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Opioid-Prescribing Patterns in Connecticut and New Jersey Following Third Molar Extractions
Steven Halepas1, Cameron Christiansen2, Alia Koch3
1Resident, Division of Oral and Maxillofacial Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York.
Anesthesia Progress
|December 19, 2022
Summary
Dentists commonly prescribe NSAIDs and acetaminophen for pain after third molar extraction, with opioid prescriptions averaging 11 pills. Opioid prescribing habits need review to reduce complications.
Area of Science:
- Oral and Maxillofacial Surgery
- Pain Management
- Pharmacology
Background:
- Opioid misuse has increased scrutiny on healthcare providers' prescribing practices.
- Third molar extractions serve as a model for analyzing postsurgical pain management strategies.
Purpose of the Study:
- To analyze the prescribing habits of oral and maxillofacial surgeons for third molar extractions.
- To identify trends in postsurgical pain management and opioid use.
Main Methods:
- A cross-sectional survey was conducted among 291 oral and maxillofacial surgeons in Connecticut and New Jersey.
- An online survey using Qualtrics Research Services gathered data on prescribing habits for third molar extractions.
Main Results:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid/acetaminophen (APAP) combinations were the most common postsurgical analgesia approach.
- Hydrocodone/APAP was the most frequent opioid formulation, with an average of 10.93 pills prescribed.
- Most providers (79%) provided opioid information, but only 22% consistently checked opioid-monitoring programs, with higher likelihood when prescribing over 11 pills.
Conclusions:
- A universal standard for opioid use in dental postsurgical pain management is lacking.
- Providers should consider NSAIDs and APAP for baseline pain with separate opioid prescriptions for breakthrough pain.
- Minimizing opioid quantities and self-reflection on prescribing habits are crucial for reducing opioid-related complications.
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