Don’t Open Wide: Pulling Dentists Off the Doctor Shopping List

Dentists prescribe a whopping 12 percent of all opiate painkillers in the U.S.

Imagine you’re getting your wisdom teeth removed and at the end of the procedure, your dentist hands you a prescription for a pain reliever – maybe Vicodin or Percocet. For many people, this wouldn’t pose a problem. For thousands of others, however, getting hooked on opioids through a valid prescription is a chilling reality.

Once hooked, as a means to fuel that addiction, doctor shopping becomes a habit. And that “shopping list” includes frequent trips to the dentist for unnecessary procedures.

When Compassion is Harmful…

Dentists, in addition to doctors and veterinarians, have become a significant source of opioid prescribing. In fact, a 2011 study in the journal of the American Dental Association estimates that dentists are responsible for 12 percent of prescriptions for opioid pain relievers – coming in right behind general practitioners and internal medicine doctors. Interestingly enough, roughly 23 percent of opioids in the U.S. are used for a non-medical purpose, according to the same study.

“Dentists don’t like to see patients in pain,” admitted Joel Funari, a dentist in Devon, Pa. “We tend to be compassionate people, and I think we were falling into a trap we were creating ourselves.”

In addition to their compassionate nature, dentists also have a habit of over-prescribing. Often times, dentists prescribe 20 to 30 tablets of a narcotic painkiller in situations where only a handful of pills are required, according to Dr. Brian Bateman, associate professor of anesthesia at Brigham and Women’s Hospital and Harvard Medical School.

This prescription-writing culture has helped contribute to the opioid crisis – and health officials are taking action. Now, some states are requiring dentists to educate themselves by taking classes on prescribing, and new guidelines argue for non-steroidal anti-inflammatory drugs (NSAIDS), such as Motrin, Advil and Aleve, to relieve pain, rather than narcotics.

Preventing Pain Relief and Addiction

“Most patients get along just fine without opioids,” said Dr. Paul Moore, a dentist and a professor of pharmacology at the University of Pittsburgh.

“We’ve found that a combination of Advil and Tylenol provide a lot of relief. It’s pretty remarkable with that combination.” Some dentists have even come to find NSAIDS as being more effective than narcotics. The American Dental Association has gotten on board, too, when last October it issued a statement, recommending that dentists consider over-the-counter pain relievers, such as Motrin and Advil, as “first-line therapy for acute pain management.”

Although there is growing support to reduce dental opioid prescriptions, their long-standing culture of prescribing likely won’t change quickly. In the meantime, however, dentists need to consider treatment options that utilize best practices to prevent opioid abuse.

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