The Connection Between Dental Pain and Opioid Abuse

Dec 1, 2017

Credit Marco Verch / Flickr

Prescription painkillers and their chemical cousin, heroin, killed more than 1,400 people in this state last year alone. Experts blame doctors for prescribing too many addictive pills, but another group of professionals that bears some responsibility for this epidemic and some power to prevent future deaths.

If you’ve had a tooth filled or pulled, you can say amen when Dr. Omar Abubaker explains why he provides painkilling injections before treating many of his patients.

“Dental pain is a very powerful pain.”

One reason is inflammation caused by dental infections.

“When you get an inflammation of the inside of the tooth, and of course the inside of the tooth is confined, the inflammation causes swelling inside the tooth. Swelling inside the tooth causes pressure on the nerve, and that pressure on the nerve causes the pain.”

Abubaker is a department chair at Virginia Commonwealth’s School of Dentistry, and he doesn’t like to see people suffer. That’s why he used to prescribe plenty of opioid medications.

Dental pain is a very powerful pain.

“Listen, I did that that. Everybody around me did that. We sent a survey to Virginia dentists and the data came back that they prescribe on average 20 tablets. Twenty tablets has been shown to be unnecessary, and there’s excess left. In the past people thought, well if there’s leftover people will just throw them in the trash or flush them. In reality, those excess tablets are being taken by a child, a grandchild, or the person gives them to his friends.”

And because adolescents often have wisdom teeth removed, some have discovered the appeal of opium-based drugs. So Abubaker’s been prescribing fewer pills while adding new courses to the university’s curriculum. Aspiring dentists must now take classes in pain management, addiction and the changing laws governing opioids in Virginia.

He knows that dentists are responsible for one in eight prescriptions for immediate release opioids, and 80% of heroin users started with those prescription drugs. Abubaker also knows the pain those drugs can cause.

“My son died of an overdose about three years ago – a heroin overdose. He was 21-and-a-half years old.”

The boy had his share of injuries and surgeries.

“And I think at some point he was using prescription drugs. I didn’t have the knowledge to say opioid prescriptions lead to heroin. That’s how naive I was. I have to admit it.”

When the family learned he was using drugs, the boy agreed to rehab, and he was drug free for months, but the truth is that addicts often relapse. 

Today, Abubaker is using his expertise to assure a new generation of dentists is more careful with powerful, opium-based medications. He’s traveling the state to educate those who already have their DDS, and he’s hoping for a grant that would teach practicing dentists and students how best to talk with people who may already be addicted.

“Ultimately that’s what’s going to make the difference – identify the people and deal with them and refer them.”

Often, he says, addicts are ashamed of their situation – as he was when his son confessed to using heroin. Abubaker now knows that Virginia must move past condemning people who have a true medical disease – to help them recover and, in some cases, to save their lives.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.