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The Opioid Epidemic and Its Connection to Dental Care

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You’re in the dental chair, ready to have your wisdom teeth removed. You count down from 100, and in what feels like minutes later, you wake up in a fog with a mouth full of gauze. A few hours later, it will probably hurt — but how much it hurts is different for everyone.

More than 5 million people had their wisdom teeth removed last year, the majority being teens and young adults. Having wisdom teeth removed is intensive oral surgery and afterward, you may be prescribed opioid painkillers, such as Vicodin, Percocet or Tylenol with codeine. For many young people in the United States, wisdom teeth extraction is their first exposure to opioid painkillers. According to a study by the American Academy of Pediatrics, the use of prescribed opioids before 12th grade is associated with a 33-percent increase in future opioid misuse after high school.

Research supports that over-the-counter pain relievers, such as Tylenol and Motrin, may provide equal or superior relief of postoperative dental pain. Yet a study found 80 percent of people from ages 13 to 30, who had their wisdom teeth removed, filled an opioid prescription. And those who filled their prescription were nearly three times as likely to continue to use opioids in the year following.

Dr. Ted Wong, chief dental officer at UnitedHealthcare, says that oral health professionals write 12 percent of all opioid prescriptions, including 45 percent of opioid prescriptions for adolescents*– an age group especially vulnerable to addiction.  

“Painkilling prescriptions are necessary and useful for some medical conditions; however, these powerful drugs come with a high risk of misuse and addiction,” said Dr. Wong. “It is important to recognize the connection between dental care and opioids.” 

With that in mind, UnitedHealthcare has taken the following steps to limit teens’ exposure and inform them about opioid medications, including:  

  • A prescription drug policy that limits all first-time opioid prescriptions written by dental health professionals for people age 19 and under no more than three days and fewer than 50 morphine milligram equivalents per day, as recommended by the Centers for Disease Control & Prevention (CDC). 
  • Informing dental plan participants by mail about the risks associated with opioids, specifically in connection to wisdom teeth extraction. The information aims to help parents and young adults better identify pain management alternatives and manage the frequency of use, dosage and proper disposal of unused opioids. 
  • Producing TV and radio public service announcements with Shatterproof, a national nonprofit organization dedicated to ending the devastation the disease of addiction causes by  working to ensure every American with a substance use disorder has access to treatment based on proven research.

Dr. Wong suggests to ask your dentist the following questions if you or a loved one are planning to have wisdom teeth removed: 

  • Do I really need to use opioids to manage my pain? 
  • Are there alternatives to managing pain and what are they? 
  • Will any of the medications I am currently taking interact poorly with opioids?
  • How do I properly dispose of leftover opioids?

Learn about a mother's experienceOpens a new window with opioid prescriptions and how she navigated the situation. For more information about UnitedHealthcare’s efforts to address the opioid epidemic click here.

*UnitedHealthcare pharmacy claims analysis representing more than 4 million claims, 2018
**Make sure to follow the directions from your dentist or doctor for pain management.