Wisdom Teeth Surgeries Contributing to Opioid Crisis?

(audience clapping) Almost 5 million Americans, most between the ages of 16 and 24, have their wisdom teeth removed every year. But could this common dental surgery be a major contributor to the opioid crisis? A recent study suggests that yes, it can be. Oral Maxillofacial Surgeon, Dr. Steven Kupferman joins us now to discuss this study. Tell us a little bit about this study, and also your own opinions on dental surgery, wisdom teeth surgery, and potential ties to the opioid epidemic. Sure, so a lot has changed in wisdom teeth surgery over the years and probably the biggest change is that opioid pain medications are really not needed in the vast majority of wisdom tooth surgeries. Things are changing because there are becoming more and more available medications that are non-opioid that people are able to use after they have surgery, particularly oral surgery. Let’s talk about some of these statistics. In this University of Michigan study, dentists were the leading source of opioid prescriptions for kids 10 to 19 years old, And then when you’re talking about kids in that high school age range, 33% more likely to abuse opioids if they’ve received a prescription for it. So is it that we just didn’t realize the risk here? Well there was a time where we were trying to give people pain medication to relieve their pain and the medical boards had kinda pushed, pain relief for people for a while. And with respect to the first surgery that kids generally have is their wisdom teeth. And so the statistics, of course in that study, are skewed in that way because that’s the first time they’re gonna have surgery and that’s the first time they’re gonna get a pain medication. So let’s talk about when it might be needed versus not. And it’s interesting because another study in 2018 looked at the use of nonsteroidal like Ibuprofen with Acetaminophen and pain relief was just as good, if not better than with opiates. Now what opiates do, they mask pain, right? They’re not really treating pain, they’re masking the sensation of pain and they’re giving you, in many cases a bit of a high with it. I think people are fascinated when they hear that, that, “wait, Ibuprofen and Acetaminophen “might treat my pain just as well if not better?” So if that’s the case, do you think that the dental community is starting to understand the gravity of this problem? Things are changing. People are starting to realize that pain can be controlled by more over the counter medication such as Tylenol an Advil. And then there’ve been new medications that have come out that have really helped out a lot, that are non-opioid medications. There’s one that I use in my office after I take out wisdom teeth on all my patients, which is a very long-acting Novocaine and it allows the area to be numb for three to four days after surgery. And therefore, they won’t really need to take any opioid medications. What are some symptoms or signs that you need to get your wisdom teeth out? It’s so common place, I had mine out. (laughs) And it wasn’t pleasant by any stretch. I didn’t have any opiates but I wasn’t comfortable, I didn’t enjoy it. But it just felt like a rite of passage. Is that still sort of the standard of care, or when do people make that decision? And are there situations where maybe we don’t need to take them out at all? You know patients don’t generally know that they have a wisdom tooth problem, they have a problem in the back of their mouth that’s hurting them. They go into the dentist and the dentist says, “oh your wisdom tooth is coming in, “and there’s no room for it in there”, because you had braces or because you just have big teeth and so that’s how they sort of end up in the oral surgeons office to have their wisdom teeth taken out. So it’s not necessarily a rite of passage. I mean there are people who have relatively small teeth, big mouths and the teeth fit really well and they don’t have to have their wisdom teeth taken out. But when they need them out, they should be taken out. And a lot of people will just say, “oh I need my wisdom teeth out, “my dentist can just do it”. How important is it to find someone with a great deal of experience. Not saying that a general dentist doesn’t have experience, but how important is that? Well I think it’s important on many levels. Oral surgeons, the majority of their practice is taking out wisdom teeth, and that probably speaks a lot to the ability to control pain afterwards. When you’re doing something pretty much every day, there’s a good chance that you do it quickly, you do it with less swelling and less pain. And so I think it’s important that we know there’s the availability of oral and maxillofacial surgeons who are specifically trained in taking out wisdom teeth and that they be the first choice for wisdom tooth removal. Full of wisdom. Thank you sir. (audience clapping) Dr. Kupferman , appreciate it as always.

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  • My wisdom 4 teeth were impacted and I had them removed all at once. I took 200 mg Ibuprofen for 2 or days, twice a day and stopped. My pain was minimal and I was 17. My doctor said and opioid was not necessary and stated the medication should be taken in the next couple of hours before the numbness wore off.

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