Frequently Asked Questions About Controlling Dental Pain and Opioids

There are many options for relieving short term dental pain your dentists can recommend. Often this will include over-the-counter (OTC) analgesic medications. 

America continues to face the opioid epidemic. Although nationally opioid prescribing rates are declining, there are still 43 opioid prescriptions for every 100 Americans.2 Over 74% of drug overdoses deaths in 2020 involved an opioid.1 Dentists are prescribing opioids less often with shorter duration dosing and less pills overall. However, according to the most recent Surgeon General’s report on Oral Health in America, 11.6 million or 18% of all opioid prescriptions were still written by dentists.2

Knowing your options for pain management is important, speak to your dental team about what is best for you in your situation.

Opioids should be avoided as a first line therapy option, over-the-counter (OTC) medicines, can be effective pain relief following dental procedures and for dental associated pain.2 OTC’s include acetaminophen (Tylenol®) and nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as ibuprofen (Advil® or Motrin®), naproxen sodium (Aleve®) or aspirin help keep swelling down in addition to reducing pain. Used alone or taken together, these drugs are found to be superior at relieving pain than opioid drugs.2

Depending on your pain, your dentists may suggest a prescribed medication or an opioid.

FAQs

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Opioids are prescription narcotic pain relievers. Opioids when taken as prescribed under your dentists care, can be helpful, but need to be taken as directed.3 Most often used for short term pain (acute pain) typically 24-48 hours dosing duration;4 commonly prescribed opioid drugs in dentistry, include Hydrocodone (Vicodin), oxycodone (Percocet or OxyContin) and codeine.4 Opioids alter the nervous systems response to stimuli, blocking pain receptors.4 Also opioids do not have an analgesic ceiling, that means they continue to provide added relief as dosing increases.4

Opioids contain a black box warning noting the risks associated with addiction, abuse, misuse, respiratory depression and drug interactions.4 Opioid medications can have side effects. The most common are nausea, vomiting, and constipation, but the greatest concern is their connection to addiction.3 It’s important to note, first time exposure to opioids for people under the age of 25 results in higher rates of addiction. One study found a 33% increase in future misuse when a child is prescribed opioids before high school graduation.2

First work to understand why an opioid was prescribed, be sure to complete a current health history and include all prescriptions you currently take. You can also ask to include your primary care doctor in the decision making process. Once prescribed an opioid follow the dosing instructions exactly.

A few questions you may want to ask your dentist or pharmacist when filling the prescription are:5

  1.  What is the goal of this prescription?
  2. When and how should I take this prescription?
  3. How long should I take these drugs?
  4. Are there any risks with taking this medication?
  5. What do I do with any unused medication?

Store all prescriptions including opioids safely out of sight and out of reach from children or other family members in a locked cabinet.5 It’s never safe to share or reuse opioid prescriptions. Dispose of unused, unwanted or expired prescription medications safely and immediately.

The U.S. Food and Drug Administration and the White House Office of National Drug Control Policy recommends you:5

DO

  •  Follow any disposal instructions you get with your prescription.
  • Remove all personal information from prescription bottles.
  • Find a drug take-back program or a Controlled Substance Public Disposal Location near you.

DON’T

  • Don't flush medicines down the toilet or pour them down the sink, unless the disposal instructions say to.
  • Don’t give to others.
  • Don’t give back to your dentist or doctor.

The National Institute on Drug Abuse (NIDA)

drugabuse.gov

Centers for Disease Control and Prevention (CDC) cdc.gov/rxawareness

Substance Abuse and Mental Health Services Administration (SAMHSA)

findtreatment.gov or call the SAMHSA Treatment Referral hotline at 1-800-662-HELP(4357)

1 CDC, National Center for Health Statistics, Drug Overdose Deaths. https://www.cdc.gov/drugoverdose/deaths/index.html, accessed 08-2022.

2 National Institutes of Health. Oral Health in America: Advances and Challenges. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, Nation Institute of Dental and Craniofacial Research, 2021. Page 364, Page 597, Page 619, Page 639 accessed 08/2022.

3 American Dental Academy, Mouth Healthy, Just what the doctor ordered, https://www.mouthhealthy.org/~/media/MouthHealthy/Files/A-Z/for-the-patient-opioids.pdf?la=en, Accessed 08/2022.

4 American Dental Association, Oral Analgesics for Acute Dental Pain, https://www.ada.org/resources/research/science-and-research-institute/oral-health-topics/oral-analgesics-for-acute-dental-pain, accessed 08.2022.

5 Mouth Healthy, by the American Academy of Dentistry. Opioids, Common Questions about Opioids, https://www.mouthhealthy.org/en/az-topics/o/opioids?utm_medium=VanityUrl, accessed 08.2022