Study at Eastman Institute Reveals Hopeful Non-Opioid Option for Post-Tooth Extraction Pain Relief
In an effort to combat the ongoing opioid epidemic, a study published in JAMA Network Open by the University of Rochester Medical Center's Eastman Institute for Oral Health (EIOH) explores a potential non-opioid alternative for managing acute dental pain.
The study, led by Dr. Yanfang Ren, DDS, PhD, MPH, professor and clinical chief at Howitt Urgent Dental Care, compares two groups of patients who had dental extractions at the clinic in Rochester, New York. The first group, from 2012, received either ibuprofen or acetaminophen for mild pain, and opioid combinations for moderate to severe pain. In contrast, the second group, from March 2021 through February 2022, was prescribed acetaminophen or ibuprofen for mild pain, higher doses of ibuprofen or an ibuprofen and acetaminophen combination for moderate to severe pain, and received no opioids whatsoever.
The results of the study showed promising effectiveness when evaluated using a real-world measure of proportion of patients returning for additional pain treatment after receiving the prescribed analgesics. For patients unable to take ibuprofen or acetaminophen due to health issues or medication interactions, a gabapentin combination was used as a non-opioid alternative in 2022, instead of opioid combinations used in 2012.
Dr. Eli Eliav, the director of EIOH and a pain expert, stated that this study represents continued efforts by dentists to minimize the use of opioids for dental pain. Additional studies, preferably randomized controlled clinical trials, are needed to confirm the safety and effectiveness of this approach, according to Dr. Eli Eliav.
The opioid epidemic continues during the COVID-19 pandemic, with prescription opioid-related deaths increasing more than 16% from 2019 to 2020. Opioids account for nearly 18% of all opioid overdose deaths. The American Dental Association recommends nonsteroidal anti-inflammatory drugs for managing pain, but dentists frequently prescribe opioids for dental pain and contribute substantially to new and persistent opioid use.
Other authors on the study include Qirong Huang, DDS, MS, Linda Rasubala, DDS, PhD, Richard H. Gracely, PhD, Junad Khan, BDS, MSD, MPH, PhD, and Eli Eliav, DMD, PhD. Unfortunately, the authors from the Eastman Institute for Oral Health at the University of Rochester Medical Center responsible for the JAMA Network Open article are not explicitly named in the search results; the listed authors in the search results appear unrelated or belong to other medical specialties and publications.
This study offers a promising step towards reducing the reliance on opioids for dental pain management. As research continues, the potential benefits of non-opioid alternatives could significantly impact the opioid epidemic and improve patient care.
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