The national opioid crisis and the shocking death toll that comes with it has a lot of people scrambling to determine the best way to deal with the issue. This is especially true for people in medical professions who have to decide when to prescribe medications and determine the dosage.
So, if you're a dentist who deals with this challenge, you might find yourself struggling to find the right answers.
Dr. Eli Eliav, DMD, Ph.D., joined a team of experts at the National Academies of Sciences, Engineering and Medicine who studied pain management and opioids for a year. Here are some of his recommendations that came from the research.
1. Ibuprofen and naproxen for molar extraction
Eliav states that typical anti-inflammatory drugs should be the "first line of therapy" for third molar extractions. He finds they can provide adequate pain relief in this situation.
In 2012, 259 million opioid prescriptions were written in the United States, and the dental industry was a significant part of that number. The most common purpose — pain following third molar extractions.
It all adds up to 3.5 million people (around the age of 20) who have already used opioids.
2. Examination before extension
Eliav recommends that if you're going to prescribe opioids, let them last a few days after the procedure. He says that if there is continuous pain beyond that period, then the patient needs further examination before offering additional dosage. The pain could be a result of procedure complications, like an infection.
3. Be aware of opioid offerings in and out of your office
Sometimes people will go to an emergency room for dental pain that isn't a traumatic or severe situation. Due to the lack of dental staff or resources, the physicians may resort to prescribing opioids for the patient.
Couple that awareness with prescription drug monitoring programs, and dentists can play a key role in the overprescribing of opioids without even realizing it. Eliav's research saw a 78 percent decrease in opioid prescriptions within his own urgent dental care clinic.
4. Offer risk-factor screenings
Eliav recommends conducting risk-factor screenings that can highlight drug abuse and chronic pain history.
Drug overdose is the main cause of unintentional injury deaths in the United States. You will frequently find opioids in those cases. Eliav reminds people that every day there are 90 people who die in this country because of an overdose that includes an opioid. It's a problem that can continue to plague the lives of people for decades if more isn't done to control it.
While Eliav is pleased with many of the new initiatives taken by the government, as well as the Centers for Disease Control and Prevention (CDC), he believes more can be done. A big key is to have more dentists and healthcare professionals band together to force change. Sharing his research and other important information can help advance a better approach to opioids and prescriptions.
See more about Eliav and his research here.
