Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal?

An interesting article titled “Do Oral and Maxillofacial Surgeons Over-Prescribe Opioids After Extraction of Asymptomatic Third Molars?” written by Resnick et al. appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. The authors perform a study using patients at Boston Children’s Hospital in Boston, Massachusetts to determine how many opioids (taken as oxycodone) they take after having wisdom teeth extracted. This study was motivated by some recent studies that has shown that patients given opioids for dealing with pain after wisdom teeth surgery can go on to abuse opioids, see for example the posts Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse and Persistent Opioid Use After Wisdom Teeth Removal. In the article the authors devised a study to determine how many narcotic and non-narcotic pain relief pills are taken … Read more

Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing

Recently, both insurance companies and politicians in the U.S. have intensified their efforts to limit patients undergoing wisdom teeth surgery to have access to opioids to manage their pain. See the posts on this site: 1) Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery and 2) The Effect of Opioid Prescription Limits For Wisdom Teeth Removal. Such efforts have intensified due to recent research showing that opioid prescriptions taken by young adults following wisdom teeth removal has contributed to the opioid addiction and abuse epidemic in the U.S. However, lost in these conversations is the perspectives from oral and maxillofacial surgeons. According to the 2017 white paper by the American Association of Oral and Maxillofacial Surgeons (AAOMS) titled “Opioid Prescribing: Acute and Postoperative Pain Management,” these surgeons feel: “… the practitioner-patient relationship must be upheld, allowing for practitioner … Read more

The Effect of Opioid Prescription Limits For Wisdom Teeth Removal

Recently it has been discussed how insurance companies have begun to limit prescriptions for opioids for teenagers due to recent studies suggesting that many young adults may later become addicted to opioids as a result of wisdom teeth removal, see Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery. In addition to insurance companies taking action, some politicians in the U.S. have proposed legislation to limit opioid prescriptions for seven days. On March 15 2019, U.S. Senators Kirsten Gillibrand (a Democrat from New York) and Cory Gardner (a Republican from Colorado) announced the John S. McCain Opioid Addiction and Prevention Act which would limit the supply of initial opioid prescriptions for acute pain to seven days. This bill would would create a seven-day prescription limit for opioids so that no more than a seven-day supply may be prescribed to … Read more

Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery

Recently on this website, two articles were published discussing possible opioid abuse stemming from prescriptions given after wisdom teeth surgery, see 1) Persistent Opioid Use After Wisdom Teeth Removal and 2) Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse. The first article discussed a 2018 JAMA article which found that that those who filled an opioid prescription from up to 7 days before until up to 3 days after wisdom teeth removal were 2.69 times as likely than those who did not to continue to fill opioid prescriptions weeks or months later after the wisdom teeth surgery. The second article discussed a 2018 JAMA Internal Medicine article which found that being given opioids by a dentist or oral surgeon for those who had never previously used opioids had higher rates of opioid use at … 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