Researchers at the University of Sheffield and the University of Illinois have conducted a study that suggests US dentists prescribe stronger opioids than required to address dental pain, and that UK dentists are 37 times less likely than their US counterparts to prescribe opioids as UK guidelines recommend NSAIDs or paracetamol for dental pain management instead. 22% of US dental prescriptions were for opioids and one in 10 were opioids with a high potential for abuse and diversion, like oxycodone and long-acting opioids, raising the possibility of opioid abuse. 0.6% of UK dental prescriptions were for opioids where prescribing is restricted to the lower strength dihydrocodeine.
Martin Thornhill, professor of translational research in dentistry at the University of Sheffield and co-author of the study, said: “The high level of opioid prescribing in the US is shocking, particularly when there is good evidence that NSAIDs and acetaminophen are as good or better than opioids for treating dental pain and don’t cause the unpleasant side-affects, addiction and misuse problems associated with opioids. UK dentists manage exactly the same pain problems as their US colleagues and achieve high levels of patient satisfaction using NSAIDs and acetaminophen, without the need to resort to opioids. Unsurprisingly, more than half of opioids prescribed following tooth extraction in the US remain unused by patients. This means an estimated one million opioid pills a year can be diverted to other purposes, creating a huge potential for opioid misuse.”
“UK and US dental opioid prescriptions compared in new study“
Dr Susan Rowan, co-author and executive associate dean and associate dean for clinical affairs at the UIC College of Dentistry, said: “Dentists need to be part of the opioid conversation. This data provides substantial information and should be a wake-up call to individual dental practices and collaborative organisations of dental care providers to push the envelope towards greater efforts to reduce opioid prescribing or patients’ potential for abuse.”
Dr Katie Suda, associate professor of pharmacy systems, outcomes and policy at UIC, said: “To see such a difference among two groups of dentists in countries with similar oral health and use of dentists is an indicator that opioid prescribing practices in the US warrant a second look. This study tells us that efforts to adopt national guidelines for treating dental pain and for promoting conservative opioid prescribing practices among dentists in the US should be a priority and should be included as part of more comprehensive judicious opioid prescribing strategies.”