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

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

Senate Report Calls for Removing Deceptive Corporate Dentistry Entities From Medicaid

Previously I have written an article titled Fraud and Abuse in Medicaid Clinics where a discussion was made that currently dentists have large amounts of debt when they graduate from school. This leads to them having to face potentially hard and difficult choices to pay their bills as they essentially become indentured servants. Recently Senators Charles Grassley (R-IA) and Max Baucus (D-MT) published a 1517 page report in June 2013, titled “JOINT STAFF REPORT ON THE CORPORATE PRACTICE OF DENTISTRY IN THE MEDICAID PROGRAM.” This report is a very large PDF file (143 MB) and is available for download over at http://www.finance.senate.gov/library/prints/.  Don’t be intimidated by the size of the report though as it really is a bit over 30 pages with the rest of the 1400+ pages serving as an appendix. Hence, it is very readable. The report talks … Read more

The Right to Health and Information

An interesting article is written by Trudo Lemmens and Candice Telfer titled “Access to Information and the Right to Health: The Human Rights Case for Clinical Trials Transparency,” which appeared in the 2011 issue of the American Journal of Law and Medicine (vol. 38, pages 63-112). In the article the authors argue that information about clinical trials should be recognized as a fundamental component of the right to health. The authors make a mention of two controversies in recent years. The first is of GlaxoSmithKline and its use of the antidepressant Paxil for treatment of depression in the pediatric population. In 2004, the Attorney General of New York prosecuted GSK for allegedly hiding negative data, selective publishing of positive data, and use of skewed publications to promote off-label prescriptions. The second case is the mention of Vioxx in which the … Read more

Fraud and Abuse in Medicaid Clinics

I have previously discussed on this blog how students graduating from medical school have an average debt of around $158,000 and the average debt of those graduating from undergraduate college is around $27,000 in the U.S.  In fact, the video called College Conspiracy https://blog.teethremoval.com/college-conspiracy-and-united-states-hyperinflation/ profiles a dentist who is stuck with with high loans from school  (around the 11 minute mark). One quote appearing in this video is “…as soon as you get out of school you are indentured for life.” This figure below showing the inflation cost of college tuition (in blue), medical care (in red), and general inflation (in black) from http://www.leftbusinessobserver.com/College.html pretty much tells more of the story. In fact I would argue that college tuition costs and medical costs are correlated with each other and you should be able to calculate some sort of correlation coefficient. An interesting article titled “Our Junior Colleagues … Read more