Dental

Supporting Literature

Chung et al. 2018 (Level 3 evidence)

• doi: 10.1542/peds.2017-2156
• Retrospective cohort study that analyzed the prevalence of and indications for outpatient opioid prescriptions and the incidence of opioid-related adverse events in children undergoing dental extraction at a single institution between 1999-2014.
• 1362503 outpatient opioid prescriptions; The annual mean prevalence of opioid prescriptions was 15%
• 437 cases of opioid-related adverse events confirmed by medical record review; 88.6% were related to the child’s prescription and 71.2% had no recorded evidence of deviation from the prescribed regimen.
• Adverse events increased with age and higher opioid dose. Adverse events accounted for 38.3% of prescriptions.

Chua et al. 2021(Level 3 evidence)

• doi:10.1016/j.amepre.2021.02.008.
• Used IBM MarketScan Dental, Commercial, and Medicaid Multi-State Databases to analyze data from privately and publicly insured patients aged 13–64 years who underwent a dental extraction between 2011-2018. Included 8,544,098 procedures among 5,562,589 unique patients.
• When ≥1 initial prescription did occur the 90-day risk of overdose was 5.8 per 10,000 procedures and the 90-day risk of overdose in a family member was 1.7 per 10,000 procedures.
• When ≥1 initial prescription did not occur, the 90-day risk of overdose was 2.2 per 10,000 procedures and the 90-day risk of overdose in a family member was 1.0 per 10,000 procedures.

Moore & Hersh 2013 (Level 4 evidence).

• doi: 10.14219/jada.archive.2013.0207
• Systematic review to determine the safety and analgesic efficacy of combining ibuprofen and N-acetyl-p-aminophenol (APAP).
• Found that ibuprofen and APAP may be a more effective analgesic with fewer side-effects than current treatments for third molar extractions.
• Number of doses of ibuprofen + APAP to treat pain = 1.6