Patterns of postoperative pain medication prescribing after invasive dental procedures

Barasch, Andrei; Safford, Monika M.; McNeal, Sandre F.; Robinson, Michelle; Grant, Vivian S.; Gilbert, Gregg H.

doi:10.1111/j.1754-4505.2011.00181.x

Cited by 18 publications

(12 citation statements)

References 16 publications

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“…Similar prescription patterns for analgesics in the dental setting have also been observed in studies conducted in Istanbul, [9] Bangladesh, [10] Karnataka [11] and Alabama. [12] It is noteworthy that analogous results have also been reported in a study illustrating country comparisons in analgesic usage. [13] Evaluation of the prescription patterns revealed that there was a great deal of variability in the drugs prescribed and the protocols followed for their prescription.…”

Section: Discussionsupporting

confidence: 68%

A survey of analgesic and anti-inflammatory drug prescription for oral implant surgery

Datta¹,

Grewal²,

Batth³

et al. 2015

Plast Aesthet Res

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Aim: This study was conducted to determine the preferred analgesic and anti-inflammatory drugs prescribed by oral implantologists in India. Methods: A structured questionnaire was distributed to 332 dentists to gather information regarding their prescription habits for analgesics and anti-inflammatory drugs. Frequency distributions were computed by type of drug being prescribed and the protocol followed. Results: Analysis of data showed that majority of dentists (85.8%, n = 285) prescribed conventional non-steroidal anti-inflammatory drugs (NSAIDs) for implant surgery. The most common prescription was ibuprofen with paracetamol combination (32.2%, n = 107) followed by diclofenac (20.2%, n = 67). Most dentists reported prescribing different NSAIDs for the same procedure in different patients (64.7%, n = 215). Only, 35.5% (n = 118) followed the peri-operative protocol. Adjunctive prescription of steroids was done by only 33.7% (n = 112). Conclusion: Our study illustrates that the general trend of analgesic and anti-inflammatory drug prescription for dental implant surgery among Indian dentists is mostly in accordance with the guidelines for pain management worldwide. However, it is noteworthy that a few dentists do prescribe drugs not primarily indicated for dental pain management and use widely varying protocols for the same. Therefore, in order to avoid potential complications, it is essential to raise awareness of among the dental practitioners of the appropriate indications and dosage regimen of specific drugs.

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Section: Discussionsupporting

confidence: 68%

A survey of analgesic and anti-inflammatory drug prescription for oral implant surgery

Datta¹,

Grewal²,

Batth³

et al. 2015

Plast Aesthet Res

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“…Dental pain is one of the most common types of bodily pain. Opioid analgesics are among the most frequently prescribed drugs by dentists [ 11 – 13 ]. Accordingly, dentists have contributed significantly to the prescription opioid epidemics by prescribing 12% of all immediate release opioid drugs in the United States, second only to family physicians in amounts of such prescriptions [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists

et al. 2015

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Prescription Drug Monitoring Programs (PDMP) are statewide databases that collect data on prescription of controlled substances. New York State mandates prescribers to consult the PDMP registry before prescribing a controlled substance such as opioid analgesics. The effect of mandatory PDMP on opioid drug prescriptions by dentists is not known. This study investigates the impact of mandatory PDMP on frequency and quantity of opioid prescriptions by dentists in a dental urgent care center. Based on the sample size estimate, we collected patient records of a 3-month period before and two consecutive 3-month periods after the mandatory PDMP implementation and analyzed the data on number of visits, treatment types and drug prescriptions using Chi-square tests. For patients who were prescribed pain medications, 452 (30.6%), 190 (14.1%), and 140 (9.6%) received opioid analgesics in the three study periods respectively, signifying a statistically significant reduction in the number of opioid prescriptions after implementation of the mandatory PDMP (p<0.05). Total numbers of prescribed opioid pills in a 3-month period decreased from 5096 to 1120, signifying a 78% reduction in absolute quantity. Prescriptions for non-opioid analgesics acetaminophen increased during the same periods (p<0.05). We conclude that the mandatory PDMP significantly affected the prescription pattern for pain medications by dentists. Such change in prescription pattern represents a shift towards the evidence-based prescription practices for acute postoperative pain.

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“…Drug allergies, medical conditions, and other medications were not considered before analgesic prescription. Students prescribed NSAIDs for 9% of their patients, whereas residents did not prescribe this class of analgesics at all or naprosin (43%) [15].…”

Section: Resultsmentioning

confidence: 99%

Knowledge and Pattern of Antibiotic and Non Narcotic Analgesic Prescription for Pulpal and Periapical Pathologies- A Survey Among Dentists

Mavuluri

Karunakar

Vishwanath

et al. 2014

JCDR

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Aim:The objective was to assess the knowledge and pattern of antibiotic and non narcotic analgesic prescription for pulpal and periapical pathologies among dentists, registered with IDA, in and around Hyderabad. Materials and Methods:Cross-sectional survey was conducted from January 2014 to February 2014 in and around Hyderabad, Andhra Pradesh, India. A questionnaire for this cross-sectional survey was designed for evaluating the knowledge and patterns of antibiotic and non narcotic analgesic prescription for pulpal and periapical pathologies. It included some demographic information, questions regarding clinical and non clinical factors, type of antibiotics and non narcotics analgesics prescribed were recorded. Data was computed and analysed using SPSS software. Descriptive statistics was performed. Results:The response rate for the study was 85%, 51.4% being males and 53.9% were pursuing post graduation. Of the respondents, 44.3% would prescribe medication with elevated body temperatures and evidence of systemic involvement, while 42.8% would prescribe medication for non clinical factors such as unsure of diagnosis. Necrotic pulp with acute apical periodontitis with swelling present and mod/severe preoperative symptoms was the most common condition identified for antibiotic therapy (56.4%). The first antibiotic of choice in patients with no medical allergies is amoxicillin, followed by amoxicillin and metronidazole. The first antibiotic of choice in case of allergic to penicillin was erythromycin. 55.1% and 37.3% would not prescribe antibiotic and analgesic after Root canal treatment respectively. The most commonly prescribed NSAID is Diclofenac (51.1%). Factors influencing the choice of analgesics among respondents is severity of pain (61.4%). 31.7% remained informed of current prophylactic practices through pharmaceutical companies followed by university training sessions and scientific societies (30.7%). Conclusion:The results of the present survey have demonstrated a lack of uniformity among the dental practitioners. All the clinicians should make themselves aware of the current guidelines available, to ensure highest degree of patient care.

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Patterns of postoperative pain medication prescribing after invasive dental procedures

Cited by 18 publications

References 16 publications

A survey of analgesic and anti-inflammatory drug prescription for oral implant surgery

A survey of analgesic and anti-inflammatory drug prescription for oral implant surgery

Impact of a Mandatory Prescription Drug Monitoring Program on Prescription of Opioid Analgesics by Dentists

Knowledge and Pattern of Antibiotic and Non Narcotic Analgesic Prescription for Pulpal and Periapical Pathologies- A Survey Among Dentists

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