Dental Care and Opioid Use Disorder – A Shocking Connection

The opioid epidemic is a complex problem affecting much of America. According to the National Institutes of Health, approximately 128 people die every day because of opioid overdoses. In 2017, an estimated 1.7 million people fell victim to a prescription opioid use disorder. The opioid crisis has led many healthcare and government leaders looking for a reason, and some have come up with a surprising potential source – the dentist’s office.

Could a simple trip to the dentist leave you or your child with a lifelong drug addiction? While this might sound far-fetched, current research shows it is a true possibility, and for a reason, many people would not normally think about. In a recent report, UnitedHealthcare’s health insurance company shed some light on the connection between dental work and the opioid epidemic.

Early Opioid Prescription Increases Risk of Opioid Addiction

A 2015 study released by the American Academy of Pediatrics indicates that prescribing opioids before 12th grade increases the risk of becoming addicted to opioids by 33%. Even if the prescription had a legitimate reason, such as recent surgery, if it occurred before a child graduates high school, the risk of future diction was quite high.

Dentists Prescribe Opioids to Young People at Higher Than Average Rates

So, what is the connection between opioid use disorder and dental care? According to the UnitedHealthcare report, dentists prescribe approximately 12% of the nation’s opioids. Yet in the 19 and under the category, they are responsible for 54% of opioid prescriptions. Since these early prescriptions greatly increase the risk of an opioid use disorder, this is a problem worth looking into more closely.

Why Are Dentists Prescribing Opioids to Teenagers?

So why are dentists prescribing opioids to the 19 and under population at such a high rate? The answer is simple. This is the age when most people need their wisdom teeth extracted. Dentists are quick to send families home with a prescription for opioid painkillers after wisdom tooth removal, and well-meaning parents fill the prescription to keep their children comfortable. Yet doing so can have serious repercussions. Pairing a person’s first major oral surgery with age at high risk for opioid addiction is a dangerous combination.

How bad is the risk? It’s awful, according to a 2018 study in the Journal of the American Medical Association. Not only is the risk of early opioid use putting kids at higher risk of future opioid abuse, but the study found that filling an opioid prescription after wisdom tooth removal made a teenager almost three times more likely to continue opioid use over the following year.

Are dentists irresponsible by prescribing opioids in this way? The research into the connection between opioid use disorder and the early use of opioids is relatively new, so some dentists may simply be following standard procedures as they have for decades. In many ways, it is up to patients and parents of patients to advocate for their own health and avoid the risk of opioid prescriptions after wisdom tooth removal surgery.

Potential Solutions to the Dental Care and Opioid Connection

Now that the connection between dental care and opioid use disorder is clear, what needs to happen to prevent this problem from growing? The opioid crisis is a complex problem, and dental care is not the only cause, but some steps can help limit the impact of oral surgery on future drug abuse. Here are some strategies that can help:

• Pharmacies can adopt policies to limit the number of opioids prescribed to teenagers. By limiting the 19 and under population with first-time opioid prescriptions to no more than three days, the risk of future drug abuse decreases significantly.
• Dental offices need better education about the risk of opioid abuse disorder connected to wisdom tooth extraction. This, in turn, may encourage dentists to offer alternative options to their patients for pain control after this common procedure.
• Parents of patients undergoing wisdom tooth extraction should receive literature helping them understand the risk to make informed decisions about their child’s pain management plan.

Checklist for Talking with Your Dentist About Opioid Prescriptions

If you or your child is heading to the dentist for wisdom tooth surgery or another oral surgery, take some time to do some research over your options. Here are some questions you can ask as you talk with your dentist about your post-procedure pain management.

1. What alternatives do I have over prescription painkillers?

Many dentists prescribe prescription painkillers because they feel it is the best option and their patients’ option. If you ask about alternatives, they may happily provide them. Opioids work best for severe pain, which you may not experience after wisdom tooth removal. Other options that have no drug abuse connection include:

• Acetaminophen (Tylenol)
• Aspirin
• Ibuprofen
• Naproxen sodium

These are all over-the-counter medications that often provide enough pain relief for wisdom tooth surgery. Ice packs on the jaw and a soft-food diet also help. When OTC medications aren’t sufficient, long-lasting anesthetics may work just as well as opioids at preventing immediate post-surgery pain.

2. Am my child or I at risk for addiction?

Have an open discussion with your dentist about the risk of drug abuse for you or your child. If either of you feels the risk is high, push for alternative pain relief methods.

3. Do these painkillers interact with the other medications or supplements I am taking?

If you or your child take medications or supplements regularly, discuss them with your dentist or pharmacist before the procedure or before filling the opioid prescription. Opioids can mix dangerously with other drugs, especially drugs used to treat anxiety, epilepsy, or sleeping disorders. The same is true for over-the-counter medications. Many prescription painkillers have similar ingredients to OTC painkillers, and you should not take them simultaneously.

4. How can I ensure I am taking the right amount?

If you decide to move forward with the opioids, make sure you do not take too many. The lowest dose that provides effective pain relief, taken for the shortest period of time, is what the Centers for Disease Control and Prevention recommends.

Wisdom Tooth Removal and Opioids – The Risk Is Too High

So, what is the bottom line? Even though opioids are commonly prescribed for wisdom tooth removal, the risk for those ages 19 and younger is too high. The pain from wisdom teeth extraction is intense but short-lived. Most young people can get sufficient relief from over-the-counter medications and do not require dangerous opioids. With the opioid crisis continuing to grow and opioid use disorder numbers rising, parents and young adult patients must remain proactive to protect their children or themselves against this risk.