Dental Opioid Stewardship
Did you know that 12% of immediate release opioids are prescribed by dentists, with dentists writing 18.5 million opioid prescriptions in the United States annually?
There is also evidence showing that nearly half of all opioids prescribed by dentists post-operatively go unused, which can result in nonmedical use or diversion of unused opioid medications. Additionally, opioids prescribed after wisdom teeth removal are frequently the first opioid experience for patients under the age of 25. Opioid use in this age population can alter brain development and increase the risk of developing substance use disorders. Reducing unused opioids and opioid exposure in the adolescent and young adult population are two critical strategies to combat the opioid epidemic.
The IHS Division of Oral Health has approved clinical recommendations to reinforce evidence-based acute pain management strategies, including optimizing non-steroidal anti-inflammatory drugs, acetaminophen, and topical/local pain strategies to avoid or reduce opioid exposure. It also includes a decision tree for pre- and post-operative pain management, as well as recommended dosing for pain medications based on anticipated post-procedural pain.
IHS Acute Dental Pain Management Guidelines:
CDC Acute Dental Pain Treatment Recommendations & Resources Link:
Providers Clinical Support System (PCSS) Continuing Education Courses Links:
IHS Dental Opioid Stewardship Continuing Education Courses:
- DE0212 - IHS Recommendations for Management of Acute Dental Pain: A Collaboration with HOPE
- DE0371 - Pain Management Series 1/4: Opioids and Pain - An Overview
- DE0372 - Pain Management Series 2/4: Pain Management in Dental Settings
- DE0373 - Pain Management Series 2/4: Pain Management in Dental Settings
- DE0374 - Pain Management Series 4/4: Effective Patient Communication
- DD0043 - USPHS Dentist Webinar: Managing Dental Patients with Opioid Use Disorder [Medication-Assisted Therapy]
- DD0024 - USPHS Dentist Webinar: Opioid Overdose Reversal with Naloxone in Dental Settings
Mandatory IHS Essential Training on Pain and Addiction and Refresher Course Link:
Oral Health/Mental Health Toolkit:
- Oral Health, Mental Health and Substance Use Treatment: A Framework for Increased Coordination and Integration. (PDF - 4MB)
ADA Opioid Prescribing Policies and Practice Resources: