Study: Patients commonly prescribed opioids and antibiotics for dental conditions at EDs

A study in the March issue of The Journal of the American Dental Association from the Centers for Disease Control and Prevention found that antibiotics and opioids are frequently prescribed during emergency department visits for dental conditions, further emphasizing the need for continued efforts to combat both opioid abuse and overuse of antibiotics.

The authors found that more than 50 percent of patients who visited the emergency department for a dental-related condition filled a prescription for antibiotics and approximately 40 percent filled a prescription for opioids, based on data from 2012-2014. Further, the authors found that more than 30 percent of patients filled prescriptions for both an antibiotic and an opioid as a result of their visit.

"Given previous findings that dental-related diagnoses are a common and potentially avoidable reason for [emergency department] visits, the prescribing of antibiotics and opioids for these conditions becomes even more concerning," wrote the study authors.

In 2019, as part of its longstanding antibiotic stewardship efforts, the American Dental Association (ADA) released a new guideline indicating that, in most cases, antibiotics are not recommended for toothaches, which are a common dental-related reason to visit an emergency department. The guideline was developed by a multidisciplinary panel, including an emergency medicine physician nominated by the American College of Emergency Physicians.

The ADA has also held a longstanding commitment to raising awareness and taking action on the opioid public health crisis. Since 2011, the ADA has advocated to keep opioid pain relievers from harming dental patients and their families and worked to raise professional awareness on medication alternatives to opioids. A growing body of research supports ADA policy that dentists should consider prescribing non-steroidal anti-inflammatory drugs (NSAIDs) alone or in combination with acetaminophen over opioids as first-line therapy for acute pain management. In March 2018, the organization adopted policy that indicates a combination of ibuprofen and acetaminophen can be just as effective as opioids for acute pain.