Ying Jo Wong1, James Keenan2, Keith Hudson3, Henry Bryan4, Frederick Naftolin5, Van P Thompson6, Ronald G Craig7, Don Vena8, Damon Collie9, Hongyu Wu10, Abigail G Matthews10, Ashley C Grill11, Frederick A Curro12. 1. Principal Clinical Practitioner-Investigator, PEARL Network, currently Clinical Instructor, New York University, College of Dentistry, New York, New York. 2. Practitioner-Investigator PEARL Network, Rockaway Beach, NY, currently Clinical Assistant Professor, New York University, College of Dentistry, New York, New York. 3. Practitioner-Investigator PEARL Network, Beverly Hills, Michigan. 4. Practitioner-Investigator PEARL Network, Roseville, Michigan. 5. Medical Director, PEARL Network; Professor, Department of Obstetrics and Gynecology; Professor, Department of Environmental Medicine Obstetrics and Gynecology; Director Reproductive Biology Research New York University, New York, New York. 6. Executive Management Team PEARL Network, currently Professor, Tissue Engineering and Biophotonics, Kings College, London, United Kingdom. 7. Executive Management Team, PEARL Network, Professor, New York University, College of Dentistry, New York, New York. 8. Principal Investigator, The Emmes Corporation, Rockville, Maryland. 9. Project Manager, The Emmes Corporation, Rockville, Maryland. 10. Biostatistician, The Emmes Corporation, Rockville, Maryland. 11. Clinical Coordinator, PEARL Network, Adjunct Clinical Assistant Professor, Dental Hygiene Programs, New York University, College of Dentistry, New York, New York. 12. Director, PEARL Network, Adjunct Clinical Professor, Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University, College of Dentistry, New York, New York.
Abstract
OBJECTIVE: Dental treatment is often categorized as a moderately or severely painful experience; however, no clinical data reported by the patient and dentist currently exists to support this degree of pain. This has contributed possibly to the overprescribing of analgesics, in particular the opioid class of medications. The primary objective of the study was to document the dentists' postprocedural prescriptions and recommendations for analgesic medications and their effectiveness for a 5-day period. Medications prescribed or recommended in the patient-reported outcomes included: opioid, nonsteroidal anti-inflammatory drugs (NSAIDs), and over-the-counter (OTC) analgesics. Met hods : This study used both dentist and patient responses to evaluate the use of opioid, NSAID, and OTC recommended or prescribed analgesics following one of seven classes of dental procedures encompassing over 22 specific coded procedures thought to elicit pain. The patient-centered study included a 5-day postprocedural patient follow-up assessment of the medication's effectiveness in relieving pain. RESULTS: Baseline questionnaires were completed by 2765 (99.9%) of 2767 eligible patients, and 2381 (86%) patients responded to the Day 5 follow-up questionnaires. CONCLUSION: The data suggest NSAIDs, both OTC and prescribed dosages, may be a sufficient analgesic to treat most postoperative dental pain. Clinical judgment as to the use of an opioid should include the physiological principles related to the pharmacology of pain and inflammation and may include a central effect. ClinicalTrials.gov Identifier: NCT02929602.
OBJECTIVE: Dental treatment is often categorized as a moderately or severely painful experience; however, no clinical data reported by the patient and dentist currently exists to support this degree of pain. This has contributed possibly to the overprescribing of analgesics, in particular the opioid class of medications. The primary objective of the study was to document the dentists' postprocedural prescriptions and recommendations for analgesic medications and their effectiveness for a 5-day period. Medications prescribed or recommended in the patient-reported outcomes included: opioid, nonsteroidal anti-inflammatory drugs (NSAIDs), and over-the-counter (OTC) analgesics. Met hods : This study used both dentist and patient responses to evaluate the use of opioid, NSAID, and OTC recommended or prescribed analgesics following one of seven classes of dental procedures encompassing over 22 specific coded procedures thought to elicit pain. The patient-centered study included a 5-day postprocedural patient follow-up assessment of the medication's effectiveness in relieving pain. RESULTS: Baseline questionnaires were completed by 2765 (99.9%) of 2767 eligible patients, and 2381 (86%) patients responded to the Day 5 follow-up questionnaires. CONCLUSION: The data suggest NSAIDs, both OTC and prescribed dosages, may be a sufficient analgesic to treat most postoperative dental pain. Clinical judgment as to the use of an opioid should include the physiological principles related to the pharmacology of pain and inflammation and may include a central effect. ClinicalTrials.gov Identifier: NCT02929602.
Authors: Katie J Suda; Michael J Durkin; Gregory S Calip; Walid F Gellad; Hajwa Kim; Peter B Lockhart; Susan A Rowan; Martin H Thornhill Journal: JAMA Netw Open Date: 2019-05-03