Yilei Liu, Kawtar Zouaidi, Colin C Hubbard, Muhammad F Walji, Matthew R Cooke, Donald B Rindal, Kristin N Ray, Elsbeth Kalenderian, Katie J Suda
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引用次数: 0
Abstract
Background: High-risk medications such as opioids and benzodiazepines are frequently prescribed in pediatric dental care, yet their prescribing patterns and associated adverse outcomes remain poorly understood. The aim of this study was to determine the extent of such prescribing to pediatric patients and factors associated with adverse outcomes.
Methods: MarketScan data for patients younger than 18 years with a dental visit from 2014 through 2019 were analyzed. High-risk medications included benzodiazepines, barbiturates, and opioids. Composite outcomes included hospitalization, emergency department visit, or urgent care visit within 7 days after the dental visit. Opioid-attributable outcomes included opioid-related overdose within 7 days or persistent opioid use 4 through 365 days after the visit. Generalized estimating equations assessed the association between outcomes and patient and visit characteristics.
Results: Among pediatric dental visits, 0.72% (n = 269,991) involved high-risk medications, with 4.3% experiencing a composite outcome. Higher odds were observed in ages 9 through 11 years (odds ratio [OR], 1.56), male patients (OR, 1.05), patients with complex chronic conditions (OR, 2.22), and care delivered in hospital or ambulatory surgery settings (OR, 2.20). Among dental visits with opioids, 10.1% had an opioid-attributable outcome, with the highest odds in patients 4 through 5 years (OR, 1.48), female patients (OR, 1.08), patients with complex chronic conditions (OR, 1.22), and care delivered in outpatient clinics (OR, 1.43).
Conclusions: One in 10 pediatric dental visits involving opioids was associated with opioid-related overdose or persistent use, with the highest odds in young children. These results highlight the need for caution in opioid prescribing and providing guideline-based nonopioid analgesia to children.
Practical implications: Promote safer, equitable pediatric dental prescribing through guideline adherence, nonopioid pain management, and provider training.
期刊介绍:
There is not a single source or solution to help dentists in their quest for lifelong learning, improving dental practice, and dental well-being. JADA+, along with The Journal of the American Dental Association, is striving to do just that, bringing together practical content covering dentistry topics and procedures to help dentists—both general dentists and specialists—provide better patient care and improve oral health and well-being. This is a work in progress; as we add more content, covering more topics of interest, it will continue to expand, becoming an ever-more essential source of oral health knowledge.