opioid

Insurance Companies Limiting Access to Opioids After Wisdom Teeth Surgery

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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

Persistent Opioid Use After Wisdom Teeth Removal

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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

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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 https://blog.teethremoval.com/opioid-prescriptions-from-dental-clinicians-for-young-adults-and-subsequent-opioid-use-and-abuse/ and https://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

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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

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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