FALLS CHURCH, Va.  –  

If you’ve had certain dental procedures, like wisdom teeth removal, a root canal, or oral surgery, some dentists may prescribe an opioid painkiller to help manage your pain. While your comfort is a priority, it’s important to also understand any potential negative side effects posed by opioids and the importance of using opioids responsibly.

What are opioids?

Opioids are a medication that blocks pain signals to your brain. Dentists will prescribe them for short-term pain, and likely only for a maximum of seven days. A dentist might prescribe this kind of pain reliever if they expect you to experience moderate to severe pain.

Here are a few opioids dentists commonly prescribe:

• Hydrocodone (Vicodin®, Norco®)
• Morphine (MS Contin®, Kadian®)
• Oxycodone (OxyContin®, Percocet®)

The risks of opioids to oral health

• Dry mouth (xerostomia). Saliva reduction is one of the most common side effects of opioids. Our mouth needs saliva because its essential purpose is to wash away food particles, neutralize acids from the foods you eat and drink, and protect your tooth enamel (the outer covering of the tooth). Dry mouth puts you at risk of developing cavities and gum diseases like gingivitis.
• Addiction. The biggest concern with opioids is they’re highly addictive. According to the Centers for Disease Control and Prevention, there are severe side effects and risks to taking opioids that happen even if you use them responsibly and as intended, including:
  • Reduced effectiveness. The longer you take opioids, the less effective the pain relief becomes, which will make it feel like you need to take more opioids to experience the same amount of relief.
  • Withdrawal. Opioids make it hard on your body to stop taking them. You might feel symptoms like shaking, vomiting, and muscle aches and pains when you stop the medication. If you or someone you know is struggling or in crisis, call the Substance Abuse and Mental Health Services Administration’s National Helpline, 800-662-HELP (4357) or TTY: 800-487-4889. It’s a confidential, free, 24-hours-per-day, 365-days-per-year, information service, in English and Spanish, for individuals and family members facing mental or substance use disorders. 
  • Heightened pain. The longer you take opioids, the more sensitive to pain you become, which makes your body less tolerant to pain that would have felt manageable before taking opioids.
  • Mood. Opioids also affect your mood. Some symptoms include confusion and depression. When you’re depressed, it’s far harder to take care of yourself, which often means being less diligent about your oral hygiene.

Exploring alternative pain management

Don’t be afraid to talk openly about your pain management options with your dentist.

“By understanding the potential risks of opioids and exploring alternative options, you can protect your oral health and overall well-being,” said Douglas Elsesser, a program analyst with the Dental Program Branch of the TRICARE Health Plan at the Defense Health Agency. “Don't hesitate to ask questions and work with your dental provider to create a pain management plan that meets your needs.”

Non-steroidal anti-inflammatory drugs, more commonly known as NSAIDs, are an excellent way to manage pain safely.

Common over-the-counter NSAIDs include:

• Ibuprofen (Advil and Motrin)
• Naproxen (Aleve)

According to the CDC, dentists should choose NSAIDs as a first choice as pain relief for their patients. Studies also show NSAIDs are more effective than opioids in treating pain from oral surgery. If your dentist still recommends an opioid to treat pain, the CDC suggests taking the lowest dose possible and only taking opioids for as long as necessary.

Don’t forget the ice!

Along with NSAIDs, don’t forget the simple power of a cold compress. Applying ice packs to the affected area can help reduce swelling and pain, especially in the first 24-48 hours after a procedure.