OBJECTIVES: Dentists are the second leading prescribers of immediate-release opioids and in 2011, accounted for 12% of all immediate-release opioid prescribed in the US. Currently, little is known about factors that influence this behavior. The objectives were to estimate the prevalence of opioid analgesic prescribing for dental conditions and determine predictors of opioid prescribing by dentists.

METHODS: A retrospective cohort analysis was conducted using Mississippi Medicaid administrative claims data from January 1, 2015 to December 31, 2016. Medical claims for dental related procedures were extracted. Visits were classified as being associated with an opioid prescription if an opioid prescription claim was filled for the beneficiary within 7 days after the dental visit event. Descriptive statistics for prevalence of opioid analgesic prescribing and logistic regression analyses to identify predictors of receiving a opioid prescription following a dental related visit were conducted.

RESULTS: A total of 16,409 dental visit events were identified and 27% were associated with an opioid prescription. Cleaning/preventive procedures had the lowest rate of opioid prescribing (16%) while tooth extraction procedures had the highest rate of opioid prescription (55%). Logistic regression showed that beneficiaries undergoing extraction procedures were six times more likely to be prescribed an opioid than were those undergoing cleaning/preventive procedures [OR=6.27, 95% CI:4.64-8.46]. Beneficiaries < ages 18 years were less likely to receive an opioid in comparison to beneficiaries ages 19 to 45 years [OR=0.30, 95% CI: 0.27-0.33]. Approximately 12% of opioids prescriptions for dental conditions had dosages of 50 morphine equivalents/day or higher; 53% were written for more than a 3-day supply and 16% for more than a 7-day supply.

CONCLUSIONS: In this population opioids are frequently prescribed for many dental procedures. The results indicate that education would benefit many dentists regarding appropriate dosing and quantities when opioids are needed following dental procedures.