The abuse of opioids in the United States is astounding. All doctors are being monitored closely in regards to prescribing opioids, and dentistry is no exception. In mid-August 2018, the Center for Opioid Research and Education (CORE) released new guidelines based on the number of opioids necessary in relation to the procedure. Also, the number prescribed will vary depending on the situation and the invasiveness of the procedure.
These guidelines refer to common procedures and suggest that the first drug of choice should be OTC acetaminophen and/or ibuprofen. These two can be used in conjunction on an alternating basis and work very well in this manner.
Following is the maximum number of opioids that CORE recommends with respect to the specific procedure:
- Wisdom tooth or impacted tooth extraction – (15) 5mg oxycodone
- Surgical extraction- (12) 5mg oxycodone
- Routine tooth extraction- 0
- Implant placement- (10) 5mg oxycodone
- Periodontal bone graft and regeneration- (6) 5mg hydrocodone
- Soft tissue graft- (10) 5mg oxycodone
- Osseous procedure- 0
- Tooth resection/ root amputation- 0
- Apicoectomy- (4) 5mg oxycodone
These guidelines can be confusing for the dentist because they don’t want their patients suffering. However, they are merely recommendations at this point. The bottom line is that CORE wants all clinicians across the board to stop prescribing more opioids than they deem truly necessary.