Alternatives to Dental Opioid Prescribing After Tooth Extraction

Launched by DOUGLAS OYLER · Feb 16, 2024

Keywords

ClinConnect Summary

This large, multi-site study (ADOPT) tests whether a simple, three-part plan can reduce the chance that teens and young adults (ages 12–25) are given an opioid prescription after having a tooth extracted, without making pain worse. The plan is being tested in about a dozen dental clinics and involves: (1) a 45–60 minute education session for the dentists/oral surgeons with a pharmacist, (2) clear patient instructions for after the procedure, and (3) blister packs of acetaminophen (Tylenol) and ibuprofen to give to patients after extraction. The researchers will compare this intervention to usual practice and look at whether an opioid is prescribed on the day of the tooth extraction (the main outcome) using electronic health records. They’ll also study how feasible and appropriate the approach feels to providers, and how patients rate their pain, pain-related problems, and satisfaction with pain management within about 10 days after the extraction.

Who can join and what to expect: clinics must have licensed dentists/oral surgeons who regularly perform extractions on adolescents/young adults and who have historically prescribed opioids to a portion of these patients. Patients eligible are those aged 12–25 undergoing a tooth extraction at a participating clinic during the study and who can complete a short online survey. Providers consent to participate, and patients complete brief surveys after their extraction. The study is currently enrolling by invitation, with an estimated completion date in 2028. No results are available yet.

Gender

ALL

Eligibility criteria

• Inclusion Criteria (Provider):
• • Actively U.S. licensed dentist or oral surgeon practicing at a participating cluster. Participating clinics were finalized prior to the beginning of the study based on the following criteria: (1) perform tooth extractions on at least 70 AYA patients during a 5-month screening period from July 1, 2022 through November 30, 2022 and (2) electronically prescribe opioids to at least 30% of AYA patients who underwent extraction during the screening period. Additionally, each participating cluster signed a data use agreement (DUA) for sharing electronic health record data, can provide the necessary electronic health record data, and agreed to comply with study procedures and be available for the duration of the study.
• • Provide a signed and dated informed consent form.
• • Willing to comply with all study procedures and be available for the duration of the study.
• Inclusion Criteria (Patient):
• • Undergoes any tooth extraction at a participating cluster during the study (intervention condition, transition period, or control condition) between 6-10 days earlier.
• • Age 12-25 at the time of tooth extraction.
• • Reads and acknowledges survey cover letter in lieu of a full consent/assent process.
• • Can access the electronic survey using an internet-capable device.
• Exclusion Criteria:
• • There are no other exclusion criteria for clusters or provider/patient participants that meet all inclusion criteria.