Important Studies on Opioid Prescribing: Implications for Dentistry

Recently on this site several articles have appeared discussing opioid prescribing after wisdom teeth removal see for example the posts Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal? and Opioid Prescriptions From Dental Clinicians for Young Adults and Subsequent Opioid Use and Abuse. Very recently several interesting studies regarding opioid prescribing have published. The first study is titled “Trends in Opioid Prescribing for Adolescents and Young Adults in Ambulatory Care Settings” written by Hudgins et al. appearing in Pediatrics in June 2019 (vol.143, no. 6, e20181578). The article explored opioid prescribing for adolescents (ages 13 to 17) and young adults (ages 18 to 22) receiving care in emergency departments and outpatient clinics. Data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) and National Ambulatory Medical Care Survey (NAMCS) over the time period from January 1, 2005, … Read more

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

Opioid pain relievers to reduce overdose risk

Researchers at the The Scripps Research Institute (TSRI) in Florida have developed opioid pain relievers that do not slow or stop breathing which is the cause of overdose. According to the U.S. Centers for Disease Control and Prevention, 91 Americans die every day from opioid overdoses when opiates like heroin, oxycontin, and fentanyl slow and later stop a person’s breathing. The research shows that a range of compounds can deliver pain-blocking potency without affecting respiration. The study builds on two decades of research, where the researchres have long explored whether the painkilling pathway, the G protein pathway, could be unlinked from the breathing suppression pathway, the beta-arrestin pathway. The researchers had their doubts about being able to separate out the pathways and also wanted to know how much separation was needed to see analgesia without respiratory suppression. For the study, the researchers worked to develop … Read more

How to Avoid Opioid Addiction When You’re Prescribed Pain Medication

Have you been prescribed pain medication, but worry that you might become addicted to it? This fear is common, and it’s also valid. Some pain medications can alter your brain in a way that doesn’t just keep the pain away, but can leave your body craving more than you once needed to have the same effect. Long-term use of pain medication, especially, can cause an addiction. Here’s what you need to know to avoid becoming addicted to your pain medication. What Pain Medications are Addictive? From drugs to help prevent migraines to prescriptions for menstrual pain, there is a medication for just about any type of pain you can have, from mild to severe. Some pose a rare chance of an addiction, whereas others can have more serious consequences. Unfortunately, virtually any medication carries a risk of causing an addiction … Read more

Comparing Ibuprofen and Etodolac on Swelling and Pain After Wisdom Teeth Removal

An interesting article titled “Comparative Assessment of the Effect of Ibuprofen and Etodolac on Edema, Trismus, and Pain in Lower Third Molar Surgery: A Randomized Clinical Trial” appears in the 2016 Journal of Oral an Maxilofacial Surgery written by Julio Cesar Silva de Oliveira and et al. (vol. 74, pp. 1524-1530). The authors set out to explore if ibuprofen or etodolac is more effective in managing pain, swelling, and trismus after wisdom teeth removal. After wisdom teeth removal symptoms such as swelling, pain and limited mouth opening (trismus) can present. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the rapid relief of moderate pain in inflammatory conditions and soft tissue trauma. The mechanism of action of NSAIDs is the inhibition of the release of cyclooxygenase (COX), an enzyme that is responsible for the production of prostaglandins (PGs). Ibuprofen is an NSAID which inhibits COX-1 and COX-2. Etodolac differs from other NSAIDs by being … Read more