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Farooqi OA, Bruhn WE, Lecholop MK, Velasquez-Plata D, Maloney JG, Rizwi S, Templeton RB, Goerig A, Hezkial C, Novince CM, Zieman MT, Lotesto AMN, Makary MA. Opioid guidelines for common dental surgical procedures: a multidisciplinary panel consensus. Int J Oral Maxillofac Surg 2020; 49:397-402. [PMID: 31611048 PMCID: PMC8771805 DOI: 10.1016/j.ijom.2019.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/13/2019] [Accepted: 09/10/2019] [Indexed: 02/06/2023]
Abstract
One in 16 patients prescribed opioids after a surgical procedure will become a long-term user. The lack of procedure-specific guidelines after common dental procedures contributes to the opioid overprescribing problem. We convened a multidisciplinary panel to develop consensus recommendations for opioid prescribing after common dental procedures. We used a three-step modified Delphi method to develop a consensus recommendation for outpatient opioid prescribing for 14 common dental procedures. The multi-institution, multidisciplinary panel represented seven relevant stakeholder groups (oral surgeons, periodontists, endodontists, general dentists, general surgeons, oral surgery residents, and oral surgery patients). The panel determined the minimum and maximum number of opioid tablets a clinician should consider prescribing. For all 14 surgical procedures, ibuprofen was recommended as initial therapy. The maximum number of opioid tablets recommended varied by procedure (overall median = 5 tablets, range = 0-15 tablets). Zero opioid tablets were recommended as the maximum number for six of 14 (43%) procedures, one to 10 opioid tablets was the maximum for four of 14 (27%) procedures, and 11-15 tablets was the maximum for four of 14 (27%) procedures. Procedure-specific prescribing recommendations may help provide guidance to clinicians and help address the opioid overprescribing problem.
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Affiliation(s)
- O A Farooqi
- Department of Veteran Affairs, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - W E Bruhn
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M K Lecholop
- Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC, USA
| | | | | | - S Rizwi
- Dow International Medical College, Dow University of Health Sciences
| | | | - A Goerig
- Department of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - C Hezkial
- Department of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - C M Novince
- Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - M T Zieman
- Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - A M N Lotesto
- Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - M A Makary
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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