ReviewJournal of the American Dental Association (1939)2019
Is it time US dentistry ended its opioid dependence?
Review in Journal of the American Dental Association (1939), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis.Clinical oral investigations · 2020Pooled it
- Customized pharmacological approach to acute and post-operative dental pain control in Iran: guideline review and adaptation.BMC oral health · 2026Article
- Drug interaction between non-steroidal anti-inflammatory drugs and warfarin: a cross-sectional study.Clinical oral investigations · 2025Article
- Opioid Prescribing Trends by Croatian Dentists - Is there a Reason for Concern?Acta stomatologica Croatica · 2024Article
- Facts and trends in dental antibiotic and analgesic prescriptions in Germany, 2012-2021.Clinical oral investigations · 2024Article
- Rural-urban differences in dental opioid prescribing among adolescent/young adult and adult Medicaid beneficiaries.Frontiers in public health · 2024Article
- Dental Pain Medication Prescriptions in Minas Gerais, Brazil (2011-2021): A Time-Series Analysis.International journal of environmental research and public health · 2023Article
- Photobiomodulation in dental extraction therapy: Postsurgical pain reduction and wound healing.Journal of the American Dental Association (1939) · 2023Review
- Article
- Opioids and older adults: Increasing trends in opioid usage in a dental population compared to a National Database (NHANES).Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry · 2022Article
- Opioids in oral surgery: preliminary findings between Birmingham, UK and Boston, US.British dental journal · 2021Article
- Pain Management for Dental Medicine in 2021: Opioids, Coronavirus and Beyond.Journal of pain research · 2021Article
- Patient, Provider Type, and Procedure Type Factors Associated with Opioid Prescribing by Dentists in a Health Care System.Journal of pain research · 2021Article
- Behavior Change Following Pain Neuroscience Education in Middle Schools: A Public Health Trial.International journal of environmental research and public health · 2020Article
- The feasibility of academic detailing for acute oral pain management in outpatient dentistry: A pilot study.Journal of the American Pharmacists Association : JAPhAArticle
- Barriers to dental providers' use of a clinical decision support tool for pain management following tooth extractions.Implementation research and practiceArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIn 2017, 11.4 million US citizens misused prescription opioids, resulting in 46 overdose deaths daily and a $78.5 billion burden on the economy. Dentists are one of the most frequent prescribers of opioids, and there is concern that dental prescribing is contributing to the opioid crisis.
methodsA 2019 study showed 22.3% of US dental prescriptions were for opioids compared with 0.6% of dental prescriptions in England where nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen accounted for most analgesic prescriptions. This observation prompted a review of international analgesic prescribing habits and of the advantages and disadvantages of opioids and NSAIDs for treating dental pain.
resultsUS opioid prescribing far exceeded that in other countries where NSAIDs accounted for most dental analgesic prescribing. Furthermore, results from reviews published respectively in 2018 and 2016 help confirm that NSAIDs and NSAID-acetaminophen combinations are as effective as or more effective than opioids for controlling dental pain and cause significantly fewer adverse effects.
conclusionsIn light of the potential for misuse and evidence that NSAIDs are as effective as opioids and have fewer adverse effects, there is clear patient benefit in avoiding opioids for the prevention or management of dental pain. PRACTICAL IMPLICATIONS: A growing preponderance of evidence shows that opioids are not needed for routine oral health care. This article provides an overview of the evidence and outlines possible pain management models to minimize opioid use in dentistry. The purpose is to stimulate debate about this important topic and encourage the development of definitive guidance by professional bodies, health care providers, and state and federal agencies.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.