Opioid prescribing patterns by dental procedure among US publicly and privately insured patients, 2013 through 2018

The objective of this study was to determine which dental procedures accounted for the most opioid prescriptions and to assess trends in prescribing for these procedures. Using national commercial and Medicaid claims between 2013-2018, we found that 5 procedures accounted for 95% of dental opioid prescriptions for privately and publicly insured patients aged 13-64 years. One procedure alone – tooth extraction – accounted for 65% of dental opioid prescriptions and almost 80% of dental opioid prescriptions among adolescents and young adults aged 13-25 years. Despite modest decreases in the opioid prescribing rate and size of opioid prescriptions, 45% of patients undergoing tooth extraction still had an opioid prescription in 2018, with an average prescription size of 20 pills. Our findings suggest that eliminating routine dental opioid prescribing could greatly reduce overall dental prescription opioid exposure. Eliminating such prescribing is feasible given that ibuprofen and acetaminophen are effective and safer options for pain control after this procedure.

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