Dentists who prescribe opioid painkillers to teenagers and young adults after pulling their wisdom teeth may be putting their patients at risk of addiction, a new study finds.
The study, published in JAMA Internal Medicine on Monday, shines a light on the largely overlooked role dental prescriptions play in an epidemic of addiction that has swept the United States, leading to a record 70,237 drug overdose deaths in 2017.
“Given the gravity of the opioid epidemic, the degree of persistent use and abuse we observed in adolescents and young adults, especially females, is alarming,” said researcher Alan Schroeder, a pediatrician and professor at Stanford University School of Medicine. “Our findings should trigger heightened scrutiny over the frequency of prescribing dental opioids.”
Adolescents and young adults often are introduced to highly addictive opioid painkillers when they have their third molars pulled. Millions of Americans undergo the procedure every year, and dentists routinely prescribe opioids to the vast majority. Only recently have dentists — the most frequent prescribers of opioids for youths between ages 10 and 19 in 2009 — started to reconsider the use of narcotics in managing post-surgical pain.
Schroeder and his team examined the private health insurance claims of more than 750,000 patients from 16 to 25 years old. Close to 100,000, or a striking 13 percent, received at least one opioid prescription in 2015, and dental practitioners wrote 30 percent of them.
Nearly 6 percent of almost 15,000 people in the study group who received initial opioid prescriptions in 2015 from dentists received an opioid abuse diagnosis within a year, said the study by Schroeder and four other researchers shows. In comparison, 0.4 percent in a similar group who didn’t get dental opioids had such diagnoses in the same period.
“These are kids who could have gotten Advil and Tylenol, and 6 percent showed evidence of becoming addicted,” said Andrew Kolodny, who codirects opioid treatment research at Brandeis University. “That’s huge.”
The numbers are troubling given that most people who have wisdom teeth extractions do just as well or better on over-the-counter pain relievers. An April study in the Journal of the American Dental Association found that anti-inflammatory analgesics, such as ibuprofen and acetaminophen, generally work better than opioids for acute dental pain.
“We certainly don’t need to expose adolescents to opioids after we take out their wisdom teeth,” said Kolodny. “On that particular topic, the science is clear.”