J Am Dent Assoc. 2018 Apr;149(4):237-245.e6. doi: 10.1016/j.adaj.2018.01.005.
Dentists wrote 6.4% of all opioid prescriptions in the United States in 2012. The purpose of this study was to examine opioid prescription rates, dosage of opioids prescribed, type of opioid drug prescribed, and type of dental visit at which dentists prescribe opioids.
The authors used the 2010 through 2015 Truven Health Marketscan Research databases and the Prescription Drug Monitoring Program (PDMP) Training and Technical Assistance Center conversion data set. The authors conducted descriptive analyses for days' supply, quantity prescribed, and daily morphine milligram equivalent dose.
The opioid prescription rate per 1,000 dental patients increased from 130.58 in 2010 to 147.44 in 2015. Approximately 68.41% of all opioids prescribed were during surgical dental visits and approximately 31.10% during nonsurgical dental visits. During nonsurgical dental visits at which dentists prescribed an opioid, most of the procedures were restorative.
Among a population of dental patients with private insurance, opioid prescribing rates in the United States increased slightly from 2010 to 2015. The largest increase was among 11- through 18-year-olds. Almost one-third of opioid prescriptions written by dentists were associated with nonsurgical dental visits.
Use of PDMP resources and use of nonopioid analgesics could help reduce the number of opioid prescriptions in dentistry.
2012 年，美国牙医开具了所有阿片类药物处方的 6.4%。本研究的目的是检查牙医开具阿片类药物处方的比例、开出的阿片类药物剂量、所开阿片类药物的类型以及开具阿片类药物的牙科就诊类型。
作者使用了 2010 年至 2015 年 Truven Health Marketscan 研究数据库和处方药物监测计划（PDMP）培训和技术援助中心转换数据集。作者对供应天数、处方数量和每日吗啡毫克当量剂量进行了描述性分析。
每千名牙科患者的阿片类药物处方率从 2010 年的 130.58 增加到 2015 年的 147.44。大约 68.41%的阿片类药物是在牙科手术就诊时开具的，大约 31.10%是在非手术牙科就诊时开具的。在牙医开具阿片类药物的非手术牙科就诊中，大多数手术是修复性的。
在美国，在有私人保险的牙科患者中，从 2010 年到 2015 年，阿片类药物的处方率略有上升。增幅最大的是 11 至 18 岁人群。牙医开具的三分之一以上的阿片类药物处方与非手术牙科就诊有关。
利用 PDMP 资源和使用非阿片类镇痛药可能有助于减少牙科的阿片类药物处方数量。
