Wehler CJ, Panchal NH, Cotchery DL, Farooqi OA, Ferguson DK, Foran D, Hakki OW, Silva R, Smith GM, Gibson G. Alternatives to opioids for acute pain management after dental procedures: A Department of Veterans Affairs consensus paper.
J Am Dent Assoc 2021;
152:641-652. [PMID:
34325780 DOI:
10.1016/j.adaj.2021.03.022]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/11/2021] [Accepted: 03/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND
Opioid misuse is a widespread public health problem, and opioids are often prescribed in the dental environment. These recommendations provide alternatives to opioids to reduce or eliminate dental procedure-related acute pain.
METHODS
A multidisciplinary working group developed these clinical recommendations to specifically address procedure-related acute pain. These recommendations, which are based on published peer-reviewed research and guidelines, include therapies used before, during, and after dental procedures. When evidence is not definitive, the best practices, which are based on experts' consensus, are included. The recommendations are not intended to be exhaustive.
RESULTS
These recommendations are a summary of the evidence and best practices for opioid alternatives to treat acute pain related to dental procedures.
CONCLUSIONS
Dental providers should prioritize opioid stewardship when managing procedure-related pain with strategies such as thorough preprocedure pain assessment, minimally invasive techniques, preemptive analgesia, intraprocedure pain management, and appropriately selected postprocedure pharmacologic therapy.
PRACTICAL IMPLICATIONS
These recommendations are a concise resource for clinical providers. It is important to address patients' procedure-related pain, using nonopioids whenever possible. Alternatives are outlined, allowing providers to make informed decisions.
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