January 2022 Social Commentary

Do you think oral health professionals have a role to play in combatting the opioid epidemic?

Karen Davis, RDH, BSDH

Dimensions Corporate Council Member

Very few patients will positively check a direct drug abuse question on medical histories, so the dental hygienist must become a bit of a private detective. A pertinent question to is, “Do you have any areas in your body where you routinely experience chronic pain?” If so, inquire how they manage the pain, and observe body language to their responses. Additionally, checking for oral indicators of drug overuse should be top of mind. Dry mouth, gingival inflammation, and increased caries may be unrelated to drug abuse, but these signs coupled with positive responses about living with chronic pain could be indicative of drug abuse. Due to the frequency that dental hygienists see patients, they are well positioned to help identify those caught in substance abuse that may be overlooked by other healthcare professionals. Dental practices may want to post substance abuse information in obvious sight. The Substance Abuse and Mental Health Services Administration offers a 24/7 free help line: 1-800-662-HELP (4357) that can be posted on a placard, added to your website, or included on business cards for practices that want to be proactive in increasing awareness during this current opioid crisis.

Aurora M. Graves DeMarco, BA, RDH, CDA

Dimensions Brand Ambassador

Dental hygienists can work to curb the opioid epidemic through educating their patients as to when opioids are appropriate and when they are not. Sometimes patients assume that only an opioid will take away their pain, when an anti-inflammatory or an antibiotic may actually be more appropriate. Also, I believe hygienists can and should talk with their dentists about prescribing appropriate medications on a case-by-case basis.

Lil Caperila, RDH, BSDH, MEd

Dimensions Corporate Council Member 

Dental hygienists are keen in recognizing characteristics in their patients who have masked their opioid addictions. Our education in pharmacology prepares us for asking the proper questions during a medical history review. Some of the common “red flags” are frequent occurrences of pain and requests for narcotic prescriptions. Dental hygienists can offer assistance in getting patients professional advice to safely taper off of these addictive drugs. Dental hygiene visits are scheduled often enough to provide a continual monitoring of their progress.

Marie Fox, LDH

Dimensions Facebook Commenter

I believe we, as dental hygienists, are already combatting it. When I started in hygiene 16 years ago, every extraction patient left with a script for Vicodin. I haven’t seen that in years and I’m proud of dentistry for no longer prescribing opioids as often, if at all. The dentists I work with do not prescribe them.

Maria Dimino, RDH, BS, MA

Dimensions Facebook Commenter

Yes, I believe having a good rapport with your patients is extremely important. When patients feel comfortable, they are more likely to answer questions honestly. We have resources to help people improve their overall daily health in addition to their oral health. Also, patients put a lot of trust in us during their appointments and, at times, they are very open. If we can help one person, it is worth building strong interpersonal relationships with patients by discussing the ramifications of these medications after reviewing their medical history. A strong motivational interview with patients while doing the medical history would be the best approach. Also, it is important to find out why they are taking opioids. Some patients have chronic pain disorders, so it is extremely important to understand that medical history in full and without judgment.

Linda​ Bellisario, RDH, BS

Dimensions Facebook Commenter

Dental hygienists and dentists are trained to screen patients for substance use and are knowledgeable about addiction, and may ask about substance use/misuse. Additionally, such signs of misuse can manifest  as decay, infection, or other oral disease. Thus, during examination, this could be detected. This gives the dentist the ability to appropriately prescribe the proper medication related to specific dental treatments so as not to exacerbate, but rather mitigate future issues

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From Dimensions of Dental Hygiene. January 2022; 20(1)10.