Avoiding Opioids & Addiction After a Dental Procedure

Avoiding Opioids & Addiction After a Dental Procedure
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Avoiding Opioids & Addiction After a Dental ProcedureClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. Why Are Opioids Prescribed After Dental Procedures?
  2. Which Procedures?
  3. How Addictive Are Opioids?
  4. Dangers of Not Following Doctor's Orders
  5. Weaning Off
  6. Alternatives to Opioids
  7. Resources for Help
  8. References

It’s not a news flash that we associate serious dental problems and oral surgeries with pain. Teeth and gums have numerous nerve endings, and tooth decay, mouth injuries and other significant issues tend to create sharp pain, dull aches or something in between to let us know something’s wrong.

Dentists, like doctors, consider it good for business when patients aren’t in pain. So it’s not surprising that they prescribe pain medication before and (mostly) after dental procedures such as root canals and wisdom teeth extractions.

But as with other physicians, dentist and oral surgeons are aware of the addiction dangers that accompany the use of a specific painkiller: opioids. Following a surge of opioid deaths over the past decade, medical professionals now lean toward prescribing non-opioid painkillers to patients.

Life expectancy in the United States has dropped since 2016 largely because of an opioid crisis that continues to show worsening mortality rates.

Why Are Opioids Prescribed After Dental Procedures?

From 2010 to 2016, prescription opioid use among dental patients increased 68 percent. In addition, for many people, a trip to the dentist gives them their first exposure to opioids

Pain is normal after dental treatment, and the goal of any dentist is to get the pain to manageable levels. For most procedures, a mild painkiller will do the trick.

However, some dental procedures result in severe postoperative pain and dental emergencies that require radical numbing action. Additionally, some patients may undergo acute oral-facial pain that needs potent pain relief.

In such situations, dentists will prescribe opioid-based painkillers because of their powerful pain-relieving abilities.

Which Procedures Are Opioids Prescribed For?

Dentists have historically been the largest providers of opioid medications for younger people, often handing out prescriptions after the following procedures:   

  • Third molar extractions
  • Gum surgery
  • Dental implant placements
  • Other dental surgeries or dental pain

How Addictive Are Opioids?

Opioids are highly addictive because they target the pleasure centers in your brain. This leads to the release of endorphins, a group of hormones that activate the brain’s reward centers.

While this is great for eliminating pain, it also creates a feeling of elation and pleasure, unlocking a temporary sense of well-being. Understandably, you will crave to have the same feeling when the dose wears off.

With repeated uncontrollable use, you will soon have an addiction that causes an uncontrollable urge to take the drug, even when it harms you.

The NHS indicates that in the year 2020, more than 10 million people misused their opioid prescriptions, and a further 1.6 million people had an opioid use disorder.

According to the National Institute of Drug Abuse (NIDA), close to 50,000 people died of opioid overdose in 2019.

Dangers of Not Following Doctor’s Intake Instructions

How to Use Opioids Safely After a Dental Procedure

Failing to follow the dentist’s instructions can lead to opioid addiction or worse, death. Opioids have tantalizing and euphoric effects that lure someone into abusing the prescribed amounts, leading to addiction.

Addiction can tempt someone into constant opioid use, leading to overdoses that often results in death. Data by NIDA indicates that over 14,000 people died of prescription opioid overdose in 2019.

Here’s how to use opioids safely:

  • Put more significant gaps between taking doses once the pain gets reduces.
  • Follow prescriptions religiously and only for intense pain anyway.
  • Do not mix with other medications or alcohol.

Weaning Off Opioids

If you’ve taken opioids for less than two weeks and stuck to the prescription recommended by your doctor, you should be able to stop using them immediately.

On the other hand, if you went over your dosage or kept using the opioids for more than two weeks, then you need to consult your doctor before stopping cold turkey. This is especially true if you start displaying addiction symptoms, such as reduced drug effects from the exact dosage (tolerance).

That’s because you may be addicted. And halting the dosage may lead to withdrawal symptoms that can be dangerous. Consult your doctor to design a tapering withdrawal plan to reduce the opioid intake safely.

The process is challenging and may take weeks or months, but you will be successful if you follow the doctor’s instructions.

Alternatives to Opioids

Alternatives to Opioids for Dental Pain

The CDC recommends non-opioid analgesics as the first option (first-line therapy) for managing pain from a dental procedure. In cases where dentists anticipate pain after an operation, the CDC recommends prescribing acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs).

Alternatively, you can use non-medicinal means to supplement the pain medication. These include:

  • Meditation
  • Ice
  • Massage
  • Music
  • Rest
  • Saltwater rinse
  • Avoiding certain foods, including those containing salt

A 2017 study of 14 dental clinics at the University of Michigan reported that of the dental patients who were prescribed painkillers after surgery, those who used opiates reported higher levels of pain than those who took non-opiate pain relievers.

If you must use opioids, dentists should prescribe the lowest dosages of immediate-release opioids.

The CDC also points out that most patients should feel the pain wear off after three days, so the desired dose should be three days or less. There should be very rare instances past the 3-day mark, but they should be less than seven days in any case.

Moreover, combine opioids with first-line therapy while avoiding multiple preparations containing acetaminophen.

Resources for Help

There are a number of free community, non-profit and government resources to help those who abuse opioids – and their families. Three federal centers that can provide a significant amount of information are:

  • Center for Disease Control and Prevention (CDC): The Drug Overdose section on the CDC’s website is a great resource for the latest information and data about drugs and drug use (and abuse) in the United States.
  • Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA has a National Helpline that is confidential, free and open every hour of every day. You can get referrals to local resources, support groups, treatment programs and other community-based help groups. You can also order free literature.
  • National Institute for Drug Abuse (NIDA): Among other things, NIDA is a trusted source for science-based information about teen drug use. The group is also a good source for parents as they confront opioid abuse in their kids.

Other resources for people include:

  • Opioid addiction treatment programs. You can find a certified treatment program near you (or one that your insurance may cover) through the HHS treatment index here.
  • Narcotics Anonymous. NA is most often associated with drugs like marijuana, cocaine, heroin and methamphetamine, but the addition rate of opioids has proved so unyielding that many opioid abusers turn to NA for help. You can start to find a 12-step drug abuse program on the NA website.
  • Virtual help. Narcotics Anonymous also provides virtual meetings around the globe. There is virtually no day or time when there is not a meeting to be found. Find a virtual NA meeting here.

References

Managing Pain after Dental Treatment. (August 2019). North Carolina Department of Health and Human Services.

Overdose Death Rates. (January 2021). National Institute on Drug Abuse.

What is the U.S. Opioid Epidemic?. (February 2021). U.S. Department of Health and Human Services.

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. (March 2016). Centers for Disease Control and Prevention (CDC).

Opioids & Dental Pain. (April 2021). National Institute of Dental and Craniofacial Research (NIDCR). 

Tapering off opioids: When and how. (May 2021). Mayo Clinic.

Drug Overdose. (July 15, 2021). Centers for Disease Control and Prevention.

Parents: Facts on Teen Drug Use. (2021). National Institute on Drug Abuse.

Federal Resources. (August 2021). U.S. Department of Health and Human Services.

Effective Treatments for Opioid Addiction. (November 2016). National Institute on Drug Abuse.

Association of Opioid Use With Pain and Satisfaction After Dental Extraction. (March 2020). Journal of the American Medical Association Network.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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