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ADA urges panel to better address acute pain management in teens, young adults

April 02, 2019

By Jennifer Garvin

Washington — The ADA is urging a federal panel to better address dental care and teen and young adult patients in recommendations to ensure best pain management practices are being applied consistently throughout the federal government.   

In comments filed April 1, ADA President Jeffrey M. Cole and Executive Director Kathleen T. O'Loughlin praised the federal Pain Management Best Practices Inter-Agency Task Force for addressing acute pain in its draft report to Congress, but urged the panel to also address the nuances of managing acute pain in teens and young adults when their brains are at a critical stage of development. 

“[T]hird molars (or wisdom teeth) generally erupt between late teens and early twenties,” Drs. Cole and O’Loughlin wrote. “In some cases, a wisdom tooth extraction can be a teen or young adult’s first exposure to an opioid.” 

They also noted that the ADA recommends that dentists use nonsteroidal anti-inflammatory drugs as a first-line therapy for managing acute pain. 

While the ADA supported the task force’s findings, Drs. Cole and O’Loughlin did note the need to change a section of the report suggesting that dentists are clinical specialists “on par” with physician assistants and nurse practitioners. 

“This is not an accurate observation given the scope of dental practice and the nature of a dentist’s education and training,” they wrote, adding that dentists “receive a sound general medical training during their professional education and supervise and perform surgical procedures outside the scope of other trained dental personnel, such as dental hygienists and dental assistants.” 

Drs. Cole and O’Loughlin added that “routine dental care is a primary care service and general and pediatric dentists are primary care clinicians. Their primary function is to provide comprehensive oral health care beginning before age one and continue doing so throughout the patient’s lifetime, with appropriate referrals as necessary.” 
Authorized by a 2016 law, the Pain Management Best Practices Inter-Agency Task Force was created to propose updates to best practices and issue recommendations to address gaps or inconsistencies for managing chronic and acute pain. 

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