The finding is based on an analysis of data from 8.5 million Americans who had teeth pulled or 119 other types of dental work between 2011 and 2018. All had Medicaid or private dental insurance.
“Our paper shows that when patients fill dental opioid prescriptions, the risk of opioid overdose increases both for themselves and their family members,” said study leader Dr. Kao-Ping Chua of the University of Michigan, in Ann Arbor.
“This underscores the importance of avoiding dental opioid prescribing when non-opioids like ibuprofen [Motrin] and acetaminophen [Tylenol] are effective options for pain control, as is the case for the majority of dental procedures,” Chua added in a university news release.
Nonetheless, nearly 27% of teens and adults filled a prescription for an opioid painkiller, such as hydrocodone or oxycodone, and 2,700 opioid overdoses occurred within 90 days of the dental procedures, the study found.
The overall rate of opioid overdoses was about three for every 10,000 dental procedures, according to the report. But the rate was 2.5 times higher among patients who filled an opioid prescription within three days of their procedure than among those who did not (5.8 versus 2.2 per 10,000).
In 2016 alone, U.S. dentists wrote 11.4 million opioid prescriptions, so the findings suggest that 1,700 overdoses a year could be associated with dental opioid prescriptions, the study authors said.
Family members of dental patients who receive opioid prescriptions are also at risk for overdoses, the findings showed.
The researchers examined data from 3.5 million privately insured dental patients and found that 400 of their family members were treated for opioid overdoses in the 90 days after the patient’s procedure.
The rate was 1.7 per 10,000 procedures among family members of privately insured patients who filled opioid prescriptions, compared with 1 per 10,000 procedures among those who did not. Patients’ children accounted for 42% of the family overdoses, spouses for 25%, and the rest occurred in siblings and parents.
“Our finding of increased overdose risk in family members also shows the importance of emphasizing safe storage and disposal when prescribing opioids to dental patients,” said Chua, a pediatrician at Michigan Medicine and health care researcher at the Susan B. Meister Child Health Evaluation Research Center in Ann Arbor.
Senior study author Dr. Romesh Nalliah, associate dean for patient services at the University of Michigan School of Dentistry, said this is one of the most powerful truths the team unlocked in their “big data” study of dental opioid prescribing. “That when a dentist, like me, prescribes an opioid to a patient I am putting their entire family at risk of overdose,” he said. “Dentists should consider, if the family concerned was yours, would you take that risk?”
The study was published online April 29 in the American Journal of Preventive Medicine.
The U.S. National Institute on Drug Abuse has more about prescription opioids.
SOURCE: University of Michigan, news release, April 29, 2021