A study from Rutgers School of Dental Medicine has revealed a troubling connection between dentistry and America’s opioid crisis.
Dentists wrote nearly 9 million opioid prescriptions in 2022, often exposing young adults to these drugs for the first time after wisdom tooth extractions. The research suggests that these prescriptions may be unnecessary and less effective than over-the-counter alternatives.
The research, published in the Journal of the American Dental Association, followed 1,815 patients undergoing wisdom tooth removal across five clinical sites. It compared the effectiveness of hydrocodone with acetaminophen, a commonly prescribed opioid, with a combination of over-the-counter ibuprofen and acetaminophen.
The results are striking. Patients taking the non-opioid combination reported significantly less pain during the critical first 48 hours after surgery, when discomfort tends to peak. This group also experienced fewer side effects such as nausea, dizziness, and drowsiness, as well as better sleep and faster recovery.
The study employed a double-blind setup, meaning neither the patients nor the healthcare providers knew which medication was being administered. This approach added credibility to the findings, which reflect real-world conditions more accurately than earlier studies with tightly controlled environments. The patient group was diverse, averaging 25.7 years old, and included a mix of genders and ethnicities, with most requiring complex surgical techniques typical of wisdom tooth extractions.
According to Dr. Janine Fredericks-Younger, more than 80,000 Americans die annually from opioid overdoses, and many of these tragedies are rooted in initial exposure through prescription medications. Young adults prescribed opioids for dental pain are at a higher risk of eventual misuse, with leftover pills often contributing to addiction issues within communities.
The over-the-counter combination works by targeting pain through multiple mechanisms. Ibuprofen addresses inflammation at the surgical site, while acetaminophen interrupts pain signals in the brain. This dual approach makes it more effective than opioids, which focus on a single pathway.
Dr. Cecile Feldman, dean of Rutgers School of Dental Medicine and the study’s lead author, noted that prescribing opioids for routine cases like wisdom tooth removal is increasingly difficult to justify unless specific medical conditions prevent the use of ibuprofen or acetaminophen.
This research could signal a major shift in how dental pain is managed. The team plans to extend its work to other procedures, exploring safer alternatives to opioids.
Early experiments with cannabinoids for dental pain are already underway, further broadening the scope of options available to both patients and providers. These advancements are influencing not only current practices but also how future dentists are trained, as dental schools integrate emerging scientific evidence into their curricula.
In one of the most common surgical procedures in the United States, the evidence is compelling: a simple combination of ibuprofen and acetaminophen can deliver better outcomes than opioids, without the risks of addiction or debilitating side effects.
As the nation grapples with the devastating consequences of the opioid epidemic, findings like these offer a path to safer, more responsible pain management. For many, this could mean not just relief from dental pain, but also protection from a crisis that has claimed far too many lives.