Addiction is defined as the continued desire to seek pleasure from some stimuli even though there are adverse consequences associated with doing so. Although substance use disorders can occur from various medications, opioids are the most addictive substance dentists prescribe. Opioids relieve pain by blocking pain receptors in the brain but can be misused by taking more medication than prescribed, using the medication for an unintended purpose or sharing the medication. In addition, many people are introduced to prescription opioids after common dental surgeries, such as wisdom tooth extractions or root canals. Therefore, it’s often the case that patients aren’t abusing prescription opioids on purpose. Thus, it’s essential to question a dentist’s role in treating patients while preventing them from misusing prescription opioids.
Many factors can influence a patient’s risk of abusing prescription opioids. One of these considerations includes a patient’s genetic makeup. Patients that have a family history of substance abuse also have an increased risk of developing abusive behaviors. As a result, dentists must assess a patient’s family medical history for substance abuse disorders before treating them with prescription opioids.
Moreover, the characteristics of a patient’s environment can also play a substantial role in substance abuse. For example, people may be poorly influenced by friends, family or coworkers who downplay the risks of prescription opioids. Also, patients who have suffered from physical, psychological or sexual abuse have a greater risk of developing a substance use disorder. These patients may be resulting to prescription opioids to cope with the trauma they have experienced. This makes it crucial for dentists to be open with their patients and communicate any concerns to minimize the risk of prescription opioid abuse.
Some of the most desirable conditions for individuals after an injury include experiencing the least amount of pain and adverse effects associated with that injury. In many cases, opioids will need to be prescribed in dentistry to prevent the intense pain that a patient is experiencing. However, if the patient can undergo therapy that can successfully relieve pain while not using an opioid, the risk for adverse effects is minimized. Non-opioid medications such as NSAIDs, topicals and muscle relaxants have less abuse potential and associated risk, and can be effective in reducing pain. Alternative non-drug therapies can also effectively treat a patient’s symptoms, such as cold compresses or saltwater rinses. This means dental professionals are not limited by their treatment options for pain when concerned with misuse potential.
Because many dental procedures require prescription opioids for pain relief, dentists should be educating their patients on responsible medication behaviors and following up with patients after prescribing them. This will allow dentists to improve patient wellness and can prevent people from developing a substance use disorder. As dentistry advances, new techniques and guidance will strengthen the current approach to treating patients in pain. But until then, dentists will continue to play an essential role in ensuring healthy and safe medication behaviors.
~Ethan Hermensky, Ohio ‘23
