Oral health and the opioid epidemic

Published 9:57 am Wednesday, February 13, 2019

The opioid epidemic is affecting countless lives and communities across the country, including here in Tennessee. In fact, opioids each day cause more than 130 overdose deaths in the United States, according to the Centers for Disease Control & Prevention (CDC); and the economic cost exceeds $500 billion annually, according to a study from The Council of Economic Advisors.
Painkilling prescriptions are often necessary and useful for some medical conditions; however, these powerful drugs — such as oxycodone or codeine — come with a high risk of misuse and addiction. This is especially true for teens and young adults, in part because adolescent brains are not fully matured and are therefore more susceptible to the effects of opioids.
One potentially overlooked aspect of the opioid epidemic is the connection to oral health. In fact, oral health professionals write 12 percent of all opioid prescriptions, including 45 percent of opioid prescriptions for adolescents, according to a UnitedHealthcare analysis of claims data.
February is National Children’s Dental Health Month, an opportunity to recognize the risks for young people — and provide a reminder for parents — about the connection between oral health and opioids. With that in mind, here is information for people to consider:
WISDOM TEETH: More than 5 million people had their wisdom teeth removed last year, mostly teens and young adults. While the decision to remove wisdom teeth should involve professional advice from a dentist or oral surgeon, patients and parents should also be aware of the risks associated with potential exposure to opioids following this procedure. For many young people, wisdom teeth extraction often represents their first exposure to opioids, and a recent study from Stanford University found that teens can end up in a battle with opioid addiction following this procedure.
LIMIT SUPPLY: Other than in extreme cases, it is important to limit prescriptions for the minimum appropriate dosage and number of days, which the CDC recommends at three days and fewer than 50 morphine milligram equivalents per day. This is because the likelihood for chronic opioid use increases after the third day of use and rises rapidly thereafter, according to the U.S. Department of Health and Human Services, and misuse or dependence on opioids can lead to addiction to more powerful illicit drugs.
ALTERNATIVE PAIN MEDICATIONS: If you or a loved one is prescribed an opioid following a dental procedure or another medical event, it is good to ask your health care professional if there are alternatives, including over-the-counter pain relievers such as a combination of acetaminophen and ibuprofen. In many cases, these medications can be equally effective in pain management, without the risk of addiction.
PROPER DISPOSAL: Approximately 70 percent of misused opioid prescriptions were obtained, stolen or purchased from a friend or relative, according to the CDC. That’s why it is important to keep opioids in a safe place — like a locked cabinet — and always properly dispose of unused medications. That can include returning the drugs to your pharmacy, or mixing them with water and an unappealing substance, such as cat litter, and putting in the trash (if simply thrown in the trash, unused prescription drugs can be retrieved and misused).
Addressing the connection between oral health and opioids is one part of curbing this epidemic.
(Dr. Ted Wong is the Chief Dental Officer for UnitedHealthcare Dental. A board-certified prosthodontist, Dr. Wong has more than 30 years of experience in the oral health field, including serving as a board member on the board of the Harvard School of Dental Medicine’s Dental-Medical Integration Initiative.)

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