Persistent opioid use after wisdom tooth extraction

Researchers analyzed nationwide database records to characterize opioid use after wisdom teeth removal, a common procedure typically performed on young and healthy patients. Although elective surgery elevates the risk of new opioid users becoming persistent users, whether the same can be said of oral surgery was unknown.

Researchers analyzed nationwide database records to characterize opioid use after wisdom teeth removal, a common procedure typically performed on young and healthy patients. Although elective surgery elevates the risk of new opioid users becoming persistent users, whether the same can be said of oral surgery was unknown. Investigators from the University of Michigan Medical School and the Michigan Opioid Prescribing Engagement Network looked at data for patients aged 13–30 years during the period of July 1, 2009–December 31, 2015. They specifically examined perioperative opioid prescriptions, or those filled during the week ahead of the procedure to up to 3 days after it. Out of 70,492 deidentified patients, 56,686 were found to have filled a perioperative opioid prescription—especially younger and female patients; preoperative prescription users; those with chronic depression, anxiety, and chronic pain; and patients whose wisdom teeth were impacted. Persistent opioid use, the primary endpoint, was defined as prescriptions 4–90 days after the extraction and 91–365 days after. The rate was 5 per 1,000 patients without a filled perioperative prescription, but it more than doubled to 13 for patients who did fill a prescription. With patient traits or tooth impaction by itself failing to adequately explain the trend, the researchers concluded that a filled perioperative prescription after wisdom teeth removal is associated with greater risk of persistent use down the road.