The Opioid Epidemic; Finding safe and effective methods of controlling dental pain

In a news bulletin dated April 20, 2018, the American Dental Association forwarded a study to its members in regard to the use of opioids in controlling dental pain.  The study was conducted at Case Midwestern Dental School and the report appears in the April ADA Journal.

In the studies‘ summary Dr. Anita Aminoshariae is quoted, saying  “What we know is that prescribing narcotics should be a last resort,” In summary, the study finds Ibuprofen (Advil) and Acetaminophen (Tylenol) to be more effective than opioids for dental pain. 

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    The cover articles in the ADA Journal are timely as the national media confronts the opioid epidemic which so damages our society.  We have made a conscious effort in our dental implant practice to limit prescribing opioids.  The ADA article re-enforces or long held belief that non-steroidal anti-inflammatory medications are superior to opioids in moderating dental pain.

    Unlike some drugs which are chosen by individuals as an escape or a lifestyle, opioid addiction is quite often initiated by the prescribing doctor in an attempt to alleviate pain.  Anyone who has been faced with a need for pain control and been prescribed a narcotic will attest to the unwanted and often unknown side-effects including difficulty with withdrawal and, most alarmingly, addiction.

    Some of the more common opioid drugs include the following: Vicodin, Lorcet, codeine, fentanyl, Oxy-Contin and morphine. Some of these drugs are directly made from  opium (poppy plant) while others are synthetic or semi-synthetic derivatives.  Overdose from opioid drugs can lead to death due to respiratory suppression.

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    The studies included in the April edition of the ADA Journal site the effectiveness of over-the-counter pain relievers and this is tremendously important for the public and the medical/dental community to understand.  Assisting patients in dealing with pain is a challenging job but we should be diligent in finding answers and assisting in a compassionate and medically informed manner.

    I encourage all patients and family members to have a good understanding of drugs being prescribed for pain management.  Most importantly, ask questions to the prescribing doctor and your pharmacist.  

    Sometimes pain management addresses long term disorders, other times it is used to combat acute or short-term pain.  The choice of medications is sometimes complicated but to study their effectiveness and consequences it is very important for the individual and the public to understand.  As I said, please ask questions and find the answers before beginning the use of any prescribed or over-the-counter drugs.  The dangers presented to us by opioids cannot be underestimated but we can find solutions to this awful epidemic.  Moving forward, the most important summary and suggestion from these studies is that Ibuprofen (Advil) and Acetaminophen (Tylenol) are just as effective, if not superior at times, in combating pain.

Bruce Twaddle, DDS, DICOI | Plaza Dental Implants