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Are Dentists Contributing to Prescription Opioid Abuse?

January 10, 2017

Filed under: Pain control,Pain Medications — Tags: , — Dr Gillis @ 7:00 am

Are Dentists Contributing to Prescription Opioid Abuse?  The answer is probably!

Are Dentists Contributing to Prescription Opioid Abuse?  Our dental office hopes to do what we can to prevent contributing to narcotic abuse.  The questions we will be asking are:

  1. Do our patients need a narcotic prescription after their dental treatment?
  2. How many tablets is appropriate?

Have you ever had dental surgery?  Have you ever been prescribed opioids for pain?  Were you one of the many who left several tablets unused and not disposed of correctly?  That is Prescription Opioid Abuse.

Prescription Opioids - sometimes needed, sometimes not!

Prescription Opioids – sometimes needed, sometimes not!

The rate of overdose deaths due to prescription narcotics or  Prescription Opioids has more than tripled in the past 20 years!  And, it is a fact that using narcotic pain pills when they are not needed can contribute to addiction.

A recent study noted that 100 million prescription opioids go unused every single year following tooth extractions.  Another study conducted by the University of Pennsylvania Schools of Medicine and Dental Medicine found that more than half of opioids prescribed were left unused by the patients.  There is an opioid epidemic currently.  Evidence shows that people who abuse prescription opioids often use leftover pills that were prescribed for friends or family members.  Your dentist should not be contributing to this epidemic!

Pain following a typical dental procedure such as an uncomplicated extraction is effectively managed with over-the-counter (OTC) medications.   Most dental pain is due to inflammation,and most NSAIDS like ibuprofen have strong anti-inflammatory effects.

What we want! Smiling, comfortable patients!

What we want! Smiling, comfortable patients!

Many articles confirm that  providing opioids like oxycodone or hydrocodone

  • Does not decrease inflammation any more than ibuprofen
  • Does not prevent opioid abuse, and
  • May lead directly to opioid overdoses, exposing you to opioid abuse, leading to possible dependence and opioid overdose death!

Although Hydrocodone/Tylenol combinations are the most wisely prescribed analgesic in the United States, there is no published data indicating that they result in pain relief any better than common NSAIDS like Ibuprofen or Naprosyn.  My recommendation (ooh the self promoting blog!) would be to read our blog on pain management after dentistry (https://www.juliegillisdds.com/blog/). If you do have leftover prescription narcotics or opioids – dispose of them correctly!

Yours for better dental health,

Julie Gillis DDS, PC

Restoring Smiles/Restoring Health

Managing Pain After Dentistry

January 3, 2017

Filed under: Pain control,Pain Medications — Tags: , , — Dr Gillis @ 7:00 am

It is very important to our office that we effectively manage pain during and after dentistry!  Managing pain after dentistry is typically done with Prescription opioids but may be more effectively managed with other safer medicines.

Pain following a typical dental procedure such as an uncomplicated extraction is effectively managed with over-the-counter (OTC) medications.   Manage inflammation and you will be managing pain after dentistry! Most dental pain is due to inflammation, so this is important to prevent.  Most NSAIDS (Non-steroidal anti inflammatory drugs)  like ibuprofen have strong anti-inflammatory effects.

Trauma to front tooth led to the surrounding inflammation, gum recession and pain.

Managing pain after dentistry or dental trauma is important!  Trauma to the front tooth led to the surrounding inflammation, gum recession and pain.

What is inflammation? Inflammed skin or gums may appear red, swollen and painful. The tissue may also feel warm, and may have lost function.  Inflammation is part of the body’s response to harmful stimuli, such as bacteris,  damaged cells from surgery, or trauma.  This is your body’s response at a cellular level that includes your immune cells and your blood vessels.  Evidently, tissue becomes inflammed to help remove the cause of the cell injury, and begin the process of repair.  The downside of this is pain or discomfort.

Managing pain after dentistry leads to happier patients!

Managing pain after dentistry and of course, during dental treatment leads to happy, comfortable, satisfied patients.

Here are a couple other suggestions your dentist may do to help with managing pain after dentistry or dental trauma and be as comfortable as possible following dental treatment:  Note: goal is minimize inflammation, to delay the onset of pain, minimize the pain intensity and prevent acute pain.

  1. Give NSAID before pain occurs or while you are still numb!
  2. It is helpful to take prescription dose of NSAID (400 mg to 600 mg Ibuprofen) prior to your procedure.  Try taking two OTC Ibuprofen about 30 minutes before your appointment.
  3. Your dentist can add additional long-acting anesthetic (0.5% bupivacaine with epinephrine) at the start of a short procedure or near the end of a longer procedure.
  4. Take NSAIDs in the appropriate amount by the clock for 48 – 72 hours after treatment.
  5. Add OTC Tylenol as part of the medications taken after surgery if not taking Ultracet which contains acetaminophen. Tylenol 600/650 mg by the clock either with the Ibuprofen listed above or alternated every 3 hours to maintain blood levels of both medications.
  6.  Use ice if swelling present, 20 minutes on/20 minutes off for 24 hours
  7. Prescribing Tramadol (Ultracet) for 3 days may be very beneficial without the abuse potential of other narcotics. Ultracet combined acetaminophen with tramadol which is an orally effective opioid drug with much less abuse potential than an oxycodone or hydrocodone combination.  (2 tablets of 325-mg acetaminophen plus 37.5 mg tramadol (Ultracet) every 4 – 6 hours)
  8. For mild to moderate pain you may just need ibuprofen 400 mg to 600 mg every 4-6 hours by the clock for the first 48 – 72 hours until pain subsides.

Together we can help decrease opioid abuse!

Yours for better dental health,

Julie Gillis DDS, PC

Restoring Smiles/Restoring Health

 

Prescription Narcotics or Opioids Are Prescribed Too Often!

December 29, 2016

Filed under: Pain control,Pain Medications — Tags: , , — Dr Gillis @ 9:45 pm

Narcotics or Opioids Are Prescribed Too Frequently!

Prescription Narcotics or Opioids have contributed to too many deaths recently!

The over prescribing of narcotic pain relievers had become a big problem.  An article in the June 2016 COMPENDIUM had these things to say about pain prescriptions and pain management.  A 2015 study showed that it takes less tablets of fast acting Ibuprofen 400mg to obtain 50% pain relief following all types of surgery than Ibuprofen 400mg with ocycodone 5 mg (a Prescription Narcotics or Opioids)!  Ketoprofen 24 and Diclofenac potassium 100 required even less tablets.  The number of tablets of Codeine needed to provide 50% pain relief over 4 to 6 hours was more than four times as many as ibuprofen 400 mg  (2 tablets vs 9 tablets)!

What we want! Smiling, comfortable patients!

What we want! Smiling, comfortable patients!  If this can be achieved with minimal prescription opioids or narcotics that is even better.

 

Prescription Narcotics or Opioids are sometimes needed

What can happen! Prescription Narcotics or Opioids – sometimes needed, sometimes not!

Prescription narcotics or opioids may not even be needed after uncomplicated dental treatment or surgery.  The June COMPENDIUM article noted that 400 mg Ibuprofen (that’s two OTC tabs of Advil) is superior to 650 mg aspirin, or 1000 mg Tylenol (acetaminophen), or even combinations of aspirin and Tylenol plus 60 mg of codeine or 30 mg of dihydrocodeine.  Someone taking more than 400 mg ibuprofen may modestly prolong the duration of pain relief but will likely not result in increased pain relief.  Other NSAIDs such as naproxen sodium may achieve comparable pain relief without the narcotic complications.

Our office would like to do what we can to prevent prescription narcotic abuse.  We also want to make sure you are comfortable after dental treatment!

It is interesting to look at how pain medications work.  I think your mind contributes a lot to this.  So, if you think something like a prescription narcotics or opioid will work it has a much better chance of working!  My dad, a Family Medicine MD for 40+ years, often told us the story of being in terrible pain one night and going to the bathroom cupboard for a pain pill.  (He had some narcotics at home in case this was needed).  He accidentally took a tablet of penicillin which was in a similar bottle and his pain went away.  Of course, the penicillin had nothing to do with the relief of his pain.  His mind, however, had everything to do with his pain relief!

You are welcome to call our office for more information. (970) 242-3635

We are very concerned about your comfort during and after dental treatment!

Yours for better dental health,

Julie Gillis DDS, PC

Restoring Smiles/Restoring Health

 

Drugs – It Pays to Shop Around!

April 8, 2015

Drugs – It Pays to Shop Around!

If you actually pay for your prescription medications out of pocket this may be important.  Our office does not prescribe many medications.  We leave that to the MD’s and other care providers.  Our office does prescribe occasional pain medications, antibiotics, and other prescription medications as needed for dental infections and pain.  We use a couple medications for our patients who are fearful of going to the dentist to make their appointments more comfortable.  It has become increasingly necessary to be careful that patients are taking their medications correctly and not creating the environment for super-infections and antibiotic resistant bacteria – but more on that later!

Drugs (1 of 1)

So many drugs, so many prices

If you would like to save money on your prescription medications and by doing this possibly decrease the cost of these medications for others you might want to try this.  We were surprised recently when we made a couple calls to local popular pharmacies to check on the price of some our most prescribed medications. The difference in price for one inexpensive medication was anywhere from $6.00 to $28.00 depending on where it was purchased.  Another prescription medication was offered in different concentrations (as many are) and the price changed dramatically between pharmacies and even from the same pharmacy when you ordered the same overall milligrams of medication but pills of different concentrations.  (For example 20 tabs of a medication at 5 mg/tab versus 10 tabs of the same medication at 10 mg per tab)  It is certainly NOT true that more pills means higher cost.  The cost probably fluctuates by the market for the drug and its availability. So, if the goal is to take 10 mg of something and you don’t care if you take one pill or two at half the strength then this might save you a lot of change!

So, I would suggest this:  Call a couple pharmacies about your needed prescription medication, and see where you would like us to call in your prescription!  Or alternatively, our office can give you a written prescription and you can decide where you want to have that filled.  It’s your choice and your money!

Yours for better dental health, Julie Gillis DDS

Restoring Teeth/ Restoring Smiles

Magnets for Pain Relief? Maybe!

January 27, 2015

Filed under: Pain control — Tags: — Dr Gillis @ 3:36 pm

Magnets for Pain Relief

This information brought to you by Dr. Gillis’ wonderful hygienist, Melanie

Magnet therapy has a long history in traditional folk medicine.  Chinese doctors believed in the therapeutic value of magnets at least 2,000 years ago.  In the middle decades of the twentieth century, scientists in various parts of the world began performing studies on the therapeutic use of magnets.  From the 1940’s on, magnets became increasingly popular in Japan.  Magnet therapy became a commonly used technique of self-administered medicine.  Magnetic mattress pads, bracelets, and necklaces also became popular, mainly among the elderly.  During the 1970’s, magnets became popular among athletes in many countries.  In 1997 the United States properly designed clinical trials of magnets to be reported.  Several preliminary studies suggest that both static magnets and electromagnetic therapy may indeed offer therapeutic benefits for several disorders including possible relief from tempero-mandibular joint  (TMJ) pain!

Willis Judd New Mens Titanium 3000g Magnetic Therapy Bracelet In Black Velvet Gift Box Free Link Removal ToolWillis Judd and Magnalinx  magnetic bracelets

The term magnet therapy usually refers to the use of static magnets placed directly on the body, generally over regions of pain.  Static magnets are either attached to the body by tape or encapsulated in specially designed products such as, belts, wraps, or mattress pads.

 

There is interest in magnet therapy for medical conditions due to the variety of electromagnetic fields that naturally occur within the body.  For example, nervous system transmissions and related muscle contraction are associated with magnetic activity.  Several other activities in the body are associated with magnetic activity.  At one time it was thought that abnormal magnetic fields in the body result in certain disease states and that magnets could play a role in making these magnetic fields normal again.  In scientific studies, static magnets have shown promise for a number of conditions, but in no case is the evidence strong enough to be relied upon.

 

Hematite therapy bracelets - also very good looking!

Hematite therapy bracelets – also very good looking!

Hematite therapy bracelets - also very good looking!

Hematite therapy bracelets – also very good looking!

Scientific evidence shows that wearing a magnetic bracelet of a particular strength for 12 weeks significantly improves pain related to osteoarthritis of the knee and hip.  We recently had a patient in our office who was suffering from TMJ pain.  Rather than trying a prescribed medication which may have unwanted side effects, the patient bought a magnetic bracelet and has had complete loss of pain.  It is recommended that magnets may not be safe for those who use pacemakers or insulin pumps.  Also do not postpone seeing your health care provider for health problems.  Otherwise, magnets are generally considered safe when applied to the skin.

 

Just some fun information that may or may not be useful.  May be worth a try if the alternative is extensive therapy or medications.  Our office is not promoting and as noted there is no strong scientific evidence.

1190 Bookcliff Ave. Suite 201, Grand Junction, CO 81501 USA
Julie M Gillis DDS Grand Junction, CO cosmetic, general, & restorative dentist. (970) 242-3635 (970) 242-8479 jgillis@juliegillisdds.com