Policy Changes Lead to Significant Drop in Dental Opioid Prescriptions

In January 2018, Tennessee’s Medicaid program, TennCare, changed its reimbursement policy regarding dental opioid prescriptions to patients age 20 and younger with significant results. New data demonstrate a 45% decrease in the number of opioid prescriptions written by TennCare dentists in 2019 compared to 2017. The policy change caps opioid prescriptions at a maximum of 60 morphine milligram equivalence (a measurement of potency) per day and limits the supply to three days. Once the initial prescription is up, 10 more days may be requested but this requires authorization from the state.

TennCare partnered with its dental claims administrator DentaQuest Partnership for Oral Health, to determine the outcomes of the policy change. In addition to 11,000 fewer opioid prescriptions being written in 2019, the research brief also found a significant decrease in the percentage of opioids prescribed for nonsurgical oral care, from 21% in 2017 to 9% in 2019, the elimination of codeine-containing medications prescribed to children, and a reduction in the number of high-dose opioid prescriptions from 9% in 2017 to 1.5% in 2019.

Sean G. Boynes, DMD, MS, vice president of health improvement at DentaQuest Partnership for Oral Health Advancement, notes, “The work of TennCare and subsequently this analysis showed a significant impact on the health of children by decreasing the number of those receiving high daily doses of opioids that lead to addiction and overdose risk. Additionally, the fact that the state now reports zero prescriptions for opioids containing codeine for children between the ages of 0 and 11 is phenomenal work, and provides a great model that all states can utilize.”

These results correspond to a decrease in the number of overdose deaths due to opioid use in Tennessee between 2017 and 2018, according to the research brief. To read the full report, click here.