For many teens, having their wisdom teeth removed is almost a rite of passage. Social media is even full of hilarious videos of teens coming out of anesthesia after oral surgery. But there’s a risky side to wisdom teeth extraction that is rarely talked about: the prescribing of post-surgery opioid pain medications, which increase a teenager’s risk of future misuse and addiction. A study in the journal Pediatrics1 found that teens who received a prescription for opioid pain medication by Grade 12 were at a 33% increased risk of misusing an opioid between the ages of 19 and 25. This study further found that the risk was even greater among teens who would be expected to be at a low risk of drug misuse. For these teens, having an opioid prescription increased their risk of post high school opioid misuse three-fold.1 These statistics are startling and scary.
I came face to face with this issue this past summer when my 16-year-old son, Connor, had to have his wisdom teeth removed.
The oral surgeon and his nurse discussed the procedure with me and my son. They explained that Connor may experience a bit of discomfort, but should be fine in a few days. Then, the surgeon casually handed me a prescription for 30 Percocet (an opioid pain medication) with an instruction that I should immediately fill the prescription and start giving them to my son as soon as we got home. I stopped him mid-speech and said I was concerned about giving him an opioid medication, and wouldn’t it be better to try to manage the pain with ice and Tylenol or Advil first? He and the nurse explained that I “just didn’t understand pain.” It was a Friday afternoon, they said, and it was better for everyone to “get ahead of the pain and give Connor the Percocet.” They even strongly implied that I was a bad mom if I made my son suffer with pain and discomfort that the opioid would immediately take away.
At this point, I got upset—or as my son not so fondly says, I went ‘Mama Bear’ on them. I explained the risks of opioid exposure for teens, the risks of unused medication in the home, and my concerns that we, like many others, have a family history of addiction. Despite my arguments, they wouldn’t let us leave without the opioid prescription, as it was their standard protocol for all wisdom teeth extractions.
You may be surprised to learn that dentist prescriptions account for 31% of adolescents’ first exposure to opioids.2. While general opioid prescription use among children is far less common, 10-19-year-olds who are prescribed opioids receive, on average, a 60-day supply. In 2016, that equated to enough opioid prescriptions written for teens for every one out of five children to have their own prescription. 3
In the case of my son, I’m happy to say that this Mama Bear trusted her knowledge and instincts and tore up the prescription after we left the office. I pampered my son with ice, Tylenol/Advil, and lots of mint chocolate chip milkshakes. He was back on the lacrosse field, pain free, in two days.
I often think that this situation could have ended very differently. I’m fortunate that I work for Shatterproof and have access to information and resources on prevention, treatment, and recovery from substance use disorders. As I shared my story with friends, most were surprised to learn that introducing teenage brains to prescription opioids can contribute to an increased risk in later use. Even more frightening was the realization that almost all had received an opioid prescription for their teens when they had had their wisdom teeth removed. With an estimated five million people getting wisdom teeth removed each year5, that’s a lot of potential exposure to opioid medication for young adults.
I am pleased to see that this week, the American Dental Association (ADA) announced new policy to significantly reduce opioid prescribing among their members by supporting mandatory continuing education for dentists in prescribing opioids, supporting limits on opioid dosage and duration consistent with the CDC evidence-based guidelines, and supporting dentists to register with and utilize Prescription Drug Monitory Programs (PDMPs) to promote the appropriate use of opioids and deter misuse. The April issue of The Journal of the American Dental Association (JADA) published data that concluded acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDS like Advil) are equal or superior to using opioids for dental pain4.
There is no one solution to solving our country’s opioid epidemic, but reducing over-prescribing and strengthening the education and dialogue between health care providers and patients/parents is a very important step. And to my fellow Mama Bears: Know the risks, trust your instincts, and push back on healthcare providers who recommend opioid medications for our teens. We may get an eye-roll from our teenagers, but someday they will appreciate our protection—or at least appreciate the milkshakes.
Shannon Hartley is Shatterproof's Chief Marketing Officer.