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Alternatives to opioids for acute pain management after dental procedures: A Department of Veterans Affairs consensus paper.

Wehler CJ, Panchal NH, Cotchery DL, Farooqi OA, Ferguson DK, Foran D, Hakki OW, Silva R, Smith GM, Gibson G. Alternatives to opioids for acute pain management after dental procedures: A Department of Veterans Affairs consensus paper. Journal of the American Dental Association (1939). 2021 Aug 1; 152(8):641-652.

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Abstract:

BACKGROUND: Opioid misuse is a widespread public health problem, and opioids are often prescribed in the dental environment. These recommendations provide alternatives to opioids to reduce or eliminate dental procedure-related acute pain. METHODS: A multidisciplinary working group developed these clinical recommendations to specifically address procedure-related acute pain. These recommendations, which are based on published peer-reviewed research and guidelines, include therapies used before, during, and after dental procedures. When evidence is not definitive, the best practices, which are based on experts'' consensus, are included. The recommendations are not intended to be exhaustive. RESULTS: These recommendations are a summary of the evidence and best practices for opioid alternatives to treat acute pain related to dental procedures. CONCLUSIONS: Dental providers should prioritize opioid stewardship when managing procedure-related pain with strategies such as thorough preprocedure pain assessment, minimally invasive techniques, preemptive analgesia, intraprocedure pain management, and appropriately selected postprocedure pharmacologic therapy. PRACTICAL IMPLICATIONS: These recommendations are a concise resource for clinical providers. It is important to address patients'' procedure-related pain, using nonopioids whenever possible. Alternatives are outlined, allowing providers to make informed decisions.




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