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

Long-acting Local Anesthetic After Wisdom Teeth Removal

A new medication called Exparel produced by Pacira Pharmaceuticals provides an alternative to opioids for use as pain relief following wisdom teeth removal. Exparel is a long-acting local anesthetic that is delivered during the surgery that numbs the site of surgery for up to three days. Exparel is not an opioid and is not habit forming and therefore will not lead to any opioid addiction. Many patients are already familar with local pain analgesics such as lidocaine that are given as a dental injection to numb an area for several hours. Exparel is a long lasting analgesics which seems to share some similarities but lasts much longer. Recently the use of opioids after wisdom teeth removal has been more closely scrutinzed, see for example http://blog.teethremoval.com/opioid-prescriptions-from-dental-clinicians-for-young-adults-and-subsequent-opioid-use-and-abuse/ and http://blog.teethremoval.com/persistent-opioid-use-after-wisdom-teeth-removal. Many are concerned that patients having wisdom teeth surgery are exposed to opioids … Read more

Alternatives To Painkillers After Dental Work

It is common for people to have pain after they have dental work. That is why dentists often prescribe opiates. However, opiates can cause dangerous side effects. They can also be addictive. Fortunately, there are many alternatives to opiates. To learn more about opiate addiction, please visit The Recovery Village website. Over-the-Counter Medication  Many people find that over-the-counter pain relievers, such as Tylenol and Advil, can alleviate toothaches. They can also reduce inflammation. If you find that over-the-counter relievers are not working, then your dentist can write you a prescription for a stronger medication.  Apply Ice  Ice is one of the most effective home remedies for alleviating pain after toothaches. Not only can ice alleviate pain but it can also get rid of inflammation. You will need to wrap the ice up in a towel or paper towel before you apply … Read more

Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse

A very interesting article titled “Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse” written by Schroeder et al. was published online on December 3, 2018, in JAMA Internal Medicine. The article sought out to examine the association between dental opioid prescriptions from dental clinicians for adolescents and young adults and new persistent use and subsequent diagnoses of abuse. The article states that dentists are the leading source of opioid prescriptionsfor children and adolescents from age 10 to 19 and in 2009 prescribed 31% of total opioids given to this age group. A common source of dental opioid exposure is of course wisdom teeth extractions. The article states that the authors were at least partially motivated to perform their study over the controversy surrounding whether or not one should extract or retain healthy wisdom … Read more

Exploring opioid deaths in chronic pain patients

Research has found that over half of patients who died from an opioid overdose had been diagnosed with chronic pain and many had psychiatric disorders. The study was conducted by researchers at Columbia University. According to the U.S. Centers for Disease Control, the number of opioid-related deaths has quadrupled in recent years, from 8,048 in 1999, to 33,091 in 2015, and the researchers were interested in learning more about what lead those patients to take opioids. The researchers analyzed clinical diagnoses and filled medication prescriptions for 13,089 adults in the Medicaid program who died of an opioid overdose from data collected between 2001 and 2007. During the last year of life, more than half of these adults (61.5%) had been diagnosed with chronic pain and many had also been diagnosed with depression and anxiety. This included 59.3% who were diagnosed with … Read more