Thornhill, M.H. orcid.org/0000-0003-0681-4083, Suda, K.J., Durkin, M.J. et al. (1 more author) (2019) Is it time US dentistry ended its opioid dependence? Journal of the American Dental Association, 150 (10). pp. 883-889. ISSN 0002-8177
Abstract
Background.
In 2017, 11.4 million US citizens misused prescription opioids, resulting in 46 overdose-deaths daily and a $78.5 billion burden on the economy. Dentists are one of the most frequent prescribers of opioids and there is concern that dental prescribing is contributing to the opioid crisis.
Methods.
A recent study showed 22.3% of US dental prescriptions were for opioids compared to 0.6% in England, where nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen accounted for most analgesic prescriptions. This observation prompted a review of international analgesic prescribing habits and of the advantages and disadvantages of opioids and NSAIDs for treating dental pain.
Results.
US opioid prescribing far exceeded that in other countries where NSAIDs accounted for the vast majority of dental analgesic prescribing. Furthermore, recent reviews confirm NSAIDs, and NSAID-acetaminophen combinations are as or more effective than opioids for controlling dental pain and cause significantly fewer side-effects.
Conclusions.
In light of the potential for misuse, and evidence that NSAIDs are as effective as opioids and have fewer side effects, there is clear patient benefit in avoiding opioids for the prevention or management of dental pain.
Practical Implications.
A growing preponderance of evidence shows that opioids are not needed for routine dental care. This article provides an overview of the evidence and outlines possible pain management models to minimize opioid use in dentistry. The purpose is to stimulate debate on this important topic and encourage the development of definitive guidance by professional bodies, health providers, and state and federal agencies.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019 American Dental Association / Elsevier. This is an author produced version of a paper subsequently published in Journal of the American Dental Association. Uploaded in accordance with the publisher's self-archiving policy. Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Odontogenic pain; postoperative analgesia; dental; opioid; nonsteroidal anti-inflammatory drugs; acetaminophen; analgesic; opioid crisis; guidelines |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 23 Jul 2019 08:47 |
Last Modified: | 24 Sep 2020 00:44 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.adaj.2019.07.003 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:148097 |
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Filename: JADA Accepted Manuscript (plain text) clean 06-28-19.pdf
Licence: CC-BY-NC-ND 4.0