It’s been all over the news the past few years and, if you haven’t seen it yet, there are several state attorneys general who are bringing class action lawsuits against the makers of opioid medications for their negligence to disclose how addictive certain kinds of pain medications are. And because surgeries provide the pretext for the prescription of such heavy-duty painkillers, the American Medical Association and the American Dental Association have begun to reconsider the kinds of pain medications they prescribe.
Most people usually think about surgeries at hospitals, but quite a few forget that dentists also perform surgeries, and can also prescribe painkillers to their patients. So, we want to highlight the ethical responsibility we feel, here at Carolinas Dental Choice, for handling painkiller medications. We also want to highlight some of the good things happening across America in a concerted effort to deal with the opioid crisis (as it relates to the dental industry), and lastly, we want to point you in the direction of some pain management alternatives that do not involve taking heavy-duty painkillers. We want you, our patients, both to be well-informed and to know you have choices when it comes to how we administer your oral health care.
The ADA and the Opioid Crisis
The American Dental Association has begun to acknowledge the role it has in diminishing the impact of opioid drugs on Americans. It has begun to address the issue by training dentists, and issuing advisements, about the dangers of opioid addiction, as well as, ways to recognize signs of such addiction in our patients. In 2018, the ADA resolved and enacted a policy regarding the prescribing of opioid painkillers. They committed the organization to three initiatives around the issue of calling for mandatory education on opioid prescription practices: provision for continuing education credits for dentists, developing coursework for dentists on issuing these painkillers, and enacting a phase-in period so that dentists can reach compliance with Congressional concerns.
In other words, the ADA is making strides in seeing how it can, as an organization, ensure that its dentists to not contribute to the opioid crisis and are, therefore, well-educated in how to prevent the spread of addiction to such classes of painkillers like OxyContin, Vicodin, or similar drugs. The ADA has also resolved issuing guidelines for dentists, advising them to prescribe a maximum seven-day dosage of opioid-classed painkillers, bringing the ADA into compliance with the CDC’s guidelines.
These resolutions by the ADA mean a safer, better America for us all. They also mean that dentists are better informed about the risks and responsibilities associated with prescribing opioid painkillers to their patients. That means they can better instruct their patients on how to take a painkiller and how to avoid developing an addiction to an opioid. Dentists and patients alike can take responsibility, together, for growing their knowledge of opioid use and thus help put an end to the crisis. A recent webinar, led by Dr. Cathy Carlson and Dr. Aaron Gilson at the ADA, addressed these concerns. Simply know this: the ADA is taking steps to help curb the opioid addiction in this country, and we too are following in their footsteps by adhering to ADA’s guidelines for prescribing opioids. We at Carolinas Dental Choice want you as safe and as healthy as you can be. We know about the crisis our doctors, Dr. Brown and Dr. Kashyap along with the whole team, and are committed to seeing this crisis abate.
The Benefits and Risks of Using Prescription Painkillers
When you have any kind of oral surgery—and the most common or familiar surgery is the removal of wisdom teeth—it means you will have to manage post-surgical pain. So, we want to highlight the pros and cons of using any opioid painkillers, so that you are as informed as possible. Our recommendations draw on the ADA’s advice to patients, found here. We will highlight a few key pieces of information and make a few suggestions, below:
- Know what kinds of opioids there are: Vicodin, OxyContin, Percocet, morphine, and codeine are all drugs that call into the opioid class of painkillers. They can be made from natural substances occurring in the poppy, for example, morphine, or synthetic drugs that mimic the substances of the poppy (fentanyl-based drugs like OxyContin are synthetics).
- Understand how they work: opioids work by making you feel that pain is lessened and they also increase the “feel-good” hormone in your brain, called dopamine. (Dopamine is one of several hormones that give you a “feel-good” rush after exercise, for example.)
- Pain management choices: over-the-counter painkillers, like acetaminophen or ibuprofen, can be highly effective painkillers for post-oral surgeries. That said, prescription drugs are available but it is extremely important that you: a) update your medical history to us; b) disclose to us any previous drug addictions or use you (or others in your family) had or have now; and c) keep an open, honest dialogue with us, including asking questions.
- If you prescribed an opioid, in consultation with your dentist, then seek to understand: the goal of the prescription; dosage and usage instructions; length of prescription; risks involved in taking the painkiller; how to dispose of extra, unused medication (you can return the remainder to a pharmacist for disposal).
- Talk to your family! It is important that they stay informed about your prescriptions and the risks they could pose (not just opioid prescriptions but all of them). They can help monitor your progress, after surgery and while taking painkillers.
- It is importation that you, the prescribed patient, are the only one who takes the medication. You should never turn over your medication to others, or give it to another person to use. If you feel at risk of developing an addiction, talk to your dentist as well as your general practitioner/family doctor.
- Know those groups at higher risks of developing addictions: adolescents (tooth extractions) and those with a history of past or current drug abuse struggles.
This is how we can, together, stop the opioid crisis. It’s up to us, so staying informed about how to handle our responsibilities together means we empower ourselves and each other to make healthy, proactive decisions about prescription painkillers. If you feel at risk, it’s important to convey that to us so that we can help you find alternative ways of planning for pain management, after oral surgery. We want to help you make the best, most informed and healthiest choices for post-surgical care. We are here for you.
Pain Management Alternatives
Because dental providers are among some of the leading prescribers of prescription painkillers, especially for tooth extractions, it is important to know what other choices you have available to you for pain management, besides prescription-strength opioids.
Firstly, be aware that we can prescribe both prescription-strength ibuprofen and prescription-strength acetaminophen, which means they have to be picked up from a pharmacy. These are stronger versions of the over-the-counter (OTC) painkillers you’re used to seeing on the shelf. Many times, regular OTC ibuprofen or acetaminophen can be enough of a painkiller; depending on the kind of oral surgery you have, prescription-strength versions of these can also be highly useful.
If you know yourself to have a relatively high pain tolerance, then consider either OTC or prescription-strength ibuprofen or acetaminophen. There isn’t much use in filling a prescription for a stronger class of painkiller if you don’t really need it. You know your body well, so make an informed decision. And, when it comes to caring for your children, you know their pain tolerances well, also, so bear those facts in mind.
Secondly, consider homeopathic remedies for pain management and pain relief. Some practitioners of homeopathic medicine have made the following suggestions:
- Consider taking pre-surgery immunity-boosters. Bulking up on Vitamin C, Vitamin B complex, and Vitamin A can help boost your body’s immune system in preparation for fighting off any potential for infections.
- See food as medicine: post-surgery nutrition can be part of the solution for easing the healing process. Consider eating foods that have anti-inflammatory properties (like olive oil, avocados, and other foods). Pineapple contains “bromelain,” an enzyme that is meant to help with pain relief; you could make a smoothie that features pineapple.
- Make use of supplements: you can use Calendula (marigold) leaves to make a tea or mouth rinse. Calendula contains antiseptic and anti-inflammatory properties. Or you can use myrrh oil, which also contains antiseptic and anti-inflammatory properties, in a homemade mouthwash. Licorice root has numerous properties, which can promote healing and restoration, as well as, reduce pain or inflammation.
- Consider ingesting or using (depending on the substance) some natural antimicrobials, like honey, coneflower (Echinacea), or myrrh. A cloth soaked in witch hazel tea, and applied to site of extractions, was a common practice among Native Americans. Slavic peoples of Russia and the Balkans have, for centuries, made use of nettle root to deal with inflammation and pain. Blueberries have also been found to contain anti-inflammatory properties (you can make a paste out of them and apply to inflamed gums.)
If you are interested in exploring, more in-depth, these alterative homeopathic remedies or treatments, look at this site as well as this one. (We highlighted some of the points these websites made in the numbered list above.) Though we as Carolinas Dental Choice cannot endorse or support all of the claims made by homeopathic sites, we do respect your right to explore all of the options available to you for pain management and relief. Just talk to us about what strategy you want to take, if you decide to go the homeopathic route so we can help you to monitor your pain relief and post-surgical recovery.
Pain management and relief is a responsibility, and we all need to see it as such. Carolinas Dental Choice sees the need to curb and end the opioid crisis, and we want to assure you that we are committed to making responsible, informed decisions together with you, about your own oral hygiene and care.
We want you to talk to us about any health issues you have, as well as any previous exposure to illicit or prescription drugs. You don’t need to be afraid or ashamed about previous drug use or abuse, but we do need to know so we can make an informed decision. Also, if you feel at risk for developing a dependency on a painkiller, alert us right away. It’s best we know beforehand, during the initial consultation, of any risks you might face for dependency, but we also want to help intervene if you are post-surgery and find yourself growing dependent. We are here to ensure you stay safe and healthy, so keep the lines of communication open with us at all stages of your oral health care.
Let’s sit down and talk about ways to manage pain and find relief after your oral surgery. Our doctors and staff at Carolinas Dental Choice are committed to your total well-being. Let’s make responsible choices, together.