Opioids are no better than other meds at quelling the pain of a pulled tooth, a new study finds, suggesting it may be possible to significantly reduce their use in dentistry.
University of Michigan researchers asked more than 325 people who had teeth pulled to rate their pain and satisfaction within six months of their extraction.
About half of those who had surgical extraction and 39% of those who had routine extraction were prescribed opioids, according to the study.
"Patient satisfaction with pain management was no different between the opioid group and non-opioid group, and it didn't make a difference whether it was surgical or routine extraction," study co-author Dr. Romesh Nalliah said in a university news release. He is associate dean for patient services at Michigan's School of Dentistry.
In fact, his team was surprised to find that patients who got opioids reported worse pain than those given non-opioid painkillers for both types of extractions.
The study also found that about half of the opioids prescribed went unused.
If leftovers are not disposed of properly, patients or people around them could be at risk of future opioid misuse, the researchers noted.
"The real-world data from this study reinforces the previously published randomized-controlled trials showing opioids are no better than acetaminophen and nonsteroidal anti-inflammatory drugs for pain after dental extraction," said study co-author Dr. Chad Brummett. He's director of the Division of Pain Research at Michigan Medicine.
The authors said their findings suggest that major changes are needed in dental prescribing practices in light of the current opioid crisis in the United States.
The American Dental Association suggests limiting opioid prescriptions to seven days' supply, but Nalliah thinks that's too much.
"I think we can almost eliminate opioid prescribing from dental practice," he said. "Of course, there are going to be some exceptions, like patients who can't tolerate nonsteroidal anti-inflammatories. I would estimate we can reduce opioid prescribing to about 10% of what we currently prescribe as a profession."
The study was published March 13 in the journal JAMA Network Open.
The U.S. National Institute on Drug Abuse has more about prescription opioids.