Nov. 1, 2016. Accessed Sept. 7, 2018.  
  5. Drug Enforcement Administration press release. Published Nov. 7, 2017. Accessed Sept. 7, 2018.
  6. CDC Guideline for Prescribing Opioids for Chronic Pain. Published Aug. 29, 2017. Accessed Sept. 7, 2018.  
  7. American Dental Association. FAQs on Opioid Prescribing. Published Aug. 9, 2018. Accessed Sept. 7, 2018.  
  8. The ADA Practical Guide to Substance Use Disorders and Safe PrescribingPublished July 2015. Accessed Sept. 7, 2018.