Opioids and Dental Pain

Over-the-counter medicines, like ibuprofen and acetaminophen, can be effective for pain relief following dental procedures. Still, there is no one-size-fits all approach to treatment. To help your dentist decide what course of action is right for you, make sure you update your health history form, talk to your dentist about medications you are currently taking and ask plenty of questions. Feel free to include your primary medical doctor in the conversation. If you are in recovery or struggled with addiction in the past, tell your dentist. Let your dentist know if anyone in your family has struggled with addiction.

Opioids can include hydrocodone (Vicodin), oxycodone (OxyContin or Percocet), morphine and codeine.

If you are prescribed an opioid, ask your dentist or pharmacist the following questions before filling the prescription:

1. What is the goal of this prescription?
2. When and how should I take these?
3. How long should I take these drugs?
4. Are there any risks for me from this medication?
5. What do I do with any extra medication?

After picking up your prescription, take it according to directions. Store it safely out of sight and out of reach from children in a locked cabinet. Put the medication back immediately after taking any dose.

You play an important role in keeping prescription medications from becoming a source of abuse in your household and in the community. Keep your narcotic pain medication in a locked cabinet. Dispose of unused, unwanted or expired prescription medications safely and immediately to reduce the risk of another person taking these drugs for nonmedical reasons.

Follow these guidelines from the U.S. Food and Drug Administration and the White House Office of National Drug Control Policy:

• Follow any disposal instructions on the label or patient information you get with your prescription.
• Don't flush medicines down the toilet or pour them down the sink unless the disposal instructions say to do so. (You can also consult this list from the FDA.)
• If there are no disposal instructions, participate in a drug take-back day or find a Controlled Substance Public Disposal Location near you.
• If you are unable to attend a drug take-back day, take unwanted prescription medications out of the original bottle and mix them with coffee grounds or kitty litter in a sealed bag or closed container. This makes medications less appealing and less recognizable to anyone who can see your trash—including your kids.
• Remove all personal information from prescription bottles to protect your privacy. 

If you or a loved one has pain after having a tooth pulled or has a toothache and hasn’t been able to see a dentist yet, widely available medications that have no abuse potential are recommended as first-line treatments. According to an ADA-endorsed guideline, acetaminophen and NSAIDs (like ibuprofen or naproxen) are safe and effective for short-term dental pain in children, adolescents and adults when used as directed.

Advil® DUAL ACTION is the first product to be awarded the ADA Seal of Acceptance for its safety and efficacy in relieving short-term dental pain. Advil DUAL ACTION contains both ibuprofen and acetaminophen. Learn more about the Seal program here.

The ADA recommends patients seek professional help when experiencing dental pain and that patients with short-term dental pain use the product as directed until they can see a dentist.

Opioids work by making your brain feel like your pain is lessening. They also make your body release a hormone called dopamine. Dopamine causes you to feel pleasure, which could lead to addiction.

Abusing opioids is extremely dangerous. According to the National Institute on Drug Abuse, even one large, misused dose can cause “severe respiratory depression and death.” The American Dental Association is working with the American Medical Association Task Force to Reduce Opioid Abuse and the American Academy of Addiction Psychiatry to help educate dentists and physicians on safe prescribing of opioids and help stop this trend of addiction.

In March 2016, the Food and Drug Administration announced major label changes for all prescription opioids to warn patients about the risks of misusing and abusing these drugs. That same month, Massachusetts became the first state to limit first-time opioid prescriptions for adults and minors to only seven days.

According to the Journal of the American Medical Association, up to 23 percent of prescribed doses are used for nonmedical reasons. For example, a friend or family member who may take extra pills left from someone else’s prescription.

Unfortunately, prescription medications have become a leading source of drug abuse among teens and young adults. These medications are often obtained from a friend or family member who had received a prescription for a legitimate purpose. Parents are sometimes fooled into handing over these drugs to treat an apparent symptom of physical distress or pain. More often, they are stolen from the medicine cabinet or lifted from the trash.

Making your loved ones aware of how important it is to use opioids as prescribed and how to safely dispose of extra pills can help save lives.

If you or someone you love is struggling with addiction, call the Substance Abuse and Mental Health Services Administration hotline at 1-800-662-HELP (4357). It's confidential, free and available 24 hours a day, 365 days a year. You can also find a treatment center near you.