Opioids & Dental Pain

Overview

Opioids are a type of medication used to relieve pain. They require a prescription from health care providers such as your dentist or doctor, and include drugs such as hydrocodone, oxycodone, morphine, and codeine. Opioids also include illegal drugs such as heroin.

To ease discomfort that can result from some dental procedures, such as tooth extraction, gum and other dental surgery, or placement of dental implants, dentists may prescribe medications for pain relief, including opioids. Commonly prescribed opioid medications for relief of dental pain include hydrocodone, oxycodone, and acetaminophen with codeine. (Visit the Drugs, Herbs, and Supplements database from NIH’s MedlinePlus for generic and brand names of medications.)

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury (visit CDC’s Prescription Opioids webpage). But because they can cause temporary feelings of well-being and happiness as well as pain relief, they can be misused. For example, taking these types of medications for a longer period of time or at a higher dose than prescribed can increase your chances of becoming dependent on opioid medications. And, when misused, opioids can lead to addiction, overdose, or death. (See NIH’s National Institute on Drug Abuse information on opioids.)

Addiction or overdose is possible for anyone who takes prescription opioids, even when used as directed. In 2021, opioid overdoses in the U.S. accounted for nearly twice as many deaths as car accidents (25 vs. 13 deaths per 100,000 people). Many of these deaths – 16,000 or nearly 1 in 6 of all opioid overdoses – were from overdoses involving prescription opioids.

Moreover, recent research shows that patients who fill an opioid prescription after a dental procedure have a higher overdose risk compared to patients who don’t receive opioids. Overdose risk is also higher in family members of those patients, especially their children. For many teens and young adults, first exposure to opioids often happens after wisdom-tooth removal. In young people, prescription opioid use is linked to continued and non-medical use of opioids.

It is important to know there are over-the-counter, non-opioid medications—acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen—that can be just as or more effective for managing most dental pain, with fewer side effects and lower likelihood of harm. Talk with your dentist about which medications may be right for you.

Helpful Tips

Be sure to talk with your dentist about how to manage pain after a dental procedure:

• Ask your dentist if there are other ways besides opioids to relieve your pain.
• If your dentist prescribes an opioid pain medication, you should:
  • Let your dentist know about any other medications you are currently taking, and also whether you or others in your family have had any problems with substance use, such as with alcohol, prescription medications, or illicit drugs.
  • Ask if the medications are necessary and about the risks of taking the medication.
  • Ask how to take the medicine and how long you should take it.
  • Be sure to take the medicine according to the directions you have received.
  • Never use alcohol when taking an opioid medication.
  • Store the medication in a safe place out of sight and out of reach of children, teens, and guests, preferably in a locked cabinet.
• If pain persists or symptoms worsen, call your dentist.
• If you are prescribed opioids for dental pain by a physician or in an emergency room visit, consider checking in with a dentist to discuss your symptoms and pain management.

Dispose of any unused or expired medication as soon as possible. The U.S. Food and Drug Administration offers instructions on how to dispose of any unused medication. See the Additional Resources section below.

Additional Resources

• NIH News in Health: Managing Pain, Moving Beyond Opioids
  An article in NIH's monthly newsletter that discusses acute and chronic pain, alternatives to opioid medication, and NIH-funded research on developing better and safer treatments for pain.
• The NIH National Institute on Drug Abuse (NIDA): Opioids
  Basic facts from NIDA on opioids, the opioid overdose-reversing drug naloxone, medications to treat opioid addiction, and more.
• NIH Helping to End Addiction Long-term (HEAL) Initiative
  Trans-agency effort to speed scientific solutions to stem the national opioid public health crisis.
• NIH Pain Consortium
  Enhances pain research and promotes collaboration among researchers across the many NIH Institutes and Centers that have programs addressing pain.
• Centers for Disease Control and Prevention. Opioid Therapy and Different Types of Pain 
  Includes information on opioid therapy for different types of pain as well as options for pain management that do not involve prescription opioids.
• U.S. Food and Drug Administration (FDA). Safe Disposal of Medicines
  Includes information such as where and how to dispose of unused medicines.
• HHS.GOV/OPIOIDS
  A website from the U.S. Department of Health and Human Services that provides information about the national opioid crisis as well as help and resources.