Prescribing opioids after dental procedures may be linked to a heightened risk of continued use and adverse outcomes, according to a review published in Drug and Alcohol Dependence Reports. The finding suggests dental prescribing is a key pathway into opioid misuse.
Opioid prescribing after lower-pain dental procedures was linked to greater use in the future. Further, factors, like age and the type of insurance coverage patients have, were linked to increased risk of misuse, the authors wrote.
“These findings support the continued use of evidence-based, opioid-sparing approaches to postoperative dental pain management and emphasize the importance of individualized prescribing practices that consider both procedural and patient-related risk factors,” wrote the authors, led by Ruben Mikaelyan of Columbia University's College of Dental Medicine in New York (Drug Alcohol Depend Rep, August 9, 2026, 100467).
Globally, opioid prescriptions for dental procedures continue to be the most common first exposures to these painkillers. Though dentistry has curbed its opioid prescribing in recent years, even limited exposure to the medication may be a considerable risk for developing opioid use disorder, according to the review.
To pinpoint procedural and patient-related risk factors and assess the effectiveness of existing intervention strategies, a review of the current research was conducted.
A search resulted in 12 studies published between January 2011 and July 2026 that were included in this review. Opioid prescribing in dental alveolar surgeries, related opioid or substance use disorder outcomes, and preventive strategies were explored in these studies, the authors wrote.
Multiple factors -- including higher doses of prescribed opioids, prior substance use disorder, having public or Medicaid insurance, younger age, and complex chronic medical conditions -- were dramatically linked to persistent opioid use or adverse outcomes, the authors wrote.
Remarkably, patients prescribed opioids after having dental procedures that caused little pain showed the greatest relative risk for short-term persistent use, they wrote.
However, the review had limitations. Many of the studies included in the review relied on retrospective or administrative data that may not show complex clinical decision-making, the authors wrote.
In the future, prospective longitudinal studies and randomized controlled trials should investigate interventions that can reduce opioid exposure and prevent opioid misuse after dental procedures, they wrote.
“Opioid prescribing following dental procedures is associated with an increased risk of persistent opioid use and opioid-related adverse outcomes in certain patient populations,” Mikaelyan and colleagues wrote.
