Patterns of opioid prescribing in an Appalachian college of dentistry

Background: Nonopioids provide sufficient analgesia with less risk after most dental procedures, but opioid prescriptions are still common. This study analyzed opioid prescribing characteristics on the basis of patient demographics and procedure types. Methods: The authors conducted a secondary analysis of an existing data set of opioid prescriptions issued from 2013 through 2018 from a college of dentistry in central Appalachia. Opioid prescriptions for young children or liquids were excluded. The authors analyzed prescriptions according to patient age group and sedation level required for surgical procedures. Results: Of 12,464 opioid prescriptions analyzed, 70% were written after extractions or surgical procedures. More than one-half (57.3%) were written for patients younger than 45 years. Adolescent and young adult (AYA) patients received prescriptions of higher quantities (mean [standard deviation], 20.9 [6.4] pills; 95% confidence interval, 20.6 to 21.1) and of longer durations (mean [standard deviation], 3.3 [1.5] days; 95% confidence interval, 3.2 to 3.4) than other groups (P < .001; 1-way analysis of variance). Conclusions: AYA patients received more opioids than older patients after dental procedures, which is concerning given the high risk associated with AYA opioid exposure. Faculty in colleges of dentistry should educate students and residents on the risks and benefits of opioid therapy as well as alternative analgesics and via exemplifying appropriate prescribing behavior. Practical Implications: AYA patients represent a seemingly unidentified high-risk age group for dentists. Dentists who perform invasive procedures must examine carefully opioid prescription necessity and prescribe in a manner consistent with best practices.