U.S. Dentists Continue to Prescribe Opioids at Higher Rates Than Global Peers

Despite recent declines in opioid prescribing across many developed nations, dentists in the United States continue to prescribe powerful opioid medications at significantly higher rates than their counterparts in other countries, according to recent international data.

An analysis of dental opioid prescribing trends between 2021 and 2024 found that while the annual dental opioid dispensing rate decreased by 27.4 percent in the United States during that period, the reduction was smaller in other developed nations — 14.8 percent in Canada, 10.6 percent in France, and 10.0 percent in several other European countries.

the gap between U.S. And international prescribing rates has narrowed but remains substantial. In 2024, the ratio between the U.S. Dental opioid dispensing rate and that of Canada — the country with the next highest rate — was 1.1, meaning U.S. Dentists prescribed opioids at only 10 percent above the rate of Canadian dentists. This represents a dramatic improvement from earlier years, when the U.S. Rate was as high as 24.4 times that of other nations.

The findings come from a study published in JAMA Network Open, which analyzed dental opioid prescribing patterns across multiple countries using nationwide prescription data. Researchers noted that despite the overall decline, certain dental specialists and practices in the U.S. Continue to show elevated prescribing behaviors.

Additional research published in the Journal of the American Dental Association (JADA) examined prescribing trajectories among general dentists, specialists, and oral and maxillofacial surgeons from 2016 through 2019. While overall prescribing decreased during that timeframe, the study identified persistent high-rate prescribing among some providers, particularly those performing surgical procedures such as tooth extractions.

Public health officials have expressed concern that dental opioid prescriptions, often given for short-term pain following procedures like wisdom tooth removal, may contribute to longer-term use or misuse, especially among adolescents and young adults who frequently undergo such treatments.

Efforts to reduce unnecessary opioid prescribing in dentistry have included updated clinical guidelines emphasizing non-opioid pain management strategies, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, either alone or in combination. Some dental schools and professional organizations have also increased training on pain assessment and risk evaluation for substance use disorders.

Despite progress, experts say continued vigilance is needed to ensure that opioid prescriptions in dental settings are reserved for cases where they are truly necessary and that patients receive adequate education about the risks associated with these medications.