Managing Acute Pain and Opioid Risks Following Wisdom Teeth Extraction: An Illustrative Case

Abstract

Introduction:The opioid epidemic has awakened educators to the insufficiency of training in the areas of pain management and substance use disorders within the curricula of health sciences schools. The University of Pittsburgh Center of Excellence in Pain Education created an online educational module focusing on factors contributing to the opioid epidemic and the role of robust interprofessional communication in avoiding common practitioner errors. Methods: The 1-hour module created by an interprofessional team comprised a pretest, video presentation featuring case vignettes, posttest, and learner satisfaction survey. The content of the module focused on four core concepts: (1) managing acute perioperative pain, (2) maximizing opioid safety, and (3) identifying and (4) managing suspected opioid abuse and diversion. Results: Data were obtained from 250 dental, pharmacy, and nursing students from the University of Pittsburgh who completed the module as part of their respective profession-specific curricula. Results collapsed across the three school-specific implementations indicated an average increase in knowledge test scores from pre-to posttest (Z = −8.82, p < .001). In addition, the learner satisfaction data revealed an overall positive response to the module, with students commenting that they enjoyed the module and felt it provided them with a valuable learning experience. Discussion: Learner outcomes and feedback suggest that our interprofessional team was successful in creating an effective learning module applicable to several health care professions, namely, pharmacy, dentistry, and nursing. Future studies might address the application of the knowledge gained to actual patient care.

The Role of the Pharmacist in Combating the Opioid Crisis: An Update

“…Pharmacy students at the University of Pittsburgh, North Dakota State University, and Merced University have piloted curricular modules on opioid use, guidelines, and safety. [67][68][69][70] Students have reported these modules as being valuable and improving their confidence in dealing with situations regarding opioids in the future. 67,70 North Dakota State University also mandates that students complete a naloxone training session while embedding opioid-related education and hands-on activities in the general curriculum.…”

Assessment of Patient Characteristics Influencing the Analgesic Effects of Ibuprofen Gargle After Mandibular Third Molar Extractions

“…For patients with gastrointestinal ulcers or aspirin-induced asthma, acetaminophen may serve as an alternative [ 4 ]. Various NSAIDs, including celecoxib [ 5 , 6 ], valdecoxib [ 7 ], ibuprofen [ 8 ], flurbiprofen [ 9 ], and opioid-containing medications such as oxycodone [ 10 ], have been closely evaluated to identify optimal analgesics for pain alleviation in mandibular third molar extractions. A systematic review by Weil et al highlighted the safety and efficacy of oral paracetamol (acetaminophen) in postoperative pain management after embedded mandibular third molar extractions [ 11 ], whereas the Cochrane review by Bailey et al highlighted the superiority of oral ibuprofen over oral paracetamol in this context [ 12 ].…”

Efficacy and safety of ibuprofen gargle for postoperative pain after mandibular third molar extraction: A phase II, placebo‐controlled, double‐blind, randomized crossover trial

“…Acetaminophen presents itself as a viable therapeutic option for patients who are experiencing gastrointestinal ulcers or asthma associated with the use of aspirin (Kacso & Terézhalmy, 1994 ; Pergolizzi et al, 2020 ). Previous studies have assessed whether NSAIDs, such as celecoxib, valdecoxib, ibuprofen, flurbiprofen, lornoxicam, etoricoxib, and opioid‐containing drugs (such as oxycodone) (Benetello et al, 2007 ; Demirbas et al, 2019 ; Franco‐de la Torre et al, 2021 ; Isola, Alibrandi, et al, 2019 ; Isola, Matarese, Ramaglia, Cicciù, et al, 2019 ; Pruskowski et al, 2019 ; Rajanna & B R, 2021 ; Xie et al, 2020 ), are the most effective analgesics in patients who underwent mandibular third molar extractions. Notably, flurbiprofen, lornoxicam, and a phytotherapeutic compound consisting of baicalin, bromelain, and escin have been identified as efficacious in managing pain following third molar surgery (Isola, Alibrandi, et al, 2019 ; Isola, Matarese, Ramaglia, Iorio‐Siciliano, et al, 2019 ).…”