Dental School Setting: Narcotic Prescription Patterns Following Dental Procedures

Objectives: Dentists, Oral and Maxillofacial surgeons and other dental specialists have an inherent responsibility to help prevent the widespread abuse of opioid prescription. Dentists are the second highest prescribers of immediate release opioids in the United States. Recent studies have reported on the scope of the problem on a state-level and national-level, but little has been done to determine narcotics prescribing patterns within the dental school setting.This study aims to examine the narcotic prescribing practices within a dental school by Oral and Maxillofacial Surgery faculty, residents and by dental students in the oral surgery clinic
Methods: The VCU School of Dentistry’s patient management software (Axium) was used to retrospectively gather data of patients who were treated in the predoctoral emergency OMFS Clinic and at the OMFS faculty practice clinic. The prescriptions included are those written by the OMFS faculty, the OMFS residents and by predoctoral students but co-signed by OMFS faculty and residents. The gathered data included all patients who had undergone oral surgical procedures during the study duration (one year) in the clinics listed above and were prescribed an analgesic medication following such procedures.
Results: A total of 4,634 new patients were treated during the study period. A total of 4,433 analgesic prescriptions were written to these patients. Of these, narcotics made up a 76.2% (n=3377) and non-narcotics accounted for the remaining 23.8% (n=1056). Patients under the age of 21 accounted for 17% of the study population. This group was prescribed a significantly lower percentage of narcotic versus non-narcotics than patients over the age of 21 (63%: 79%). Among those under 21, the most common narcotic prescribed was Hydrocodone APAP (average of 18.3 pills) and the most common non-narcotic was Ibuprofen (26.1 pills). Still, a total of 14% of all l narcotics prescriptions were to patients in this young age group.
Conclusions: Patients treated within this OMFS Clinic and practice setting received a higher proportion of narcotic based analgesics compared to non-narcotic medications. Future studies are needed to examine the correlation between procedures performed, prescribers (students, faculty, resident) and the type of narcotics prescribed and the number of tablets dispensed.