New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery

Recently this past year many posts appeared on this site discussing opioids being given after wisdom teeth surgery. Such posts include Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing, Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal?, Important Studies on Opioid Prescribing: Implications for Dentistry, and Studies and Opinions on Opioids After Wisdom Teeth Removal. It is clear that finding viable alternatives to opioids without the same addicting qualities is a worthwhile endeavor. A potential opioid alternative was discussed in the post Long-acting Local Anesthetic After Wisdom Teeth Removal. Recently in September, 2019, Rutgers School of Dental Medicine was awarded an $11.7 million grant from the National Institutes of Health to conduct research on the combination of ibuprofen and acetaminophen to be used as an alternative to opioids [1]. This study will involve 1,800 patients and will … Read more

Persistent Opioid Use After Wisdom Teeth Removal

An interesting article titled “Persistent Opioid Use After Wisdom Tooth Extraction” appears in JAMA in August 7, 2018, written by Harbaugh et al. (vol. 320, no. 5 , pp. 504-506). The article sought out to see if opioid painkiller prescriptions that many young adults receive after having wisdom teeth removed could set them on a path to long-term opioid use. The authors explored data from patients 13 to 30 years old who underwent wisdom tooth extraction in the Truven Health MarketScan Commercial and Dental database (from July 1, 2009-December 31, 2015). The MarketScan database contains de-identified data from insurance claims and includes 43 million to 55 million beneficiaries annually from the 50 states in the U.S. Patients were excluded from the data the authors explored if there was a lapse in enrollment, if the patient had an opioid prescription filled within 6 months … Read more

Dentists Should be Prepared to Refer to a Counselor, Psychologist or Psychiatrist

In recent years more and more dentists have had to deal with patients with substance use disorders. Wisdom teeth extractions are sometimes said to be a potential cause of a later substance use disorder, see for example http://blog.teethremoval.com/painkiller-overdose-in-michigan-are-wisdom-teeth-extractions-contributing/. Even though dentists and oral surgeons have taken steps in recent years to reduce the amount of drugs they prescribe to their patients that would possibly be used for non-medical purposes this may not entirely solve the problem. If through the course of a patient evaluation, a dentist becomes aware of a possible drug or alcohol problem, they should be prepared to refer their patient to a counselor, psychologist or psychiatrist. As such they should have several possibilities available for the referral. The American Dental Association (ADA) had a webinar series several years ago titled “Interviewing and Counseling of patients with substance use … Read more

What Can a Surgeon Do to Prevent Opioid Abuse

An interesting article titled “The Surgeon’s Roles in Stemming the Prescription Opioid Abuse Epidemic” written by James Hupp appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 1291-1293). The article describes the current challenges oral and maxilofacial surgeons are facing when it comes to prescribing opioids. This is because regulators and politicians are getting involved due to their perception of an opioid abuse problem. He mentions that Congress is considering legislation to address prescription drug addiction problems. The author wants surgeons to remember that there are legitimate reasons for giving patients who have had oral surgery such as wisdom tooth extractions an opioid medication.  Pain that interferes with a patient’s usual routines, their ability to consume enough fluids and calories, or their ability to sleep often requires a narcotic until the pain subsidizes. As such these patients should be prescribed opioids … Read more

Comparing Narcotic Prescribing Habits For Oral Surgeons in the U.S. and Canada

In a previous blog post titled “Do Oral Surgeons Prescribe Too Many Narcotics for use after Wisdom Teeth Removal?” the issue explored was that of whether or not oral surgeons prescribe more than an adequate amount of narcotic pain killers to young adults after wisdom teeth extraction. The article that found around 25% or so of the study respondents prescribe what the authors of the article declared as too many narcotics to control pain which opened the possibility of non-medical use. A new article titled “Comparison of Narcotic Prescribing Habits and Other Methods of Pain Control by Oral and Maxillofacial Surgeons in the United States and Canada,” sought to explore whether Canadian oral surgeons have similar narcotic prescribing habits. This article was written by Bruce R. Pynn and Daniel M. Laskin and appeared in the December 2014 issue of the … Read more