Dentists craft new opioid prescription guidelines

CHICAGO — The American Dental Association wants dentists to drastically cut back on prescribing opioid painkillers.

The association announced a new policy Monday that “essentially says eliminate opioids from your arsenal if at all possible,” said Dr. Joseph Crowley, the group’s president. The Chicago-based group represents around 161,000 dentists.

The group is also pushing for its members to limit opioid prescriptions to no more than a week and to institute mandatory education for dentists that encourages them to use other painkillers.

Dentists write less than 7 percent of U.S. opioid prescriptions, but new research shows that the practice has increased in recent years, despite evidence that ibuprofen and acetaminophen work just as well for most dental pain and are less risky painkillers.

In many dental cases involving opioids, dentists prescribe Vicodin or Percocet for short-term pain from procedures including removal of wisdom teeth and other tooth extractions, root canal work or dental implants.

But nonsteroidal anti-inflammation drugs including ibuprofen (sold as Motrin and Advil) are as effective for these conditions; and ibuprofen plus acetaminophen (Tylenol) can provide better pain relief in some cases, according to an analysis of five studies published in the Journal of the American Dental Association.

Dentists are the leading prescribers of opioids for U.S. teens, and the largest increase in dental prescriptions from 2010 to 2015 occurred in 11- to 18-year-olds, according to a study published in the same journal.

The association said in a 2016 policy that dentists should consider these nonopioids as first-line treatment for pain.