36 - Use of prescription pain medications following teeth extractions in an urban dental school clinic

Abstract:

Objective: Investigate the likelihood of receiving same-day opioid or non-steroidal anti-inflammatory drug (NSAID) prescriptions after ≥2 teeth or 1 tooth extraction.

Methods: This retrospective cohort study used patient data from a dental data repository. Adults, ≥18 years, with at least 1 tooth extracted between July 1, 2010, and July 30, 2019, were included. Covariates included age, gender, clinic location, and self-reported histories of diabetes, hypertension, and arthritis. The outcome was a documented pain prescription linked to the extraction date. Statistical analyses included descriptive statistics, univariable and multivariable logistic regression models. The final model quantified the odds of receiving a same-day prescription (NSAID, opioid, or both) by comparing ≥2 teeth vs 1 tooth extraction.

Results: Of a total 18,338 patient visits, 51.4% were female, and mean±SD age was 50.9±12.6 years. Approximately one-third of patient visits had ≥2 teeth extracted. Opioids alone were the most frequently prescribed pain medication (6.7%), then NSAIDs alone (3.2%) and opioids plus NSAIDs (0.5%). Youngest patients (age 18-25 years) received more pain prescriptions (13% any, 10.6% opioid alone, 1.6% NSAID alone, and 0.8% both). Multivariable analysis showed the odds of receiving pain medication were higher in patients with ≥2 teeth vs 1 tooth extraction [OR=1.59(95%CI:1.44,1.76)], in males vs females [OR=1.17(95%CI:1.06,1.29)], in youngest vs oldest patients [OR=2.01(95%CI:1.72-2.51)], in arthritis vs non-arthritis patients [OR=1.17(95%CI:1.01,1.35)], and in post-doctoral periodontology vs oral surgery department [OR=4.80(95%CI:4.18,5.52)].

Conclusion: While we found an overall low rate for prescribing post-operative pain medications following teeth extraction, opportunities exist for educational initiatives to further minimize their use.

Source of Funding: None