Opioid prescriptions for wisdom tooth pain put young adults at risk for long-term use, study shows

Ann Arbor, MI — Young people who take opioid painkillers after having their wisdom teeth removed may be more susceptible to developing a long-term pattern of opioid use, a recent University of Michigan study shows.

Researchers analyzed insurance information from 70,942 people who underwent wisdom tooth procedures between 2009 and 2015. Of those, 56,686 filled opioid prescriptions.

Results showed that when the prescriptions were filled around the time of the procedures, patients ages 13 to 30 were about 2.7 times more likely than those in other age groups to refill the prescriptions.

Other findings:

• Patients in their late teens and 20s were more likely to be persistent opioid users than those in middle school and high school.
• Teens and young adults who experienced mental health issues or chronic pain were more likely to be persistent opioid users after filling the initial painkiller prescription.
• Overall, 1.3 percent of patients who filled opioid prescriptions had two or more additional prescriptions filled within one year of their procedure. That compared to 0.5 percent of patients who did not fill the prescriptions.
• Hydrocodone was the most commonly prescribed opioid, ordered in 70.3 percent of cases. Next was oxycodone at 24.3 percent.

“Until now, we haven’t had data on the long-term risks of opioid use after wisdom tooth extraction,” Calista Harbaugh, lead author and U-M research fellow and surgical resident, said in an Aug. 7 press release. “We now see that a sizable number go on to fill opioid prescriptions long after we would expect they would need for recovery, and the main predictor of persistent use is whether or not they fill that initial prescription.”

She added: “There are no prescribing recommendations specifically for wisdom tooth extraction. With evidence that nonsteroidal anti-inflammatories may (be) just as, if not more, effective, a seven-day opioid recommendation may still be too much.”

In the release, research colleague and U-M School of Dentistry professor Romesh Nalliah said that “opioid prescribing for dental procedures can be cut to a fraction of what it is today.”

The study was published online Aug. 7 in the Journal of the American Medical Association.