Commentary: Dentists need to be part of the opioid discussion

Dentists need proper training, especially on how to advise patients on pain management.

By Eve Rutherford

Barely a day passes without an alarming news report on the devastating effects of opioid abuse. In reading these reports, one thing is painfully clear, without a coordinated approach — which includes the dental community — opioid addiction will continue to rise, ruining lives and tearing families apart.

In October of last year, through executive order Gov. Jay Inslee took an important first step toward a coordinated approach to tackle the opioid issue in our state. His order brought together leading health organizations, law enforcement, tribal governments and other community partners. Perhaps the result of this order with the most impact is how it brought together our state’s medical and dental communities.

The important role dentists play in helping to curb the opioid epidemic cannot be stressed enough. Dentists write approximately a third, 31 percent, of opioid prescriptions for children ages 10 to 19. This time during a child’s life is critical for brain development and establishing coping behaviors. Teenagers who receive opioid prescriptions during this time are 33 percent more likely to misuse or become addicted than those who do not. As a mother and licensed dentist, this data is deeply concerning.

In addition, according to the Washington state Department of Health, there were 694 opioid-related deaths in our state in 2016. More than half, 435, were the result of prescription opioid overdoses. In fact, our state is among 19 states that are experiencing statistically significant higher cases of opioid-related overdoses in the nation.

Despite the grim news, progress is being made. In July our state published its first dental guidelines on prescribing opioids for pain. It was the work of the Dr. Robert Bree Collaborative, Washington State Agency Medical Director’s Group, and actively practicing Washington state dentists. These comprehensive guidelines cover everything from pre- to post-operative care and patient education. They recommend prescribing non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen whenever possible.

As a member of the dental community, we need to seek continuing education and training on opioid use and management. It’s also important to recognize that part of the solution to our opioids crisis involves addressing patient expectations around pain management. Dental patients expecting prescriptions that are not consistent with the state’s prescribing guidelines, may put their dentist in a tough spot.

Resources have been developed by individual dentists, to help manage patient expectations, but they are not widely known or available. In turn, parents who have children getting procedures like wisdom teeth removal are encouraged to talk with their child’s provider to discuss non-addictive alternatives to pain management.

The dental guidelines exemplify the strides we can make in holistic patient care when there is collaboration and communication between dental and medical providers.

Dr. Eve Rutherford is a member of the board of directors for Delta Dental of Washington and has served on the Arcora Foundation Board since 2008. She has a family dental practice in Snohomish.

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