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Sober Nation

Putting Recovery On The Map

03-27-18 | By

Dentists Urged To “Eliminate Opioids From Arsenal”

The American Dental Association (ADA) has released a new study accompanying a new policy on Monday, stating they now support statutory limits of seven days for dental opioid prescriptions – a response to combat what experts are calling a national health emergency.

“Eliminate Opioids From Your Arsenal”

The association announced on Monday that “essentially says eliminate opioids from your arsenal if at all possible,” stated Dr. Joseph Crowley, the group’s president. Additionally, he stated that, “as president of the ADA, I call upon dentists everywhere to double down on their efforts to prevent opioids from harming our patients and their families. This new policy demonstrates ADA’s firm commitment to help fight the country’s opioid epidemic while continuing to help patients manage dental pain.” The association, based in Chicago, represents over 161,000 dentists nationwide.

The policy states:

  • The ADA supports mandatory continuing education in prescribing opioids and other controlled substances.
  • The ADA supports statutory limits on opioid dosage and duration of no more than seven days for the treatment of acute pain, consistent with the Centers for Disease Control and Prevention evidence-based guidelines.
  • The ADA supports dentists registering with and utilizing Prescription Drug Monitoring Programs (PDMPs) to promote the appropriate use of opioids and deter misuse and abuse.

The new study shows the increase in dental opioid prescriptions from 2010 to 2015 was sharpest among young people ages 11 to 18 years of age, which is a group known to be at risk for drug addiction. CDC data shows that the overall national opioid prescribing rate declined from 2012 to 2016.

Should Dentists Consider Non-Opioids?

Another study released in the Journal of the American Dental Association shows that researchers found that for dental pain, using Tylenol or ibuprofen was “equal if not superior” to opioids. Dentists write fewer than 7 percent of U.S. opioid prescriptions, but new research shows that practice has increased in recent years, despite evidence that ibuprofen and tylenol work just as well for most dental pain and much less risky than opioids. The association said in a 2016 policy that dentists should consider these non-opioids as first-line treatment for pain – however as the opioid crisis continues to reach epic proportions, the ADA is taking a significant stance by unveiling their new policy.

In dental procedures that involve opioids, dentists have been known to prescribe Vicodin or Percocet for short-term pain from procedures including wisdom teeth removal and tooth extractions, root canal work, or dental implants.

“The fact that we’re still prescribing opioids when we’ve demonstrated that nonsteroidals are as effective most of the time is a little disturbing,” said Dr. Paul Moore, co-author of the analysis and professor at the University of Pittsburgh’s dental school. For many young patients, “This is going to be their first experience with opioids,” Moore said. “Maybe it is our opportunity to stop and counsel patients about the dangers.”

“Dentists Are Stepping Up To The Plate”

While the new policy has been praised for combating the crisis, it has also been criticized as not very effective. “Limiting quantity as opposed to duration would have been better,” Dr. Andrew Kolodny, co-director of the Opioid Policy Research at Brandeis University, told CBS. But he added, “The policy suggests the dentists are stepping up to the plate. It’s a worthwhile effort because over-prescribing for acute pain is a big deal.”

This position puts the ADA in line with recent federal guidelines. The American Medical Association, the nation’s top association of doctors’ policy, has not yet issued a policy concerning opioid limits. Additionally, The American Dental Association is calling for mandatory continuing education of all dentists and the organization says they support having dentists register with Prescription Drug Monitoring Programs.

Dr. Crowley noted, “This new policy demonstrates ADA’s firm commitment to help fight the country’s opioid epidemic while continuing to help patients manage dental pain.”

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