title: Prescription of opioid and nonopioid analgesics for dental care in emergency departments: Findings from the National Hospital Ambulatory Medical Care Survey.
abstract: OBJECTIVE
  The aim of this study was to examine trends and associated factors in the prescription of opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics by emergency physicians for nontraumatic dental condition (NTDC)-related visits. Our secondary aim was to investigate whether race/ethnicity is a possible predictor of receiving a prescription for either type of medication for NTDC visits in emergency departments (EDs) after adjustment for potential covariates.
  
  
  METHODS
  We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997-2000 and 2003-2007, and used multinomial multivariate logistic regression to estimate the probability of receiving a prescription for opioid analgesics, nonopioid analgesics, or a combination of both, compared with receiving no analgesics for NTDC-related visits.
  
  
  RESULTS
  During 1997-2000 and 2003-2007, prescription of opioid analgesics and combinations of opioid and nonopioid analgesics increased, and that of no analgesics decreased over time. The prescription rates for opioid analgesics, nonopioid analgesics, opioid and nonopioid analgesic combinations, and no analgesics for NTDC-related visits in EDs were 43 percent, 20 percent, 12 percent, and 25 percent, respectively. Majority of patients categorized as having severe pain received prescriptions for opioids for NTDC-related visits in EDs. After adjusting for covariates, patients with self-reported dental reasons for visit and severe pain had a significantly higher probability of receiving prescriptions for opioid analgesics and opioid and nonopioid analgesic combinations.
  
  
  CONCLUSIONS
  Prescription of opioid analgesics increased over time. ED physicians were more likely to prescribe opioid analgesics and opioid and nonopioid analgesic combinations for NTDC-related visits with reported severe pain.
authors.affiliation: Department of Clinical Services, School of Dentistry, Marquette University, Milwaukee, WI, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Okunseri
authors.forename: Elaye
authors.initials: E
authors.lastname: Okunseri
authors.forename: Qun
authors.initials: Q
authors.lastname: Xiang
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Thorpe
authors.forename: Aniko
authors.initials: A
authors.lastname: Szabo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D003752:Dental Health Services / Q000458:organization & administration*; D011307:Drug Prescriptions; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D014481:United States; D055815:Young Adult
chemical_list: D000700:Analgesics; D000701:Analgesics, Opioid
keywords: dental care; dental health services; emergency physicians; nonopioid analgesics; nontraumatic dental conditions; opioid analgesics; toothache