Ontario dentists asked to limit prescriptions for addictive painkillers

The Royal College of Dental Surgeons of Ontario is asking dentists in the province this year to limit prescriptions for addictive opioids, such as oxycodone and codeine, in response to a high number of overdoses.

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The college published voluntary guidelines in November, emphasizing that acetaminophen and other non-opioids are sufficient for most dental pain. 

The college also suggested that in the minority of cases in which patients are prescribed opioids, dentists should limit the number of tablets, as the most severe pain generally wanes after three days.

The guidelines come after an Ontario study found that overdoses of opioids were the cause of one in eight deaths among young adults.

Dr. Mike Gardener, a dentist with the college, said there's no evidence dentists are over-prescribing opioids but that the guidelines place reasonable limits on prescriptions.  

"We need to be thoughtful about the dynamic of pain, that pain tends to peak over the first three days and then we would expect it to diminish," he said. 

'Tiny bit more leeway'

Ottawa dentist Dr. Jonathan Mayer said while he supports the guidelines, he believes the three-day limit on opioid could be too strict.

"If I was writing them myself, I would have given a tiny, tiny bit more leeway. They talk about three days maximum dosing; I would have had four to five days. And if it's used properly even five days of narcotics is not going to make somebody hooked on it," he said.

The college is working with the province's narcotic monitoring system to track how often dentists are prescribing opioids. In a year, it will check back to see if the guidelines have helped reduce those prescriptions. 

Read the opioid guidelines by the  Royal College of Dental Surgeons of Ontario here.