Oral Health & Opioids


open pill bottle with pills spilling out

Prescription opioid abuse is a dangerous and growing problem in America. Every day more than 115 Americans die after overdosing on opioids[1]. When taken as prescribed for short periods under a doctor’s care, opioids can be an effective pain management tool. However, prescription opioids carry the risk of abuse and addiction, particularly if they are used for non-medical purposes.


The Opioid Crisis

  • The number of opioid prescriptions in the United States more than doubled in recent decades, from an estimated 76 million in 1991 to nearly 207 million in 2013[2].                                            

  • Experts estimate that 75 percent of opioid abusers were introduced to opioids through prescription drugs[3].

  • The economic burden of prescription opioid abuse, dependence, and overdose is estimated to be $78.5 billion each year in the United States[4].


What is the Link Between Oral Health and Opioids?

Dentists, including oral and maxillofacial surgeons, may prescribe opioids to treat acute pain after dental procedures or orofacial surgery.

  • Acute dental pain – it’s estimated that more than half of 14- to 17-year-olds receive opioid prescriptions from dentists following wisdom tooth extractions[5].
  • Prescribing practices – in 2010, dentists were the third-most-frequent prescribers of opioid pain medications. Since then, because of increased awareness of the potential for opioid prescription abuse, dentists have fallen to fifth[6].

How is NIDCR Investing in Opioid Research?

NIDCR funds research that aims to provide scientific solutions to help end the opioid crisis.

Examples of NIDCR-supported research include:

  • Developing non-opioid treatments – researchers are developing a method to reduce cancer pain by stimulating the release of the body’s own natural pain relief molecules, called endorphins.
  • Partnering with dentists – the National Dental Practice-Based Research Network (PBRN) engages more than 6,500 US dental practitioners in research. One PBRN study is assessing dentists’ knowledge of opioids and practice behaviors related to acute pain management and opioid prescribing. The findings from this study will increase our understanding of how and why practitioners prescribe opioids, as well as identify training gaps in opioid prescribing practices.  Armed with this knowledge, researchers are developing an educational intervention to train dentists in opioid misuse screening and advancing strategies to reduce risk when prescribing opioids.
  • Implementing alternative pain management strategies – scientists are developing tools to help change dentists’ reliance on prescribing opioid pain medications.  This research will encourage the use of non-opioid pain management methods, such as the prescription of non-steroidal anti-inflammatory drugs (NSAIDS) and/or acetaminophen, shown to be as effective for treatment of acute dental pain after surgery[7].

Additional Resources


[1] CDC/NCHS, National Vital Statistics System, Mortality. CDC Wonder, Atlanta, GA: US Department of Health and Human Services, CDC; 2017. https://wonder.cdc.gov.

[2] International Narcotics Control Board Report 2008. United Nations Pubns. 2009. p. 20.

[3] Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014;71(7):821-826.

[4] Florence CS, Zhou C, Luo F, Xu L. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Med Care. 2016;54(10):901-906.

[5] Manchikanti L, Helm S 2nd, Fellows B, et al. Opioid epidemic in the United States. Pain Physician. 2012;15(3 Suppl):9-38.

[6] IMS Health, National Prescription Audit, United States, 2012.

[7] Moore PA, Ziegler KM, Lipman RD, et al. Benefits and harms associated with analgesic medications used in the management of acute dental pain. J Am Dent Assoc. 2018; 149(4):256-265.

Last Reviewed
May 2024