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Acute Dental Pain

Dental workers and a patient

Recommendations for Management of Acute Dental Pain [PDF - 348 KB] - from IHS's Division of Oral Health (DOH) and National Committee on Heroin, Opioid and Pain Efforts (HOPE)

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?

Despite this volume, there is 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.