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Is it time US dentistry ended its opioid dependence?
Opioid prescriptions for dental pain are common in the US but not elsewhere. Nonsteroidal anti-inflammatory drugs (NSAIDs) are as effective as opioids for dental pain and have fewer side effects, suggesting opioids are unnecessary for routine dental care.
Area of Science:
- Dental Pain Management
- Pharmacology
- Public Health
Background:
- Opioid misuse is a significant public health issue in the US, with substantial economic costs.
- Dentists are frequent prescribers of opioids, raising concerns about their contribution to the opioid crisis.
Purpose of the Study:
- To review international analgesic prescribing habits for dental pain.
- To compare the efficacy and safety of opioids versus nonsteroidal anti-inflammatory drugs (NSAIDs) for managing dental pain.
Main Methods:
- Comparative analysis of dental prescription data between the US and England.
- Review of existing literature on the effectiveness and adverse effects of opioids and NSAIDs for dental pain.
Main Results:
- US dental opioid prescriptions (22.3%) far exceed those in England (0.6%), where NSAIDs and acetaminophen are primary analgesics.
- NSAIDs and NSAID-acetaminophen combinations are as effective or more effective than opioids for dental pain.
- NSAIDs demonstrate significantly fewer adverse effects compared to opioids.
Conclusions:
- Avoiding opioids in dentistry is beneficial for patients due to misuse potential and the availability of safer, effective alternatives.
- Evidence suggests opioids are not necessary for routine oral healthcare, supporting a shift towards NSAID-based pain management.
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