Many people suffer from dental fear or anxiety. The journal of the American Dental Association noted that dentists view effective pain management as “the Holy Grail for achieving patient satisfaction” because fear can cause people to delay needed treatment, resulting in more pain! Concerns about pain management may lead to the use of stronger painkillers and prescribing more pills than necessary to ease short-term discomfort. In 2016, JAMA Network Open reported that 22.3% of US dental prescriptions were for opioids that carried a “high potential for abuse.”
As part of the national effort to control the opioid epidemic, stakeholders are working together to highlight alternatives to opioid painkillers and the importance of safe medication disposal. The list includes insurers, regulators, medical waste disposal experts, providers, and educators. Education efforts target dental students, practitioners, and patients.
Over-Prescribing Opioids Increases Risk of Later Misuse
In 2020, the Journal of Preventative Medicine reported that up to half of opioids prescribed for adult dental patients were over-prescribed. Researchers found that prescriptions weren’t limited to major procedures; “29.6% of opioids were prescribed when the pain intensity post-dental procedure was expected to be mild.” Furthermore, prescriptions often exceeded the recommended morphine milligram equivalents (MME) for acute dental pain.
Over-prescribing opioids for dental pain particularly affects teens and young adults. Insurer United Healthcare cited research that showed various over-the-counter pain relievers were just as effective as opioids in controlling post-operative dental pain, but 80% of teens and young adults still received prescriptions of opioid painkillers after wisdom tooth extractions. These prescriptions can put teens at greater risk for later opioid abuse.
Fighting Opioid Misuse with Professional Education
The American Dental Association offers a series of on-demand opioid education webinars on opioid-related topics to help dentists understand the issues and follow best practices. For example:
- What You Need to Know Now About Pain Management As the Opioid Overdose Crisis Evolves
- Analgesic Prescribing in the Opioid Overdose Epidemic
- Preventing Prescription Opioid Diversion
- Prescription Drug Monitoring Programs
Dental schools are also involved. An American Dental Education Association policy white paper highlighted ways that dental schools are modifying curriculum and training protocols for students:
- Updating pain management and clinical protocols to include guidance on alternative methods for pain management
- Training students to recognize the signs of addiction and substance abuse disorders
- Explaining the importance of electronic health records and prescription drug monitoring programs that help identify and treat at-risk patients
Dr. Nico Geurs, DDS, chair of the Department of Periodontology at the University of Alabama Birmingham (UAB) is working with the ADEA to implement “transformative measures into dental education curriculums on the student and practitioner levels.” However, Dr. Geurs stresses that education is needed throughout the entire dental care system – patients included:
“The public health crisis we are dealing with stems from many roots, ranging from easy access to prescription medication and the quantity in which medication is prescribed, to the inability of physicians to set realistic expectations with patients about pain.
As dentists, we’re facing a watershed time when patients have a list of requests for pain medications that they think they need and expect to receive, none of which are in line with reality. Pain management with opioids has been normalized in American culture, and it’s rapidly spiraling out of control.”
Patient Education Can Help Reduce Prescriptions & Prevent Drug Diversion
Studies have shown that patient education on proper disposal methods for unused medication can reduce opioid misuse. A peer-reviewed study published in the Journal of Pain Research found “a clear need to increase patient awareness about the importance and methods of proper medication disposal, and a great opportunity for health care providers to increase patient education efforts.”
After its claims data showed that “oral health professionals write 12% of all opioid prescriptions, including 54% of opioid prescriptions for adolescents,” United Healthcare launched an initiative designed to encourage dental service providers and patients to reduce reliance on opioids and follow proper disposal methods for unused medication.
Patient education about opioids is so important that some states require it. For example, in Florida, certain healthcare providers must give patients information about non-opioid alternatives and review the advantages and disadvantages of non-opioid alternatives before prescribing an opioid drug listed as a Schedule II controlled substance. Patients also receive printed materials with information about non-opioid pain medications. Even non-opioid medications can still be scheduled or hazardous substances, so proper disposal is still important for these medications.
Many state and local initiatives already help raise awareness, and federal agencies recommend take-back options as the preferred method for opioid disposal. We encourage all dentists and oral surgeons to help educate patients and encourage them to choose safe disposal options. For example:
- Provide the locations of nearby MedSafe medication collection receptacles.
- Give the patient a TakeAway Medication Recovery System envelope along with the prescription or explain how to obtain one.
- Share the dates of semi-annual Prescription Drug Takeback Day events in the local community.
Sharps Compliance Supports Dental & Oral Surgery Practices
Like most medical offices, dental practices create certain types of regulated medical and hazardous wastes. Sharps Compliance can provide the tools you need to stay in compliance with state and local disposal regulations and protect your staff and patients.
Contact us to learn more about our sustainable medical and hazardous waste disposal options for dentists:
- Disposal of dental anesthetic carpules
- Understand and comply with the EPA’s amalgam separator rule
- Disposal of dental sharps and red bag wastes
- Single-use device recycling