The North American opioid crisis is not only an issue for public health and law enforcement officials; it also concerns dentists and dental hygienists in private practice. In fact, dentists can play a significant role in protecting their patients from succumbing to addiction and substance abuse.
As medical professionals who prescribe opioid drugs to patients, it is imperative for dentists to understand the link between opioids and dentistry, and the steps they can take to help combat the opioid crisis.
Opioids and Dentistry
Despite great advancements in dental techniques and technology, pain is often a necessary consequence of performing dental work. Fortunately, we have also come a long way in developing effective steps to lessen patients’ discomfort, and pain management is a top priority of any dental practice.
Among the pain management tools at a dentist’s disposal are analgesics (painkillers) and other prescription drugs. In many cases, drugs like acetaminophen and anti-inflammatories are sufficient in managing a patient’s dental pain. However, there are cases where non-opioid drugs are not enough, and that is when dentists might consider prescribing an opioid analgesic like codeine or oxycodone.
All drugs carry risks, but opioids are more liable to misuse than most, and opioid abuse can result in grievous harm. In 2016, over 42,000 peopled died from overdosing on opioid drugs in the United States alone. Many people who use narcotics first developed a dependency to legally-prescribed analgesics.
It’s not to say that dentists are unaccustomed to making judgement calls; exercising professional judgement is a part of what dentists and other healthcare professionals do every day. However, with opioid abuse causing a record-number of overdose deaths in Canada and the U.S., dentists must be especially careful in weighing the potential benefits and risks of prescribing these drugs to a patient.
What Dentists Can Do
The American Dental Association has made a commitment to help put an end to opioid abuse, urging dentists to educate themselves on the issue and follow the opioid prescribing guidelines set out by the Centers for Disease Control.
In a message to America’s dentists, ADA president Joseph Crowley asks dentists to take four specific steps to prevent opioid analgesics from harming patients:
1. Consider using non-narcotic pain relievers as the first line of treatment.
2. When prescribing an opioid pain reliever, consider prescribing fewer pills in accordance with state law and the latest pain management guidelines.
3. Counsel patients about the benefits and drawbacks of using opioids to relieve pain, especially the risk of addiction.
4. Learn to recognize when a patient might have a substance use disorder or be more prone than others to addiction.
The ADA also provides a free continuing education course on how to incorporate safe and effective protocols for using opioids to manage dental pain and offers a reference manual on how to manage dental pain for patients who are at risk of substance abuse.