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

Staying Upbeat when Facing Teeth Removal

For those who are deciding to retain or to extract healthy impacted wisdom teeth or for those who have a tooth or teeth that has a clear indication for removal, you may find yourself at times feeling sad or experiencing sadness. Perhaps this sadness is from thinking about the costs and expenses needed to have great dental health and thinking about how people in other countries might have cheaper health care yet still have good outcomes. Perhaps this sadness is from looking over what seems to be countless complications occurring from wisdom teeth such as on the wisdom teeth complications page on this site and thinking about the negative effect it had on those lives. Perhaps this sadness is from thinking about all the time and effort that is required with a dental malpractice lawsuit and feeling sorry for those … 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

Litigation Resulting from Anesthesia in Oral Surgery

A very interesting article titled “Medical Malpractice Litigation Associated With Anesthesia in Oral and Maxillofacial Surgery,” by Ji et al. appears in the Journal of Oral and Maxillofacial Surgery (vol. 76, pp. 1606-1610, 2018). The article attempts to explore malpractice in oral and maxillofacial surgery where anesthesia is involved that does not purely rely on media reports. In the study the authors used the Thomson Reuters Westlaw Next Database, to identify medical malpractice cases filed from 1985 through 2017. The cases included must have involved an oral and maxillofacial surgeon as a defendant. Furthermore, complications had to be attributable to local, intravenous, or general anesthesia delivered and the cases had to have progressed to trial by jury in a state or federal court. The authors identified an initial list of 112 cases but reduced the sample down to just 13 … Read more