Shifting Perspectives on Pain Management in Oral Surgery

In a survey of 1,015,116 opioid naïve patients undergoing surgery, total duration of opioid use was the strongest predictor of misuse and the greatest risk for individuals in the 15-24 age group. Young people aged 15-24 often get their first exposure to opioids with dental surgery. In a survey of randomly selected oral surgeons conducted by Dr. Abubaker and colleagues, the average number of opioid tablets prescribed was 20, with 22% prescribing more than 20 tablets, and 11% prescribing more than 30 tablets. These risk factors, combined with the current epidemic, have led many oral surgeons to believe that the old standards of depending on opioids as a first-line treatment should be a thing of the past. The number of opioid prescriptions written should decrease moving forward, as dental pain can often be managed without opioids. As Chair of the Department of Oral and Maxillofacial Surgery at Virginia Commonwealth University School of Dentistry in Richmond, Virginia, Dr. Abubaker has led the implementation of new guidelines for prescribing after dental surgery procedures that minimize the use of opioids while meeting patients’ pain needs.

“Dentists play an important role in the opioid epidemic through overprescribing – usually with good intentions – but we need to accept accountability for our role in the problem,” stated Dr. Abubaker. “When managing dental pain, we must strike a balance between compassionate patient care by managing their pain and not suffering, and patient safety. It is a balance that is achievable.”

In this free CME Snack, Dr. Gold and Dr. Abubaker share insights on alternative pain management strategies for oral pain with a focus on finding a balance between compassion for patient care and patient safety.