Opioid Prescribing by US Dentists and Dental Specialists after Continuing Education

The aim of this study was to determine whether dental providers wrote fewer prescriptions for opioid-containing medications and more prescriptions for non-opioid analgesics after taking a continuing education course that targeted both knowledge about an American Dental Association-endorsed guideline on the management of acute dental pain and challenges in shared decision-making.

The implementation strategy comprised a prerecorded 1-h video continuing education course and supplementary materials that were previously shown to increase knowledge about shared decision-making. Using propensity score matching, we matched 420 dentists and dental specialists who took the continuing education course to 4,200 providers who had not. We used regression analyses to compare learners with their propensity score-matched controls on their change in opioid prescribing and change in non-opioid analgesic prescribing from the 6 mo before to the 6 mo after course completion.

Providers who took the continuing education course decreased the number of opioid prescriptions they wrote by 0.60 prescriptions more than providers who did not take the continuing education course (B = -0.60; 95% confidence interval [CI] -1.07, -0.13; t = -2.50; P < 0.01). Among providers who decreased their prescribing by 3 or more prescriptions, a greater percentage took the continuing education course. There was no difference in non-opioid analgesic prescribing between providers who took the continuing education course and providers who did not (B = -0.10; 95% CI -0.87 0.68; t = -0.25, ns).

Equipping dental providers with skills in shared decision-making to use in conversations with patients about approaches to acute pain management may enable them to decrease the number of opioid prescriptions they write more than providers who are not exposed to these skills.Knowledge Transfer Statement:The results of this study can be used by groups and organizations seeking to improve dental providers' adherence to the guideline on managing acute dental pain following simple and surgical tooth extraction or toothache.