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Tag: dentists

  • Dentists Need To Make Sweeping Changes To Opioid Prescribing

    Dentists Need To Make Sweeping Changes To Opioid Prescribing

    Dentists have decreased the amount of opioid prescriptions they write by nearly 500,000—but some believe it’s not enough.

    Three years ago, P. Angela Rake decided to make a major change at her oral surgery practice.  

    “After the loss of Prince, I just drew a line in the sand that I’m going to change my prescribing practices,” Rake said, according to The Chicago Tribune. In just two years, she reduced the amount of opioids she was prescribing by 70%. 

    It wasn’t just the death of the superstar that moved her. Rake had also seen her own brother get hooked on opioids that he was given during cancer treatment. Having seen firsthand the dangers of opioid addiction, she knew that she couldn’t continue to prescribe opioids to her patients in the usual manner. 

    Today, she only prescribes opioids when absolutely necessary. The patients who do need opioids get few pills and lower doses. Rake now says she feels like the opioid industry deceived her. 

    “When these drugs came into being routinely prescribed, the industry-funded message we were being told was that the risk of addiction was less than 1 percent. We were misled.”

    The truth is that the risk of addiction for young people given opioids after oral surgery is closer to 6%. Now, more dentists are becoming aware of the danger of these pills for the youngest patients, said Andrew Kolodny, co-director of opioid treatment research at Brandeis University.

    “Dentists and oral surgeons are the No. 1 prescribers of opioids to teenagers. What’s so disturbing is that it’s so unnecessary. These are kids who could have gotten Advil and Tylenol,” he said. “It’s almost a rite of passage in the United States having your wisdom teeth out. The aggressive prescribing of opioids to adolescents may be why we’re in an epidemic.”

    Dentists have decreased the amount of opioid prescriptions they write by nearly half a million, from 18.5 million in 2012 to 18.1 million in 2017. However, that’s a far cry from the 70% reduction that Rake made, and some within the industry say it is not enough. 

    Romesh Nalliah, who teaches at the University of Michigan School of Dentistry and has studied opioid prescribing among dentists, said that dentists are concerned about customer satisfaction, and sometimes that relies on doling out opioids. 

    “Dentists are also business owners. They don’t want patients to say, ‘Dr. Nalliah did my extraction, and now I’m in agony,’” Nalliah said. Despite that, he has now changed the way that he prescribes opioids, and urges others in the field to do the same. 

    He said, ”I don’t want to be responsible for someone becoming addicted to opioids. I personally think we can cut opioid prescribing in dentistry to less than half of what we do now.”

    View the original article at thefix.com

  • Are Dentists Still Overprescribing Opioids?

    Are Dentists Still Overprescribing Opioids?

    A new study examined the opioid prescription patterns of dentists who care for patients with private insurance. 

    While dentists have been writing a declining number of opioid prescriptions in the past few years, two new studies indicate that there still may be reason for dental professionals to take precautions when prescribing. 

    According to PEW Trusts, one such study published in the Journal of the American Dental Association in April examined the prescribing patterns among dentists who tended to privately insured patients. From 2010 to 2015, opioid prescriptions per 1,000 patients increased from 131 to 147, study authors found. 

    “The fact that we’re still prescribing opioids when we’ve demonstrated that nonsteroidals are as effective most of the time is a little disturbing,” Dr. Paul Moore, co-author of the analysis and professor at the University of Pittsburgh’s dental school, told Modern Health Care.

    The study found that the biggest increase—about 66%—was in those ages 11 to 18. The study also noted that for all age groups, almost one-third of the opioid prescriptions written were for visits that were not surgical in nature, for which study authors state non-opioids could also be effective for pain.

    According to Modern Health Care, an analysis of five studies in the Journal of the American Dental Association found that nonsteroidal anti-inflammation drugs like ibuprofen are effective for dental pain.

    The second study was published at the same time in the same journal, and examined outpatient care for Medicaid patients. Researchers found that from 2013 to 2015, nearly 25% of those patients filled a prescription for opioids. They also discovered that emergency department providers were more likely to give opioids to patients with dental issues.

    The study found that 38% of patients who sought care in an emergency department then filled an opioid prescription in comparison to 11% of those who went to the dentist.

    “Dentists are providing substantially less opioid prescriptions compared to their medical colleagues for pain treatment following a dental diagnosis in the Medicaid population,” study authors wrote. “When considering pain management for dental and related conditions, dentists should continue with conservative prescribing practices as recommended.”

    According to PEW Trusts, the results of the study come at a good time, as the American Dental Association recently released an interim policy on prescribing opioids.

    The policy lays out a number of guidelines for providers to follow and encourages continuing education about opioid use for dentists. It also states that dentists should follow the Centers for Disease Control and Prevention (CDC) guidelines about dosage and length of opioid prescriptions.

    View the original article at thefix.com