Bulletin of Dental Education

U of M SOD Faculty Rethink the Way Dentists Treat Pain—One Opioid at a Time

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For years, family gatherings had become contentious for Harold Tu, D.M.D., M.D., Director of the Division of Oral and Maxillofacial Surgery at the University of Minnesota School of Dentistry (U of M SOD). Somehow, conversations always drifted to opioids. Dr. Tu, a longtime prescriber of opioids, would argue with his son-in-law about the safety and effectiveness of these pain medications. His son-in-law, Andrew Kolodny, M.D., a renowned addiction specialist, had a different perspective. 

Harold Tu, D.M.D., M.D.

Dr. Kolodny saw the aftermath. He was familiar with the wreckage left behind by addiction, and how often it started with a legitimate prescription. 

They’d disagree for a while, until one of the relatives would pipe in to get them to cut it out—dinner is ready!

Eventually, Dr. Tu agreed to join Dr. Kolodny at Fed Up!, a national rally demanding action around opioid addiction. He saw and heard stories from families ravaged by prescription drug abuse. He started to reflect on his own prescribing behavior. It opened the floodgates.

“I had an epiphany,” he says. “Dentists play a significant role in the opioid epidemic. And I came to recognize my own role and responsibility in effecting change.” Particularly for young people, he adds. One study found that adolescents exposed to opioids have a 33% higher risk of abusing prescription painkillers later in life, even if they have a legitimate prescription. Dentists in particular have an increased responsibility to curb this pipeline of addictive drugs because they prescribe more opioids to teens than any other type of health care provider.

Dr. Tu’s evolved perspective is now shaping how U of M SOD teaches its students to care for patients. Last fall, Dr. Tu established a non-opioid mandated approach to manage acute dental pain for the school’s Division of Oral and Maxillofacial Surgery. 

“Dentists need to be part of the solution in decreasing the number of opioid prescriptions and the number of pills prescribed,” he says.

The new protocol requires using non-steroidal, anti-inflammatories as the first-line analgesic, such as an acetaminophen-ibuprofen combination, which has been shown to provide equal pain relief without the associated misuse, abuse, diversion and addiction problems. 

“Peer reviewed studies in [scientific] literature fully support that non-steroidal medications are equally effective as opioids in managing acute dental pain,” says Dr. Tu.

To learn more, read the full article, see implementation results and view resources.

Courtesy of Erin McHenry, University of Minnesota School of Dentistry

Published on September 13, 2017


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