Dental Pain and Narcotic Abuse

Dental Pain and Narcotic Abuse

Many people fear going to the dentist even though dental practices have evolved to minimize discomfort. Healthy dental care is important for many aspects of your physical health and it is recommended that you see your dentist at least once a year for an examination and maintenance. However, many people only go to the dentist when they are experiencing dental pain.

About Dental Pain

Dental pain is often described as a toothache which may result from any of the following causes:

  • Tooth decay
  • Inflammation of the tooth pulp
  • Abscesses
  • Gum disease, including periodontitis
  • Loose or broken filling
  • Cracked or impacted tooth
  • Exposed tooth root
  • Food wedged between teeth or trapped below the gum line
  • Tooth nerve irritated by clenching or grinding of teeth
  • Pressure from congested sinuses
  • Traumatic injury

The first course of action is for the dentist to identify the source of the dental pain. Once identified, there are several procedures that the dentist can perform to alleviate the pain.

Dental Procedures

Two top dental procedures that receive medications include wisdom teeth removal and bridge work (dentures). Local anesthesia, general anesthesia, nitrous oxide and intravenous sedation are commonly used in dental procedures to help control pain and anxiety. Other pain relievers include prescription or nonprescription anti-inflammatory drugs, acetaminophen and anesthetics.

The FDA warns against using some of these products, indicating that the elderly are particularly sensitive to the effects of many local anesthetics. Therefore, seniors are advised to not use more than directed by the package label or the dentist.

In addition, anesthetics used for toothaches should not be used for a prolonged period of time, so they are prescribed for temporary relief until the toothache can be treated. People who use anesthetics to relieve pain from new dentures should see their dentists to determine if an adjustment to the appliance is needed to prevent more soreness.

Dental Pain and Narcotic Abuse

Dentists struggle to minimize pain and to prescribe safe levels of medication. There are no formal guidelines on how to prescribe opioids safely and effectively, and there is minimal literature in the dental community that describes opioid abuse or how patients use them.

Dr. Paul Moore, chair of the dental anesthesiology department at theUniversityofPittsburgh, presented data indicating that 3.5 million young adults have third molar surgery each year. Vicodin and Percocet were far and away the most frequently prescribed postoperative analgesic. While the median number of opioid tablets after this surgery was reported at 20 tablets, the study also found that most patients only took the painkillers for up to three days after the procedure. In short, this leaves a generous supply available for potential abuse.