FDA warns about dental problems from buprenorphine

The U.S. Food and Drug Administration (FDA) has issued a safety concern regarding the medication buprenorphine which is a medication used to treat opioid use disorder, acute pain, and chronic pain. Buprenorphine is often used to reduce opioid withdrawal symptoms and the desire to use opioids, without causing the cycle of highs and lows associated with abusing opioid. The FDA warning issued on January 12, 2022, states that dental problems have occured when patients take medicines containing buprenorphine that are dissolved in the mouth. In the warning, the FDA said that the dental problems can include those of tooth decay, cavities, loss of teeth, and oral infections, and can occur in those without prior dental issues. As a result of this warning, the risk of dental problems occuring will be added to the prescribing information and the patient Medication Guide … Read more

Low-Dose Naltrexone as An Alternative to Opioids for Wisdom Teeth Removal

Before on this site numerous posts have discussed how many feel dentists and oral surgeons prescribe (or in the past have prescribed) too many opioids for their patients to help manage pain of dental procedures like wisdom teeth removal, see for example the post Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal?. In recent years there have been investigations into alternatives to opioids for dental procedures and also for chronic pain management when opioids in the past were more regularly prescribed for as well. One such approach is to prescribe a combination of ibuprofen and acetaminophen as discussed in the articles New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery and Reducing Opioids in Oral and Maxillofacial Surgery. Recently, there have been articles and … Read more

Reducing Opioids in Oral and Maxillofacial Surgery

An interesting article titled “Opioid Prescribing Can Be Reduced in Oral and Maxillofacial Surgery Practice,” written by Tatch appears in the 2019 edition of the Journal of Oral and Maxillofacial Surgery. In the article the author discusses the results of implementing an office protocol for pain management to reduce opioid use in oral and maxillofacial surgery during a three year time period. Results from a similar study were presented previously in a post titled Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing. In the article the author discusses how a risk of opioids is dependence which can develop after just one week of using. The author came up with a 3-year retrospective study to measure changes in opioid use after the introduction of an office protocol which was designed to offer alternatives to pain relief. In the study a … Read more

Dentists Overprescribing Opioids to Adults in the U.S.

In the past on this site, some studies have discussed how dentists and oral surgeons may be prescribing too many opioids to their patients. For example see the posts Important Studies on Opioid Prescribing: Implications for Dentistry, 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. Now a new study has recently appeared in the American Journal of Preventative Medicine titled “Overprescribing of Opioids to Adults by Dentists in the U.S., 2011–2015”, written by Suda et al. (pp. 1−14, 2019 in press). The study found that between 25% and 50% of opioids prescribed to adults by dentists in the U.S. are overprescribed. This is important because dentists are responsible for prescribing 10% of all opioids to patients in the U.S. The authors feel that urgent … Read more

New Research Being Conducted at Rutgers for Opioid Alternatives Could Lead to Less Potential Drug Abuse for those Having Wisdom Teeth Surgery

Recently this past year many posts appeared on this site discussing opioids being given after wisdom teeth surgery. Such posts include Oral and Maxillofacial Surgeons Current Perspectives on Opioid Prescribing, Do Oral Surgeons Give Too Many Opioids for Wisdom Teeth Removal?, Important Studies on Opioid Prescribing: Implications for Dentistry, and Studies and Opinions on Opioids After Wisdom Teeth Removal. It is clear that finding viable alternatives to opioids without the same addicting qualities is a worthwhile endeavor. A potential opioid alternative was discussed in the post Long-acting Local Anesthetic After Wisdom Teeth Removal. Recently in September, 2019, Rutgers School of Dental Medicine was awarded an $11.7 million grant from the National Institutes of Health to conduct research on the combination of ibuprofen and acetaminophen to be used as an alternative to opioids [1]. This study will involve 1,800 patients and will … Read more