Opioid Crisis and Dentistry's Historical Role: Learning and Changing Practice
Dentists have been significant contributors to opioid prescribing in the United States — studies show that dentists are among the top prescribers of opioids per encounter, largely for post-operative pain management after extractions and oral surgery. Research suggests that opioids prescribed for dental procedures have served as a gateway to opioid use disorder for some patients, and that opioid-naive adolescents who receive opioid prescriptions after wisdom tooth extraction have elevated rates of subsequent opioid use. At the same time, undertreated acute dental pain causes real suffering. How do you think about the dental profession's historical role in the opioid crisis, and how has the evidence changed how you would approach post-operative analgesic prescribing in your future practice?
Likely follow-up · A patient who underwent surgical extraction of all four wisdom teeth under IV sedation calls your office the day after the procedure, saying the ibuprofen and acetaminophen you prescribed are not adequately controlling his pain and he is asking for something stronger. How do you manage this request?