(52) A 98% Decrease in Dental Opioid Prescribing in the University of New England, College of Dental Medicine, Oral Health Clinic from 2016 to 2023

Abstract: One component of the current opioid epidemic is the increased prescribing of opioids since 1999. Even though the number of prescribed opioids peaked in 2012, they are still the most commonly misused prescription drug in the United States. The Centers for Disease Control and Prevention (CDC) along with the American Dental Association (ADA) recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen as the first-line treatment for acute dental pain (CDC Clinical Practice Guideline for Prescribing Opioids for Pain, United States, 2022). This study analyzes opioid dental prescribing in Maine, specifically in the field of oral and maxillofacial surgeons. Opioid prescription data was obtained from the University of New England, College of Dental Medicine, Oral Health Clinic (OHC), a group practice of oral and maxillofacial surgeons in southern Maine, and the State of Maine from 2019 to 2023. The data reflects a general decrease in the overall number of opioid prescriptions and the number of doses per prescription. The most commonly prescribed opioids in all practice settings were hydrocodone and oxycodone. A 98% decrease in opioid prescriptions was seen from 2016 to 2023 in the UNE OHC which may be associated with the continuing education presented by UNE faculty that is now required for licensure by dentists in Maine after an update to the Prescription Monitoring Program in 2016. The data also shows a large difference between the UNE OHC versus SMOMS with regard to opioid prescriptions per 100 oral surgeon visits. These results demonstrate an overall decrease in opioid prescribing and a change in practice associated with the treatment of acute dental pain in the State of Maine. This change aligns with the ADA guidelines and the use of NSAIDs and acetaminophen as the first-line treatment for acute dental pain.
Table 1. A comparison of the UNE Oral Health Clinic (OHC) versus Southern Maine Oral Maxillofacial Surgery (SMOMS) practice for opioid prescriptions per 100 patient visits. The authors recognize there may be more invasive procedures in the SMOMS practice then the oral surgeon procedures in the UNE OHC. Graph 1. Trends in Average Quantity Prescribed by Drug Category at a Southern Maine group practice OMFS office from 2017 through 2023.Graph 2. Total number of Opioid prescriptions at a Southern Maine group practice OMFS office.