A common passage rite – with wisdom teeth drawn – could increase the risk of juvenile adolescents and young adults contracting opioids, a new study by JAMA Internal Medicine suggests. Adolescents who are prescribed opioids by their dentist, often for wisdom tooth removal, abuse opioids more frequently within one year than those who do not receive prescription toothpioids, the study found.
Last year, more than 60,000 people were treated for opioid overdoses in the US. The sharp increase in recent deaths has been largely caused by illegal opioids such as fentanyl, not analgesics. While only a small percentage of people who are prescribed opioids develop harmful addictions, the more we are exposed, the more risk we are looking for. This has led physicians and researchers to look for ways to safely reduce the opioid prescription.
Against this backdrop, Stanford University researchers chose this study to investigate how frequently opioids are used in dental practices and whether this use helps to achieve increased opiate dependence in adolescents.
In the medical records of nearly 15,000 insured persons aged 16 to 25, who had been prescribed opioids by a dentist in 2015. As they wanted to investigate a possible association between new opioid prescriptions and a later search risk, they concluded the study from individuals who had been prescribed opioids or had been diagnosed with opioid abuse in the past year. They then compared this group of 15,000 patients with approximately 30,000 patients with similar demographic characteristics who had not received opioid prescriptions in 2015.
Before one year had passed, 5.8 percent of the 15,000 patients had received a diagnosis related to opioid abuse, a doctor. Of the 15,000, another batch of opioids was prescribed 6.9 percent three months to a year after the first prescription. In comparison, only 0.4 percent of control groups received a diagnosis of opioid abuse.
"The findings indicate that a significant portion of adolescents and young adults are exposed to dental treatment by opioids," the authors write. 19659003] Wisdom teeth are the last adult teeth that normally grow between the ages of 17 and 26 years. Due to the limited space in the mouth, wisdom teeth can collide when growing into the teeth in front of them, preventing them from ever fully filling, a condition known as tooth impact. And although the study does not explain why people have been given opioids for their dental treatment, extractions of these affected wisdom teeth are a common dental operation for people in this age group, and patients typically receive strong pain medications such as post-opioids. Surgery.
But although these extractions are often considered a necessary procedure, there is reason to be skeptical of this idea, at least if your teeth do not hurt you. In 2016, a Cochrane literature research found that there was not enough evidence that extractions from affected wisdom teeth that cause no symptoms (such as bleeding gums or pain) are worthwhile, nor that the surgery reduces the risk of other dental problems the whole line, such as cavities of surrounding teeth or gingivitis. It also called for more high-quality evidence, such as randomized trials, to settle the matter.
Although wisdom teeth extraction is the best move, the authors of the new study say their findings should lead dentists to rethink their dependence on opioids as a first-line pain treatment for young patients. Other studies have shown that nonopioide medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) may be more effective than opioids in treating postoperative pain.
"This work raises two really important related but separate questions: Do we need opioids, and do we need the procedure? "Wrote the lead author Alan Schroeder, clinical professor of pediatrics at Stanford, in a statement.
[JAMA Internal Medicine]