JOMS: Opioid Prescribing Can Be Reduced in Oral and Maxillofacial Surgery Practice by Dr. Walter Tatch

"StellaLife is a super weapon for pain management and reduction of the inflammatory process." - Jasmin Haley

Walter Tatch, DDS, FACOMS, Diplomate, ABOMS, Fellow, AACS

Purpose
Pain management is one of the most critical aspects of practice in oral and maxillofacial surgery. The purpose of this study was to measure the change in strong (stronger than codeine 30 mg) opioid use after introducing the standardized protocol (“office protocol”) designed for opioid-free postoperative pain management.

Materials and Methods
This is a retrospective cohort study of patients who had surgical procedures performed at the NorthShore Center for Oral and Facial Surgery (Gurnee, IL). Data of patients who underwent qualified surgical procedures and filled prescriptions for strong opioids before and after introduction of the office protocol were analyzed. The primary predictor variable was introduction of the office protocol. The primary outcome variable was filling of a strong opioid prescription that was correlated to pain control as assessed by patients. Age and gender distributions also were analyzed. Proportions and associated 95% confidence intervals were used to compare the number of hydrocodone or oxycodone (strong) prescriptions filled by patients during a 3-year interval.

Results
In March 2016, the office protocol for pain management, designed to decrease opioid use, was introduced. In 2015 (before introduction of the office protocol), 2,016 adult patients (15 to 85 yr old) underwent qualified surgical procedures at the author's practice, 1,184 (59%) of whom required and filled strong opioid prescriptions. In 2017 (2 yr after introduction of the office procedure) that number decreased to 19%, whereas the number of qualified surgical procedures performed remained relatively the same between the years. Postoperative pain control was not qualitatively measured but was assumed adequate and correlated with the filling of a strong opioid prescription or requiring a refill, which would be recorded as part of total prescriptions filled.

Conclusion
A 3-fold decrease in hydrocodone or oxycodone prescription fill was seen at the 2-year interval. As alternatives, nonsteroidal anti-inflammatory drugs, acetaminophen, and a homeopathic recovery kit (Vega Recovery Kit, StellaLife, Glenview, IL) were used for pain management for patients undergoing various oral surgery procedures.

Click to view the entire study at https://www.joms.org/article/S0278-2391(19)30279-4/fulltext.

Jasmin Haley, RDH, MSDH, CDA, is the Founder and CEO of Beyond the Prophy® and Co-founder of the MOMgienist® Community. She has over 18 years of experience as a dental hygienist, national educator, and dental assistant.

When she is not directly helping to impact the lives of dental professionals with her coaching she can be found on the stage doing what she loves best — speaking from the heart. She shares her personal experiences of overwhelm, fear, and self-doubt to help professionals rediscover their greatness and pursue their goals. She is an expert on HIV/AIDS, an advocate for the opioid epidemic, and crusader for cultural sensitivity in the dental industry. Jasmin is a national leader in education, connector of peer set movers and shakers, and a 2018 recipient of the Sunstar/RDH Award of Distinction. You can reach her at www.jasminhaley.com.

"StellaLife has impacted my mission by providing a 'whole-istic' product that is a super weapon for pain management and reduction of the inflammatory process. My passion is to advocate for the most vulnerable populations and to provide healthy alternatives that can lessen the risk of developing substance use disorder. StellaLife is a staple product in my presentations because I've seen with my own eyes their benefits and I've worked with other professionals who have also seen impactful results."

- - Jasmin Haley, RDH, MSDH, CDA

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