36 LONGISLANDPRESS.COM • JULY 2019
More than half the patients getting
wisdom teeth removed will leave
the dental office clutching a prescription
for a powerful opioid pain
medication.
The surgery often comes with pain, so
more than two-thirds of patients are
prescribed opioids such as oxycodone
or Vicodin. The likelihood for chronic
opioid use, misuse or dependence
meanwhile increases after the third
day of use and rises rapidly thereafter,
according to the U.S. Centers for
Disease Control (CDC). Although sometimes
necessary, these pain relievers
come with a high risk of addiction.
Experts say dental surgery has statistically
been a contributor to the
opioid epidemic plaguing our nation,
yet its role is often overlooked. Dental
clinicians are a potential source of
initial opioid exposure and abuse for
adolescents and young adults.
“Dentists and patients are well
served to consider alternative pain
management strategies in connection
to wisdom teeth removal, including
rest and ice after the procedure and
the use of over-the-counter pain medications,”
says Dr. Ted Wong, Chief
Dental Officer of UnitedHealthcare
(UHC). “Recent studies have shown
a combination of over-the-counter
pain relievers, such as Tylenol® and
Motrin®, can be just as effective as opioids,
without the risk of addiction.”
According to Wong, UHC recently
launched several new strategies to
combat the opioid epidemic, which
include: All first-time opioid prescriptions
written by health professionals
for UHC members age 19 and under
are capped at three days and fewer
than 50 morphine milligram equivalents
per day, as recommended by the
CDC; informational campaigns have
been launched for dental health professionals,
the public, and specifically
dental plan participants on the risk
of opioid misuse among adolescents;
and parents are advised to raise
questions about opioids prescribed
for their children after wisdom teeth
removal, including the use of alternative
medications for managing pain.
Analysis by UHC officials found that
oral health professionals write 12
percent of opioid prescriptions and
45 percent for adolescents — an age
group especially vulnerable to addiction,
according to Wong.
A study published in December by the
Journal of the American Medical Association
found that adolescents who
get their first opioid prescription from
a dentist or oral surgeon are at greater
risk of falling victim to addiction.
More than 130 Americans die each
day from opioid overdoses. Teens are
especially at risk. This year, roughly
5 million people in America will
have their wisdom teeth removed,
including scores of young people in
New York State.
Under the new campaign, all United-
Healthcare dental plan participants
with dependents ages 16 to 22 will
be mailed information about the
risks associated with opioids to help
parents and young people identify
pain management alternatives and
strategies to manage the frequency
of use, dosage and proper disposal of
unused opioids.
Public Service Announcements airing
on TV and radio help parents and
health professionals understand the
connection between oral health and
the opioid epidemic.
UnitedHealthcare is also collaborating
with health care providers to
tailor ways to treat people who are
addicted and to support long-term
recovery.
“In addition, parents should be directly
involved with dispensing the medication
and keep close track of how
much has been used and how many
pills are left,” Wong says. “Following
the procedure, parents can also help
keep opioids in a safe place and help
with proper disposal of unused medications.
We know approximately
70 percent of misused opioid prescriptions
were obtained, stolen or
purchased from a friend or relative,
according to the U.S. Department of
Health and Human Services. That’s
why it is important to keep opioids
in a safe place, like a locked cabinet.”
So far, the UHC initiatives have met
with some success.
Dental health professionals identified
as among the top 10 percent of highest
opioid prescribers in UnitedHealthcare’s
network last year received
information about their status.
Prescribing patterns improved by 17
percent.
UHC is now expanding this campaign
to the top 15 percent of the highest
prescribers in its network.
Wong says that for acute pain following
wisdom teeth removal, a three
days’ supply or less is often all that is
needed.
“If people are experiencing significant
pain after that, it is likely a sign
of a complication, such as an infection
or dry socket, and a follow-up visit to
a dental professional is the recommended
next step rather than the use
of additional opioids,” he says.
For help ending addiction to opioid
pain relievers, call the Long Island
Council on Alcoholism & Drug Dependence,
Inc. at 631-979-1700.
DENTAL PAINKILLERS
EXTRACTION TO ADDICTION
THE
OPIOID
CRISIS
PRESS HEALTH
“70 percent of misused opioid prescriptions were
obtained, stolen or purchased from a friend or
relative,” says Dr. Ted Wong.
BY EDEN LAIKIN AND PATRICK MCINTYRE
/LONGISLANDPRESS.COM
