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Opioids are a risky choice for pain relief in wisdom tooth extraction

Melissa Benmark
Michigan Radio

Young people who were prescribed opioids for wisdom tooth extraction have a 2.7-fold increased risk of developing an opioid habit compared to those who were not prescribed opioids. That’s according to a new study from the University of Michigan.

The overall percentage of people who actually developed a persistent opioid habit was low – just 1.3 percent were still using opioids weeks or months later. But wisdom tooth extraction is a very common surgery – nearly 3.5 million are performed every year. That means the overall number of people affected is potentially very high.

“This could be like 50,000 kids per year becoming newly dependent through third molar extraction and those numbers probably aren't perfect, but just that kind of back of the envelope math clearly puts it into context,” says Chad Brummett, a co-director of Michigan OPEN, and a senior author on the study.

Brummett recommends that dentists and patients choose other pain relievers with tooth extraction surgery like Tylenol or ibuprofen to avoid the risk of becoming dependent on opioids.

The study included patients between the ages of 13 and 30 who filled an opioid prescription immediately before or after their wisdom teeth were removed. Within that group, people in their late teens and 20s had the highest odds of persistent opioid use.

Brummett says in many cases, the opioid use following extraction surgery was their first exposure to opioids, and represented an opportunity to become drug dependent. That was especially true for patients with other risk factors like depression, anxiety, and chronic pain. However, even when correcting for those other risk factors, the existence of an opioid prescription was still independently linked to persistent opioid use.

According to Brummett, other studies have shown that opioid drugs are not more effective than alternatives like Tylenol (acetominophen) and non-steroidal anti-inflammatories, such as ibuprofen. When considered with the additional risk of becoming opioid dependent, the study results suggest that dentists, oral surgeons, and patients should consider using non-opioid drugs for pain, if possible.