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US dentists prescribe 37 times more opioids than English dentists do, study finds

In a recent study, researchers compared the opioid prescribing practices of dentists in England and the U.S., and uncovered a significant difference. (Photograph: David Smart/Shutterstock)

Tue. 4. June 2019


CHICAGO, U.S.: With the overprescription of opioids causing many severe health and addiction issues in the U.S., it is imperative that dental professionals remain aware of the issue and carefully consider their prescription practices. In a recent study, researchers from the University of Illinois at Chicago (UIC) in the U.S. and the University of Sheffield in England, each looked at the number of opioids being prescribed in their respective countries and discovered that dentists practicing in the U.S. write 37 times more prescriptions than dentists in England do.

“To see such a difference between two groups of dentists in countries with similar oral health and use of dentists is an indicator that opioid prescribing practices in the U.S. warrant a second look,” said Dr. Katie Suda, Associate Professor of Pharmacy Systems, outcomes and policy at the UIC College of Pharmacy. “This study tells us that efforts to adopt national guidelines for treating dental pain and for promoting conservative opioid prescribing practices among dentists in the U.S. should be a priority and should be included as part of more comprehensive judicious opioid prescribing strategies.”

In order to obtain the data needed, the researchers analyzed nationally representative databases of prescriptions from both countries. These prescriptions were dispensed from retail pharmacies, including community and mail service pharmacies, and outpatient clinic pharmacies in 2016, which is considered to be a peak point in the U.S. opioid crisis. According to the results, U.S. dentists wrote 1.4 million prescriptions, compared to just 28,000 in England. The stark difference remained when the researchers adjusted for differences in population size and number of dentists.

In addition to prescribing more, U.S. dentists were prescribing a larger variety of opioids. The most common prescriptions were hydrocodone-based, followed by codeine, oxycodone and tramadol, whereas in England, dentists only prescribed one, dihydrocodeine.

“This data should be a wake-up call to individual dental practices and collaborative organizations of dental care providers to push the envelope towards greater efforts to reduce opioid prescribing or patients’ potential for abuse,” said co-author Dr. Susan Rowan from the UIC College of Dentistry.

Co-author Dr. Martin Thornhill, Professor of Translational Research in Dentistry at the University of Sheffield, said: “I was shocked to discover the high level of opioid prescribing of my U.S. dental colleagues. Particularly, when there is good evidence that NSAIDs and acetaminophen are as good or better than opioids for treating dental pain and don’t cause the unpleasant side effects, addiction and misuse problems associated with opioids.”

The study, titled “Comparison of opioid prescribing by dentists in the United States and England,” was published in the May 2019 issue of JAMA Network Open.

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