Is it time US dentistry ended its opioid dependence?

Suda, Katie J.; Durkin, Michael J.; Lockhart, Peter B.

doi:10.1016/j.adaj.2019.07.003

Cited by 25 publications

(21 citation statements)

References 38 publications

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“…treatment and, when necessary, the prescription of medicines. 2,3 Nonsteroidal anti-inflammatory drugs (NSAID), opioids, and analgesics are frequently prescribed by dental practitioners. 3,4,5 Research shows an overall increase in the prescription of medicines to control pain.…”

Section: Introductionmentioning

confidence: 99%

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Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state

et al. 2021

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The objective of this study was to describe dental prescriptions of non-steroidal anti-inflammatory drugs (NSAID), opioids, and analgesics dispensed by the Brazilian National Health System (BNHS, SUS in Portuguese) of a Southeastern state from January to December 2017, and to analyze their association with socioeconomic and oral health care services' characteristics at municipal level. Data were collected from the Brazilian Integrated Pharmaceutical Care Management System. Medicines were grouped according to the Anatomical Therapeutic Chemical Classification System. The total number of Defined Daily Doses (DDD) and DDD per 1,000 inhabitants (inhab.) per year were presented and compared between groups of municipalities. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25.0. The total number of NSAID, opioids, and analgesics prescriptions was 70,747 and accounted for 354,221.13 DDD. The most frequently prescribed medicine was ibuprofen (n = 24,676; 34.88%). The number of dental practitioners in the BNHS per 1,000 inhab. (p < 0.001), first dental appointment coverage (p = 0.010), oral health teams per 1,000 inhab. (p=0.022), and the proportion of rural population (p = 0.014) were variables positively associated with the number of DDD of NSAID per 1,000 inhab. per year. Bolsa Família program coverage per 1,000 inhab. (p = 0.022) was negatively associated with NSAID prescription. Regarding analgesics, first dental appointment coverage (p=0.002) and Bolsa Família program coverage per 1,000 inhab. (p = 0.012) were positively associated with DDD per 1,000 inhab. per year. In conclusion, dental prescriptions of analgesics and NSAID in the BNHS were associated with socioeconomic and oral health care services' characteristics.

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Section: Introductionmentioning

confidence: 99%

“…2,3 Nonsteroidal anti-inflammatory drugs (NSAID), opioids, and analgesics are frequently prescribed by dental practitioners. 3,4,5 Research shows an overall increase in the prescription of medicines to control pain. 6,7,8 It is recognized that millions of people suffer from untreated pain around the world.…”

Section: Introductionmentioning

confidence: 99%

Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state

et al. 2021

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“…The lack of solid pain and biopsychosocial training may also impede the comprehensive assessment of initiating and perpetuating factors contributing to the pain presentation, leading to a mechanistic, reductionist approach that can be ineffective, inhumane, and potentially harmful. Additionally, this knowledge is key to appropriate risk assessment (e.g., potential for addiction, intake of benzodiazepines, presence of sleep apnea) prior to prescribing opioid medications for acute pain relief after a dental procedure, which could lead to potential deleterious outcomes such as respiratory depression, abuse, misuse, dependence, and overdose 42 . Dentist should know that opioids are generally not indicated for nonmalignant OFP, and its avoidance when possible is warranted in the short and long term 42,43 .…”

Section: Barriers To Ofp Education and Evidence‐based Practicementioning

confidence: 99%

“…Additionally, this knowledge is key to appropriate risk assessment (e.g., potential for addiction, intake of benzodiazepines, presence of sleep apnea) prior to prescribing opioid medications for acute pain relief after a dental procedure, which could lead to potential deleterious outcomes such as respiratory depression, abuse, misuse, dependence, and overdose 42 . Dentist should know that opioids are generally not indicated for nonmalignant OFP, and its avoidance when possible is warranted in the short and long term 42,43 . Thus, there is great need for a coordinated effort from international experts in the field to keep OFP educational standards up to date with the best available evidence in dental schools worldwide, while facilitating collaboration with other dental, medical, and health specialties 36 …”

Section: Barriers To Ofp Education and Evidence‐based Practicementioning

confidence: 99%

Orofacial pain education in dentistry: A path to improving patient care and reducing the population burden of chronic pain

Costa

Koninck

Elsaraj

et al. 2020

Journal of Dental Education

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Dentists stand in an optimal position to prevent and manage patients suffering from chronic orofacial pain (OFP) disorders, such as temporomandibular disorders, burning mouth syndrome, trigeminal neuralgia, persistent idiopathic dentoalveolar pain, among others. However, there are consistent reports highlighting a lack of knowledge and confidence in diagnosing and treating OFP among dental students, recent graduates, and trained dentists, which leads to misdiagnosis, unnecessary costs, delay in appropriate care and possible harm to patients. Education in OFP is necessary to improve the quality of general dental care and reduce individual and societal burden of chronic pain through prevention and improved quality of life for OFP patients. Our aims are to emphasize the goals of OFP education, to identify barriers for its implementation, and to suggest possible avenues to improve OFP education in general, postgraduate, and continuing dental education levels, including proposed minimum OFP competencies for all dentists. Moreover, patient perspectives are also incorporated, including a testimony from a person with OFP. General dentists, OFP experts, educators, researchers, patients, and policy makers need to combine efforts in order to successfully address the urgent need for quality OFP education.

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“…Opioid misuse and harms are a public health issue in Australia, where opioids for nonmedical use are predominately sourced through social networks 15 . It has been shown that dentists tend to prescribe opioids unnecessarily and for longer than required 16–18 . A cohort analysis showed that a substantial proportion of young adults are exposed to opioid use through dentists, and this may subsequently lead to opioid abuse 19 …”

Section: Introductionmentioning

confidence: 99%

Improvement of dental prescribing practices using education and a prescribing tool: A pilot intervention study

Teoh

Stewart

Mariño

et al. 2020

Brit J Clinical Pharma

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Antibiotic resistance is a global public health problem. Around 55% of dental antibiotic prescribing is deemed inappropriate. The aim of this multimodal interventional pilot study was to assess the effect on prescribing of education and a dentally designed prescribing website.Methods: Twenty-six dentists were recruited for the 12-week study using a pre-post design. Dentists self-recorded their prescribing of antibiotics, analgesics and anxiolytics for 6 weeks. After dentists were provided education and website access, they recorded their prescribing for a further 6 weeks. Four outcomes were measured comparing the prescribing before and after the intervention: (i) the number of inappropriate indications for which antibiotics were prescribed; (ii) the number of prescriptions;(iii) accuracy of the prescriptions according to the Australian therapeutic guidelines; and (iv) the confidence of practitioners towards the prescribing website. Participants were interviewed for feedback.Results: There was a substantial reduction of 44.6% in the number of inappropriate indications for which antibiotics were prescribed after the intervention and a decrease of 40.5% in the total number of antibiotics. Paracetamol with codeine substantially reduced by 56.8%. For the 3 most commonly prescribed antibiotics (amoxicillin, phenoxymethylpenicillin and metronidazole), there was the improvement in the accuracy of the prescriptions ranging from 0-64.7 to 74.2-100%. Conclusion:This pilot study showed the intervention of targeted education and the prescribing tool was effective in improving dental prescribing, knowledge and confidence of practitioners, as well as providing an effective antibiotic stewardship tool. This context-specific intervention shows substantial promise for implementation into dental practice.

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Is it time US dentistry ended its opioid dependence?

Abstract: This is a repository copy of Is it time US dentistry ended its opioid dependence?.

Cited by 25 publications

References 38 publications

Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state

Prescriptions of analgesics and anti-inflammatory drugs in municipalities from a Brazilian Southeast state

Orofacial pain education in dentistry: A path to improving patient care and reducing the population burden of chronic pain

Improvement of dental prescribing practices using education and a prescribing tool: A pilot intervention study

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