MedicalResearch.com Interview with:
Alan Schroeder MD
Associate Chief for Research
Division of pediatric hospital medicine
Lucile Packard Children’s Hospital Stanford
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Third molar “wisdom teeth” extractions are one of the most common surgeries performed in adolescents and young adults, but an adequate appraisal of risks and benefits is lacking. Most patients who undergo this procedure are exposed to opioids post-operatively.
We demonstrate that, for privately-insured opioid-naïve patients 16-25 years of age, exposure to opioids from a dental provider is associated with persistent use at 90-365 days in 7% of patients and a subsequent diagnosis relating to abuse in 6% of patients. In contrast persistent use and abuse were significantly lower in control patients not exposed to dental opioids (0.1% and 0.4%, respectively). The median number of pills dispensed for the initial prescriptions was 20.
MedicalResearch.com: What should readers take away from your report?
Response: Because of this association between opioid exposure and subsequent use and abuse, the opioid prescribing and the procedures that trigger these prescriptions should be scrutinized. Given previously published estimates of the frequency of wisdom teeth extractions in the US, it is assumed that this procedure accounts for the vast majority.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Given some of the risks associated with wisdom teeth extractions, including the exposure to opioid, further research is warranted to establish the benefit of this commonly performed procedure.
Schroeder AR, Dehghan M, Newman TB, Bentley JP, Park KT. Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse. JAMA Intern Med.Published online December 03, 2018. doi:10.1001/jamainternmed.2018.5419
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