Trial reportImplementation science : IS2023
De-Implementing Opioids for Dental Extractions (DIODE): a multi-clinic, cluster-randomized trial of clinical decision support strategies in dentistry.
Trial report in Implementation science : IS, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03584789 (De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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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.
De-Implementing Opioid Use and Implementing Optimal Pain Management Following Dental Extractions
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Low-value interventions to deimplement: A secondary analysis of a systematic review of low back pain clinical practice guidelines.PM & R : the journal of injury, function, and rehabilitation · 2025Pooled it
- Efficacy and safety of ibuprofen gargle for postoperative pain after mandibular third molar extraction: A phase II, placebo-controlled, double-blind, randomized crossover trial.Clinical and experimental dental research · 2023Trial
- De-Implementing Low-Value Care in Dentistry: The Case for Choosing Wisely Campaigns.Community dentistry and oral epidemiology · 2026Article
- Opioid prescribing after nonsurgical root canal therapy: Findings from The National Dental Practice-Based Research Network.Journal of the American Dental Association (1939) · 2026Article
- A Descriptive Analysis of Potential Warfarin-NSAID Interactions in Dental Prescribing in Minas Gerais, Brazil, 2011-2021.Healthcare (Basel, Switzerland) · 2026Article
- Using Implementation Science to Improve Evidence-Based Policing: An Introduction for Researchers and Practitioners.Police quarterly · 2025Article
- Alternatives to dental opioid prescribing after tooth extraction (ADOPT): protocol for a stepped wedge cluster randomized trial.BMC oral health · 2024Article
- Clinical Decision Support to Reduce Opioid Prescriptions for Dental Extractions using SMART on FHIR: Implementation Report.JMIR medical informatics · 2023Article
- Barriers to dental providers' use of a clinical decision support tool for pain management following tooth extractions.Implementation research and practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOpioid pain relievers are commonly prescribed following dental extractions, but evidence shows that non-opioid analgesics often provide adequate pain relief with fewer risks. The current study examined clinical decision support (CDS) as a tool for de-implementing opioid prescribing in dentistry.
methodsThis prospective, cluster-randomized trial examined CDS for dental pain management at 22 HealthPartners Dental Group clinics in Minnesota. Dental providers (n = 49) were randomized to deliver care using CDS, CDS with patient education materials (CDS-E), or standard practice (SP). Randomization was stratified by provider type (dentist vs. oral surgeon) and baseline opioid prescribing volume. Patient records of dental extractions were examined for January 2019 through May 2021, representing a 12-month baseline and 15-month intervention period (N = 12,924). Opioid prescription at the visit (no vs. yes) was the primary outcome. Data were analyzed using generalized linear mixed models, adjusting for patient sex and age, extraction complexity, and baseline prescribing strata (volume and provider type).
resultsPatients were 56.2% female, with a mean age of 46.7 (SD = 20.0) years. Providers were 8% oral surgeons, 57% female, and with a mean age of 43.7 (SD = 11.2) years. There were significant decreases in opioid prescribing during the study (P < 0.001), representing a continuation of pre-existing trends to reduce opioid prescribing in these dental practices. There were no significant differences in opioid prescribing between CDS and SP (OR = 1.29; 97.5% CI = 0.93, 1.79; P = 0.08), or CDS-E and SP arms (OR = 1.27; 97.5% CI = 0.86, 1.79; P = 0.18). The direction of the association favored greater reductions in opioid prescribing in the SP arm. Despite training and implementation support, utilization of the CDS was low, particularly among oral surgeons, who were significantly more likely than other dentists to prescribe opioids. Among non-oral surgeon providers with the opportunity to access it, CDS utilization was not significantly associated with opioid prescribing.
conclusionsEquipping dentists with CDS resources, whether alone or accompanied by patient education materials, did not accelerate reductions in opioid prescribing beyond those observed in standard practice. Strategies are needed to enhance CDS utilization for patient care and safety surrounding analgesia following dental extractions.
trial registrationClinicaltrials.gov, NCT03584789.
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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.