PainRelief.com Interview with: Dana Orange MD Associate Professor of Clinical Investigation The Rockefeller Institute and William H. Robinson, MD PhD James W. Raitt, M.D., Professor Medicine Immunology & Rheumatology Stanford Health Care
PainRelief.com: What is the background for this study?
Response: Periodontitis is more common in patients with rheumatoid arthritis than those without.
Of patients with rheumatoid arthritis, those with current periodontitis are less likely to receive benefit from treatment with biologic agents than those without periodontitis.
PainRelief.com Interview with: Kao-Ping Chua, MD, PhD Susan B. Meister Child Health Evaluation and Research Center Department of Pediatrics, University of Michigan Medical School Ann Arbor MI 48109.
Dr. Kao-Ping Chua
PainRelief.com: What is the background for this study? What are the main findings?
Response: U.S. dentists account for approximately 11 million opioid prescriptions each year. Excessive opioid prescriptions from dentists can result in leftover opioids that can be diverted or misused. In part to prevent this, most states enacted policies between 2016 and 2018 that restricted the duration of opioid prescriptions for acute pain, such as dental pain.
The objective of this study was to evaluate whether these state opioid prescribing limits were associated with reductions in the duration of opioid prescriptions from dentists. Using national prescription dispensing data from 2014-2020 and a rigorous quasi-experimental study design, we found that this duration did not change after limit enactment. A likely explanation is that most limits allow up to a 7-day supply of opioids, but the typical duration of dental opioid prescriptions during the study period was about a 3-day supply. For this reason, state limits had little ability to reduce this duration in the first place.
Kao-Ping Chua, MD, PhD Susan B. Meister Child Health Evaluation and Research Center Department of Pediatrics, University of Michigan Medical School Ann Arbor MI 48109.
Dr. Kao-Ping Chua
PainRelief.com: What is the background for this study?
Response: Prior studies suggest that opioid prescriptions for surgical procedures are associated with increased overdose risk in patients. Additionally, studies suggest that opioid prescriptions are associated with increased overdose risk in patients’ family members, who often have access to patients’ opioids. However, studies have not specifically assessed whether opioid prescriptions for dental procedures are associated with increased overdose risk in patients and their family members.
PainRelief.com Interview with: Kao-Ping Chua, M.D., Ph.D. Assistant Professor, Department of Pediatrics Susan B. Meister Child Health Evaluation and Research Center University of Michigan
Dr. Kao-Ping Chua,
PainRelief.com: What is the background for this study?
Response: Persistent opioid use occurs when opioid-naïve patients prescribed opioids after procedures continue to fill opioid prescriptions well past the time that acute post-procedural pain typically resolves. Studies have shown that privately insured adolescents and young adults undergoing wisdom tooth removal are more likely to develop persistent opioid use if they fill opioid prescriptions after the procedure than if they do not. However, it is unknown whether these findings generalize to a broader variety of dental procedures or to publicly insured patients covered by Medicaid.
Prof Chris Frampton PhD Department of Medicine
University of Otago
Christchurch, New Zealand
PainRelief.com: What is the background for this study?
Response: Acute pain is a significant burden to the individual and to society. In light of the ongoing opioid crisis, there is a need for effective nonopioid pain medications that provide improved analgesia over common analgesics, without compromising tolerability. Multimodal analgesia combines multiple drugs with different mechanisms of action to improve pain relief while limiting side effects. Fixed-dose combination tablets containing acetaminophen and ibuprofen are already available in many countries; however, the therapeutic advantages of such products are not available to patients in the United States. The US Food and Drug Administration (FDA) has restricted the dose of acetaminophen in prescription drugs to 325 mg per tablet, therefore an existing product containing acetaminophen 500 mg + ibuprofen 150 mg per tablet (two tablets per dose) has been downscaled to comply with FDA restrictions (acetaminophen 325 mg + ibuprofen 97.5 mg, three tablets per dose). The goal of this study was to determine the efficacy of the new fixed-dose combination of acetaminophen 975 mg and ibuprofen 292.5 mg (FDC 975/292.5) relative to acetaminophen or ibuprofen monotherapy, or placebo following the surgical removal of at least two impacted third molars.
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