As the country’s opioid epidemic increases, dentists continue prescribing opioids after surgical tooth extraction. New research reviews nationwide patterns of painkiller prescribing following this procedure.

Brian T. Bateman, MD, MSc, of Brigham and Women’s Hospital, Boston, and colleagues reviewed patterns of opioid prescribing following surgical tooth extraction across the United States.

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The investigators analyzed data from 2 757 273 patients collected from Medicaid Analytic eXtract, a national database of health claims drawn from Medicaid transactions between 2000 and 2010. Patients who underwent surgical dental extraction were identified by Current Dental Terminology codes and were included in the review.

The researchers determined the frequency of painkiller prescriptions filled within 7 days of extraction, as well as the nature and amount of opioids dispensed.


Forty-two percent of patients filled a prescription for an opioid medication within 7 days of extraction. The researchers found that the most commonly dispensed opioid was hydrocodone (78% of all prescriptions), followed by oxycodone (15%), propoxyphene (3.5%), and codeine (1.6%). Patients between the ages of 14 and 17 had the highest proportion of those who filled opioid prescriptions (61%).

“Although a limited supply of opioids may be required for some patients following tooth extraction, these data suggest that disproportionally large amounts of opioids are frequently prescribed given the expected intensity and duration of postextraction pain, particularly as nonopioid analgesics may be more effective in this setting,” the authors wrote.

They added: “This common dental procedure may represent an important area of excessive opioid prescribing in the United States. As the nation implements programs to reduce excessive prescribing of opioid medications, it will be important to include dental care in these approaches.”


Baker J, Avorn J, Levin R, Bateman B. Opioid Prescribing After Surgical Extraction of Teeth in Medicaid Patients, 2000-2010. JAMA. 2016. doi:10.1001/jama.2015.19058.