Opioid Prescribing After Surgical Extraction of Teeth in Medicaid Patients, 2000-2010 | Substance Use and Addiction | JAMA | JAMA Network
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Research Letter
April 19, 2016

Opioid Prescribing After Surgical Extraction of Teeth in Medicaid Patients, 2000-2010

Author Affiliations
  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts
JAMA. 2016;315(15):1653-1654. doi:10.1001/jama.2015.19058

Opioid abuse has reached epidemic proportions in the United States1,2 and often begins with a prescription for a pain medication. Dentists are among the leading prescribers of opioid analgesics,3 and surgical tooth extraction is one of the most frequently performed dental procedures. Surveys suggest that dental practitioners commonly prescribe opioids following this procedure,4 despite evidence that a combination of nonsteroidal medications and acetaminophen may provide more effective analgesia for postextraction pain.5 Little information is available on nationwide patterns of opioid prescribing following tooth extraction.

The use of the Medicaid database for research was approved by Partners’ institutional review board and the need for informed consent was waived. We collected data from the Medicaid Analytic eXtract—a national database of deidentified health claims drawn from Medicaid transactions for the years 2000-2010, which were combined for this analysis.6 All patients who underwent surgical dental extraction were included, identified by Current Dental Terminology codes. The cohort was restricted to patients with continuous Medicaid coverage from 90 days before through 7 days following extraction, allowing for up to a 7-day lapse in coverage. We determined the frequency of opioid prescriptions filled within 7 days of extraction and the nature and amount of opioids dispensed. Patients were stratified by age, sex, and type of extraction. Patients who filled an opioid prescription in the 90 days prior to extraction were excluded.