Study links long-term opioid use with third molar extraction

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Study links long-term opioid use with third molar extraction

Based on their finding of a link to long-term use of opioids in teens and young adults who filled opioid prescriptions after third molar extraction, researchers have recommended that dentists and oral surgeons consider prescribing nonopioid painkillers as a first-choice option. (Photograph: VonaUA/Shutterstock)

Tue. 14. August 2018


MICHIGAN, U.S.: Opioid addiction has been a concern in America for some time. In a new study, researchers have found that teens and young adults who have been prescribed opioids after having their third molars extracted could be set on a path to long-term opioid use.

According to the results of the study, young people aged 13–30 who filled an opioid prescription immediately before or after they had had their third molars taken out were nearly 2.7 times as likely as their peers to still be submitting opioid prescriptions months later.

“Wisdom tooth extraction is performed 3.5 million times a year in the United States, and many dentists routinely prescribe opioids in case patients need it for post-procedure pain,” said the study’s lead researcher, Dr. Calista Harbaugh, a research fellow and surgical resident at the University of Michigan’s Institute for Healthcare Policy and Innovation.

As part of the study, researchers from the university collected insurance data on young people who were “opioid naïve,” meaning they had not had opioid prescriptions in the six months before their third molars were removed. Additionally, they had not undergone any other procedures requiring anesthesia in the following year.

In total, 1.3 percent of the 56,686 third molar patients who filled their opioid prescriptions between 2009 and 2015 went on to persistent opioid use, defined as two or more prescriptions submitted in the next year written by any provider for any reason. That is compared with 0.5 percent of the 14,256 third molar patients who did not fill prescriptions.

“Until now, we haven’t had data on the long-term risks of opioid use after wisdom tooth extraction. We now see that a sizable number go on to fill opioid prescriptions long after we would expect they would need for recovery, and the main predictor of persistent use is whether or not they fill that initial prescription,” noted Harbaugh.

Senior author of the study Dr. Chad Brummett, Co-Director of the Michigan Opioid Prescribing Engagement Network, added that, despite the results being some of the first data to the show long-term ill effects of routine opioid prescribing, “dentists and oral surgeons should stop routinely prescribing opioids for wisdom tooth extractions and likely other common dental procedures.”

The study findings were published in a research letter titled “Persistent opioid use after wisdom tooth extraction” on Aug. 7, 2018, in the Journal of the American Medical Association.

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