Distribution of Opioid Prescribing and High-Risk Prescribing Among US Dentists in 2019

Introduction: It is unknown whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions. Identifying and characterizing such dentists could inform the targeting of initiatives to improve the appropriateness and safety of dental opioid prescribing. Methods: In May 2021, the authors conducted a cross-sectional analysis using the IQVIA Longitudinal Prescription Database, which reports dispensing from 92% of U.S. pharmacies, and 2 provider opioid prescriptions from dentists dispensed in 2019 to patients aged >12 years. High-risk prescriptions were those considered high risk by any of 3 metrics (prescriptions to opioid-naive patients exceeding a 3-day supply, prescriptions with daily opioid dosage >= 50 morphine milligram equivalents, opioid prescriptions with benzodiazepine overlap). Among all prescriptions and high-risk prescriptions, the authors calculated the proportion accounted for by high-volume dentists - those with prescription counts in the 95th percentile or higher. Using logistic regression, the characteristics associated with being a high-volume dentist were identified. Results: In 2019, a total of 141,345 dentists accounted for 10,736,743 opioid prescriptions dispensed to patients aged >12 years; 4,242,634 (39.5%) were high-risk prescriptions. The 7,079 high-volume dentists, a group representing 5.0% of the 141,345 dentists, accounted for 46.9% of all prescriptions and 47.5% of high-risk prescriptions. Male sex, younger age, non-Northeast location, and specialization in oral and maxillofacial surgery were associated with a higher risk of being a high-volume dentist. Conclusions: In 2019, high-volume dentists accounted for almost half of dental opioid prescriptions and high-risk prescriptions. Quality improvement initiatives targeting these dentists may be warranted. Am J Prev Med 2022;62(3):317-325. (c) 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Automated summary

This study investigates whether certain dentists account for disproportionate shares of dental opioid prescriptions and high-risk prescriptions, and identifies characteristics associated with being a high-volume dentist.