The Benter Foundation is dedicated to helping communities and individuals thrive, especially in our hometown of Pittsburgh, PA. Because of this mission, we’ve grown increasingly concerned about the risks of unnecessary dental opioid prescribing to patients, their family members and communities.
These risks are especially worrisome for adolescents and young adults, who are frequently exposed to opioids for the very first time after they undergo wisdom tooth extraction. The consequences can result in opioid overdose, diversion, and persistent opioid use.
Research indicates that filling even a short-term opioid prescription after this procedure can lead to an alarmingly high rate of later opioid use disorder and persistent opioid use among adolescents and young adults. And yet, despite mounting evidence substantiating these risks, and the ready availability of better alternatives such as non-steroidal anti-inflammatory drugs and acetaminophen, high rates of opioid prescribing persists for this procedure. In fact, 4 out of 5 dental opioid prescriptions to adolescents and young adults are for tooth extraction. Dentists write 1.4 million opioid prescriptions per year to adolescents and young adults. This implies that this procedure alone accounts for over 1.1 million prescriptions per year, and roughly one-third of all opioid prescriptions in this age group. What’s more, unused prescriptions end up in medicine cabinets, risking misuse by others.
We have an opportunity to eliminate this unnecessary path to opioids. A strong research base can help us better understand the problem and find smart, long-lasting solutions for communities in Pittsburgh and around the country.
The Foundation has already funded research by the Opioid Prescribing Engagement Network (OPEN) at the University of Michigan, and at the Graduate School of Public Health at the University of Pittsburgh, to learn more about these public health dynamics. Using large data sets of procedures for publicly and privately insured patients, cross disciplinary teams are analyzing dental and medical opioid prescribing patterns and their effects. A related assessment of public policy measures to curb dental opioid prescribing in Michigan could illustrate other opportunities for change. Attitudinal research with dentists and patients will also guide further action.
We’re encouraged by the opioid free prescribing guidelines developed by the University of Pittsburgh’s School of Dental Medicine. More work is needed.
In December, 2021, Bill Benter wrote to the American Dental Association’s Committee on Acute Pain Management Guidelines to urge their adoption of guidelines that more explicitly label opioid prescribing as a last resort for most dental procedures.
We are heartened by the progress the field is making already. We believe that we can support the long-term transformation toward healthy, thriving patients, families and communities.