USA Follows UK in Dental Prescribing
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- Published: Wednesday, 29 November 2023 10:27
- Written by Peter Ingle
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UK dentistry may sometimes seem to follow the USA’s lead in dental innovations, but in at least one important area America is still trying to catch up.
The good news is that prescription of opioids for dental procedures in America is dropping, according to a recent study. But there is still some way to go, with the study showing that American dentists and oral surgeons were prescribing opioids in late 2022 at four times the rate that another study had shown British dentists were prescribing in 2016.
The new study, funded by the Benter Foundation and the Michigan Department of Health and Human Services found that dental opioids dispensed to U.S. patients of all ages declined 45% from 2016 to the end of 2022. Even with this drop there were about 7.4 million dental patients receiving opioid prescriptions in 2022 in the USA. But the study raised concerns that initial progress had not been maintained, showing a considerably steeper decline in opioid prescriptions in the pre-pandemic years 2016 to 2019, compared with the rate of decline from June 2020 to December 2022.
Had the earlier pace of decline been maintained, 6.1 million fewer dental opioid prescriptions would have been dispensed between June 2020 and December 2022.
Senior study author Dr Kao-Ping Chua, assistant professor of paediatrics at the University of Michigan Medical School, said: “These data suggest the dental profession has made major strides in reducing opioid prescribing, but also suggest that progress is slowing,”
Opioid prescriptions for teenagers and young adults, who are at especially high risk related to opioids, did keep declining rapidly even after the early pandemic pause. For other groups, the rate of decline slowed after June 2020.
One reason that has been suggested for the reduction in the rate of decline, was that dentists may have been more likely to prescribe opioids just in case they were necessary, out of concern that patients couldn’t easily access treatment during the pandemic.
The study used data from a company called IQVIA which tracks prescriptions dispensed at 92% of U.S. pharmacies. The researchers excluded data from March to May of 2020, during the pandemic pause in routine dental care.
Pandemic-associated changes in dental opioid prescribing varied widely. The number of dental opioid prescriptions from June 2020 to December 2022 was 57% higher than predicted for low-income patients covered by Medicaid. For privately insured patients, this percentage was 30% higher than predicted. Reduced access to dental care in Medicaid patients may have increased the number of painful dental emergencies and the need for opioids, the authors postulated.
There are also regional variations, nearly 56% of dental opioid prescriptions in 2022 were for people living in the Southern United States, and the decline in dental prescribing to people in the Northeast slowed to a greater degree than in other regions.
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