Dentists "Needlessly Expose" Kids To Opioids After Wisdom Tooth Removal

Dentists "Needlessly Expose" Kids To Opioids After Wisdom Tooth Removal

By Paul Fuhr 12/20/17

Dentists and oral surgeons are the number-one prescribers of opioids for adolescents ages 10 to 19.

Image: 
a dentist taking care of a young patient

As the opioid epidemic continues to claim the lives of 91 Americans per day, the problem may begin a lot sooner than many people realize. According to a recent Daily Beast story, children are being “needlessly exposed” to prescription painkillers after routine wisdom tooth surgery.

Interestingly, dentists and oral surgeons are the number-one prescribers of opioids for kids aged 10-19, the Daily Beast noted, which is a dangerous age range when it comes to addiction and the developing human brain.

“There are studies that show that children who are exposed to opioids… after their wisdom teeth come out are much more likely to use opioids non-medically—basically recreationally, to abuse them later in life,” psychiatrist Andrew Kolodny told The Daily Beast

Many experts point to eye-opening evidence that young people who were exposed to opioids before the end of high school were 33% more likely to abuse opioids than other kids. Worse yet, the at-risk kids reportedly otherwise disapproved of drug use. Part of the problem lies in the fact that young people get more of a dopamine “kick” than adults because their brains have lower baseline dopamine levels. Brains aren’t fully developed either, meaning it doesn’t assess risk very well.

Additionally, MRI scans reveal that within 30 days of daily opioid use, the brain experiences changes that aren’t reversed even after six months. “The developing brain is even more plastic and therefore more at risk of structural changes which may be permanent,” the article said. 

Still, despite the crisis, dentists still prescribe nearly 10% of all opioids nationally, with virtually everyone who gets their wisdom teeth removed going home with a prescription for powerful painkillers like Vicodin.

“Although in general I would tell parents that they should trust their doctors and dentists in the case of opioids, this is a situation where they can’t necessarily trust their doctors and dentists,” Kolodny told The Daily Beast. “Doctors and dentists have been underestimating how addictive and dangerous these drugs are, and we’ve been overestimating how helpful they are, and that has a lot to do with the influence for 15 years of a brilliant marketing campaign.” 

Some dentists, however, have taken notice and are taking some much-needed action, as they’ve begun prescribing a drug called Exparel, described as “a relatively expensive long-acting anesthetic painstakingly and precisely injected into the surgical site for proper effect, to their patients, regardless of ability to pay,” the story said. The drug, available since September 2016, isn’t “without controversy,” with many researchers questioning whether it’s worth the cost. In fact, 5 to 7% of patients will have an issue when exposed to Exparel, one oral surgeon told The Daily Beast

Beyond Exparel, other dentists are relying on the combination of ibuprofen and acetaminophen (Advil and Tylenol), which some research indicates is far more effective than opioids in the first place. Anti-inflammatories like ibuprofen, naproxen and aspirin have "consistently been shown to be more effective" than prescription opioids, according to the Tribune Review.

“This is the only disease created by doctors,” one dentist said. “And it could be fixed by doctors.”

While dentists replacing powerful opioids with ibuprofen may help dissuade childhood substance use, there's still a long way to go before the opioid crisis is fully resolved.

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at paulfuhr.com. You can also find Paul on Linkedin and Twitter.

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