Wisdom Tooth Extraction Can Lead To Persistent Opioid Use

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MedicalResearch.com Interview with:

Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow, Michigan Opioid Prescribing Engagement Network University of Michigan 

Dr. Harbaugh

Calista Harbaugh, MD
House Officer, General Surgery
Clinician Scholar, National Clinician Scholars Program
Research Fellow, Michigan Opioid Prescribing Engagement Network
University of Michigan 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Wisdom tooth extraction is one of the most common procedures among teens and young adults, with more than 3.5 million young people having wisdom teeth pulled every year.

This procedure is commonly paired with a prescription for opioid pain medication. As the opioid epidemic sweeps the nation, we must pay attention to the long term effects of opioid prescribing for even routine procedures. This is particularly important for wisdom tooth extraction where there is evidence that opioid pain medications may be no more effective than anti-inflammatories alone.

Using commercial insurance claims, we evaluated the association between receiving an opioid prescription with wisdom tooth extraction and developing new persistent opioid use in the year after the procedure. We found nearly a 3-fold increase in odds of persistent opioid use, attributable to whether or not an opioid was prescribed. This translates to nearly 50,000 young people developing new persistent opioid use each year from routine opioid prescribing for wisdom tooth extraction.

MedicalResearch.com: What should readers take away from your report? 

Response: Although many states and professional organizations are now recommending prescribing limitations, dental providers should strongly eliminating any routine opioid prescribing from their practice. Any opioid prescribing may put a young person or their community at risk. Opioid prescriptions that are filled and not used, may also be diverted into the community or become targets for theft.

Patients and families should recognize the risk associated with opioid prescriptions after procedures. They should feel empowered to ask their provider whether an opioid medication is needed and what other pain management techniques exist. In addition, they should ask how to dispose of extra medication that is not used.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In the setting of wisdom tooth extractions, future research is needed to investigate how to disseminate important information to providers and reduce unnecessary opioid prescribing. There are many motivators for routine opioid prescribing, which include improving patient satisfaction scores and preventing the need for refills. In addition, new restrictive opioid prescribing policies and mandated consent forms may make it harder for patients to obtain opioid prescriptions in settings where they are indicated. We must continue to learn from patients, families, and providers to understand how to eliminate opioid prescribing when it is not indicated, optimize pain control, and construct public policies which promote both of these endeavors. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Provide and patients can find additional resources found at the Michigan Opioid Prescribing Engagement Network website (www.michigan-open.org), including best practices for dental and acute care prescribing, educational brochures, and opioid disposal information. 

Citation:

Harbaugh CM, Nalliah RP, Hu HM, Englesbe MJ, Waljee JF, Brummett CM. Persistent Opioid Use After Wisdom Tooth Extraction. JAMA. 2018;320(5):504–506. doi:10.1001/jama.2018.9023

 

Aug 9, 2018 @ 12:20 pm

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