Houston, we have a problem. (You too, Cleveland and Chicago and Minneapolis and Denver.)
Stop looking so pleased with yourself, New York and California.
America, we need to have a talk. About our dentists. And their opioid prescribing habits.
This doesn’t have to be a long talk, but we do need to have it. And perhaps the best way to motivate everyone is a perennial favorite: sibling rivalry.
There is one realm in which British dentistry is currently beating the pants off American dentistry (and no, this is not a setup to a joke).
You see, researchers at the University of Illinois compared dental opioid prescription rates in the United States versus England, and it turns out our British dental counterparts take a far more conservative approach to pain medication prescribing than dentists in the United States—thereby helping to prevent the problem of opioid addiction at one of its earliest potential roots.
The study, conducted in 2016, tracked opioid prescriptions written by dentists.
Initially, simply the overwhelming disparity in numbers is remarkable: American dentists wrote 1.4 million prescriptions for opioid medications versus just 28,000 such prescriptions among their British counterparts in 2016. That is thirty-seven times more opioid prescriptions in the United States than in England.
Once all the numbers were crunched, and the data were analyzed and adjusted, additional findings came to light.
- In America, opioid prescriptions accounted for 22% of all prescriptions written by dentists.
- In Britain, the corresponding rate was a scant .06%.
- IN 2016, the American dentist, on average, wrote 58 opioid prescriptions (more than one per week), while English dentists wrote just one the entire year.
- When American dentists prescribe opioids, they most frequently prescribe hydrocodone-based medications (62%), codeine (23%), oxycodone (9%), and tramadol (5%).
- The UK’s prescribing laws and guidelines—which clearly shape dentist prescribing patterns in England—do not permit most of the narcotic options American dentists rely on. The only legal dental opioid prescription in England is a low-strength codeine, dihydrocodeine.
The lead author of the study, Katie Suda, pointed out an obvious issue raised by this data that cannot be ignored without a serious look at American dental prescribing practices: “We have all probably had the experience of a terrible toothache. But all dentists treat pain worldwide, so we would not expect a large difference in which pain medication is prescribed, and our results show that U.S. dentists prescribe opioids more frequently than is likely needed.”
The American Dental Association Center for Professional Success has created a centralized information center on preventing opioid abuse that gathers advocacy materials, educational resources, professional guidelines, and more.
With these resources (armed with backup data about how plenty of people worldwide receive oral care, including root canals, with nothing more than non-opioid medications for dental pain), we can start having conversations with dental patients, as well.