A recent comprehensive analysis published in JAMA Network Open unveils a persistent disparity in the prescription of opioid medications among dental patients in the United States compared to their counterparts in other high-income countries and U.S. territories. Despite significant reductions in dental opioid prescriptions observed over recent years across multiple developed nations, the rate at which opioids are prescribed post-dental procedures in the U.S. remains disproportionately elevated. This trend underscores both persistent overprescribing in American dental practices and the ongoing challenges in mitigating opioid use associated with routine dental care.
The study conducted by researchers from the University of Michigan Medical School, in collaboration with the University of New South Wales, meticulously analyzed data spanning from 2021 to 2024. The focus was on opioid prescription refill rates following dental interventions such as tooth extractions and drilling, which, while painful, have increasingly been managed through non-opioid analgesics worldwide. Notably, while the United States reported a 27% reduction in such dental opioid prescription fills during this period, its numbers still tower above those of several other industrialized countries, revealing that the efforts to curtail opioid prescriptions in dental settings have not yet normalized national prescribing behaviors.
One of the stark contrasts highlighted by the analysis is between the U.S. and the Netherlands. In the Netherlands, the rate of dental opioid prescriptions per 100,000 inhabitants is 24 times lower than that in the U.S. Specifically, where the U.S. records 2,022 dental opioid prescriptions filled per 100,000 people, the Netherlands manages this figure at an astonishingly low 83 per 100,000. This difference emphasizes the potential for substantial reduction in opioid prescribing and suggests alternative pain management protocols that have yet to be widely adopted in the U.S.
Historically, dentists in many countries prescribed opioids routinely following common dental surgeries, but the growing understanding of opioid-related risks—including the development of chronic use, opioid use disorder, and accidental overdose—has prompted guideline reforms globally. Current evidence indicates that exposure to prescribed opioids after dental procedures can serve as a gateway to long-term dependency, especially in adolescents and young adults. Consequently, modern dental care protocols increasingly recommend non-opioid pharmacological options, such as nonsteroidal anti-inflammatory drugs (NSAIDs), which have been demonstrated to provide safe and effective pain relief with fewer adverse consequences.
Lead author Kao-Ping Chua, M.D., Ph.D., emphasizes that despite measurable progress, the U.S. remains an outlier in terms of dental opioid dispensing rates. Dr. Chua, whose expertise lies at the intersection of pediatrics and health policy, points to the persistent overprescribing patterns among certain segments of U.S. dentistry as a critical target for intervention. The study elucidates that even with the push for opioid-sparing protocols, some dental practitioners have yet to fully embrace updated pain management paradigms or may lack the resources for guideline implementation.
The earlier research spearheaded by Dr. Chua and colleagues has shown a significant 45% reduction from 2016 to 2022 in dental opioid prescriptions in the U.S., with a slowdown noted coinciding with the COVID-19 pandemic. While this represents substantial improvement, it also indicates how external social factors can impact prescribing trends. Interestingly, even with this decline, the dental opioid prescription rate in the U.S. was reported to be four times higher than that of the United Kingdom as of 2022, a comparison that underscores the unique challenges still facing U.S. health care systems in opioid stewardship within dentistry.
Chad Brummett, M.D., the senior author of the study and a respected anesthesiologist and pain expert, stresses the importance of continuing education and the development of opioid-sparing initiatives for dental practitioners. Through his efforts with the University of Michigan Opioid Research Institute and the OPEN project, Brummett seeks to disseminate evidence-based pain management strategies that minimize opioid reliance without compromising patient comfort. These resources, freely available and regularly updated, provide practical instruction on dosage, alternative medications, and patient communication about pain expectations.
One intriguing facet of the study concerns the Puerto Rican dental opioid prescription rates, which also showed a decline (approximately 10%) but remain substantially lower than those of the mainland U.S. This regional variation invites further inquiry into the socio-cultural, regulatory, and educational differences influencing prescribing behaviors and patient expectations between U.S. territories and states.
The methodology employed in this research involved rigorous data and statistical analysis, allowing for cross-country benchmarking and thorough scrutiny of temporal trends. It highlights the utility of large-scale, international comparative studies in identifying public health issues and crafting targeted interventions. Moreover, the inclusion of Australia, Canada, France, and Germany broadens the understanding of how similar health care systems approach opioids in dental care, offering lessons transferrable to U.S. policies.
The persistence of higher opioid prescription rates in the U.S. dental sector contributes to broader public health concerns surrounding opioid access and misuse. Dental procedures often serve as initial exposure points to opioids for young people, making the reduction in unnecessary opioid prescriptions vital in curbing the opioid epidemic. Given that alternative analgesics meet postoperative needs effectively, the continued reliance on opioids highlights a critical area for health policy reform, provider education, and guideline enforcement.
Funding from the Benter Foundation, the National Institute on Drug Abuse, and Australia’s National Health and Medical Research Council buttressed the study, underscoring the global relevance of opioid prescribing trends and the need for collaborative efforts to address them. The repeated call for opioid stewardship in dentistry, backed by robust data, should galvanize clinicians, policymakers, and communities alike to sharpen their focus on the risks associated with opioid overprescribing and to promote safer, more effective pain management approaches.
This new research serves as a clarion call—not only illustrating the significant advances achieved in reducing dental opioid prescriptions—but also reminding us that there remains substantial ground to cover before the U.S. aligns with safer, more conservative international prescribing norms. Future directions will need to encompass targeted interventions to dispel prescribing inertia, address systemic factors enabling overprescribing, and enhance patient education to break the cycle of opioid dependency originating in dental care.
Subject of Research: People
Article Title: International Trends in Dental Opioid Prescriptions
News Publication Date: 17-Apr-2026
Web References:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2847875
https://michigan-open.org/initiatives/pain-management/dentistry/
References:
International Trends in Dental Opioid Prescriptions, JAMA Network Open, DOI: 10.1001/jamanetworkopen.2026.7824
Keywords: Dentistry, Dental care, Opioids, Analgesics, Medications, Drug dosage, Drug therapy, Pain, Pharmaceuticals, Health care, Health disparity, Health care delivery
