Opioid Analgesic Prescribing Practice in a Predoctoral Dental School Over a Decade

Dental schools play an influential role in shaping education and training of future dental professionals. This study investigated the prevalence and evolving trend of opioid analgesic prescription across dental surgical and endodontic procedures between 2013-2023 within a predoctoral dental school.

Electronic health records (axiUm database) of our predoctoral dental school were retrospectively searched for dental surgical and endodontic procedure codes dated between July 2013-May 2023. Differences in frequency of opioid prescriptions across study period and procedure types were compared using Chi-square tests. Logistic regression was used to determine whether COVID-19 pandemic, tooth involved, patient's age, or multiple-procedure were associated with the prescription of opioid analgesics.

A total of 1,145 opioid prescriptions were dispensed after 54,652 dental surgical and endodontic procedures completed over 41,343 dental visits. The prevalence of opioid-prescribing practice was 3.3% after dental surgical procedures and 0.7% after endodontic procedures, with a statistically significant difference across procedure types (p < 0.00001). 42.4% of all opioid prescriptions were dispensed after surgical removal of erupted teeth. Opioid-analgesic prescribing practice was influenced by multiple procedures conducted during the same dental visit (odds ratio, OR = 9,047,709), tooth number (OR = 1.04), and COVID-19 period (OR = 6,101,435). The 10-year period revealed a -58.3% percentage change in opioid-prescribing practices (from 1.2% in 2013 to 0.5% in 2023), after a peak in 2016 (∼6.1%).

There was a low combined 2.8% prevalence of opioid-analgesic prescriptions following dental surgical (3.3% prevalence) and endodontic (0.7% prevalence) procedures at a predoctoral dental school, with a steady decline after 2016.