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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

      52,235 Monthly downloads/views I 2.832 Impact Factor I 4.5 CiteScore I 1.2 Source Normalized Impact per Paper (SNIP) I 0.655 Scimago Journal & Country Rank (SJR)

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      Pain Management for Dental Medicine in 2021: Opioids, Coronavirus and Beyond

      meeting-report

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          Abstract

          Abstract: Over the past year our attention has inevitably been on the coronavirus pandemic, the health and welfare of our families, patients, and office staffs as well as the re-opening of our dental practices. In addition, the opioid crisis continues, is very likely to worsen as a result of the pandemic and continues to be a challenge to Dentistry. National public health issues and healthcare disparities continue and have created a global concern for providing evidence-based, adequate pain management in the dental setting. We have brought together a group of national thought leaders and experts in this field who will share their insights on the current state of opioid prescribing in Dentistry and describe some of the exciting work being done in advancing pain management.

          The learning objectives for this conference proceedings were:

          1. Describing the implications of current public health concerns for safe and effective pain management in dental medicine.

          2. Identifying risk factors and understanding the current guidelines for the use of opioid and non-opioid medications in dental medicine.

          3. Analyzing the interprofessional collaborations necessary for effective pain management in dental medicine.

          4. Recognizing the challenges and opportunities brought about by the COVID-19 pandemic for the dental profession.

          5. Applying evidence-based strategies for managing the complex pain patient in the dental setting.

          6. Appraising new and future modalities for the assessment and management of orofacial pain.

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          Most cited references88

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          Finding the missing heritability of complex diseases.

          Teri A. Manolio, Francis Collins, Nancy J. Cox … (2009)
          Genome-wide association studies have identified hundreds of genetic variants associated with complex human diseases and traits, and have provided valuable insights into their genetic architecture. Most variants identified so far confer relatively small increments in risk, and explain only a small proportion of familial clustering, leading many to question how the remaining, 'missing' heritability can be explained. Here we examine potential sources of missing heritability and propose research strategies, including and extending beyond current genome-wide association approaches, to illuminate the genetics of complex diseases and enhance its potential to enable effective disease prevention or treatment.
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            The path to personalized medicine.

            Margaret A Hamburg, Francis Collins (2010)
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              Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies

              Luis Sordo, Gregorio Barrio, María J. Bravo … (2017)
              Objective To compare the risk for all cause and overdose mortality in people with opioid dependence during and after substitution treatment with methadone or buprenorphine and to characterise trends in risk of mortality after initiation and cessation of treatment. Design Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, and LILACS to September 2016. Study selection Prospective or retrospective cohort studies in people with opioid dependence that reported deaths from all causes or overdose during follow-up periods in and out of opioid substitution treatment with methadone or buprenorphine. Data extraction and synthesis Two independent reviewers performed data extraction and assessed study quality. Mortality rates in and out of treatment were jointly combined across methadone or buprenorphine cohorts by using multivariate random effects meta-analysis. Results There were 19 eligible cohorts, following 122 885 people treated with methadone over 1.3-13.9 years and 15 831 people treated with buprenorphine over 1.1-4.5 years. Pooled all cause mortality rates were 11.3 and 36.1 per 1000 person years in and out of methadone treatment (unadjusted out-to-in rate ratio 3.20, 95% confidence interval 2.65 to 3.86) and reduced to 4.3 and 9.5 in and out of buprenorphine treatment (2.20, 1.34 to 3.61). In pooled trend analysis, all cause mortality dropped sharply over the first four weeks of methadone treatment and decreased gradually two weeks after leaving treatment. All cause mortality remained stable during induction and remaining time on buprenorphine treatment. Overdose mortality evolved similarly, with pooled overdose mortality rates of 2.6 and 12.7 per 1000 person years in and out of methadone treatment (unadjusted out-to-in rate ratio 4.80, 2.90 to 7.96) and 1.4 and 4.6 in and out of buprenorphine treatment. Conclusions Retention in methadone and buprenorphine treatment is associated with substantial reductions in the risk for all cause and overdose mortality in people dependent on opioids. The induction phase onto methadone treatment and the time immediately after leaving treatment with both drugs are periods of particularly increased mortality risk, which should be dealt with by both public health and clinical strategies to mitigate such risk. These findings are potentially important, but further research must be conducted to properly account for potential confounding and selection bias in comparisons of mortality risk between opioid substitution treatments, as well as throughout periods in and out of each treatment.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Pain Res
                Journal ID (iso-abbrev): J Pain Res
                Journal ID (publisher-id): jpr
                Journal ID (pmc): jpainres
                Title: Journal of Pain Research
                Publisher: Dove
                ISSN (Electronic): 1178-7090
                Publication date (Electronic): 24 May 2021
                Publication date Collection: 2021
                Volume: 14
                Pages: 1371-1387
                Affiliations
                [1 ]Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts University School of Dental Medicine , Boston, MA, USA
                [2 ]Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Department of Surgery, Massachusetts General Hospital , Boston, MA, USA
                [3 ]Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital , Boston, MA, USA
                [4 ]Department of Biological and Material Sciences & Prosthodontics, University of Michigan School of Dentistry, Headache and Orofacial Pain Effort, University of Michigan , Ann Harbor, MI, USA
                [5 ]fNIRS Laboratory, University of Michigan , Ann Harbor, MI, USA
                [6 ]Department of Public Health and Community Service, Tufts University School of Dental Medicine , Boston, MA, USA
                [7 ]Department of Diagnostic Sciences, Tufts University School of Dental Medicine , Boston, MA, USA
                [8 ]Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina , Charleston, SC, USA
                [9 ]Department of Pharmaceutical Services, School of Pharmacy University of California , San Francisco, CA, USA
                [10 ]Department of Clinical Pharmacy, San Francisco Medical Center , San Francisco, CA, USA
                [11 ]Department of Plastic and Oral Surgery, Boston Children’s Hospital , Boston, MA, USA
                [12 ]Harvard School of Dental Medicine , Boston, MA, USA
                [13 ]Harvard Medical School , Boston, MA, USA
                [14 ]Columbia University College of Dental Medicine , New York, NY, USA
                [15 ]Columbia University Medical Center , New York, NY, USA
                [16 ]Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital , Boston, MA, USA
                [17 ]Department of Public Health & Community Medicine, Tufts University School of Medicine , Boston, MA, USA
                [18 ]School of Social Work, North Carolina State University , Raleigh, NC, USA
                Author notes
                Correspondence: Michael E Schatman Tel +1 425647-4880 Email Michael.Schatman@Tufts.edu
                Author information
                http://orcid.org/0000-0003-3282-3952
                http://orcid.org/0000-0003-4856-6022
                http://orcid.org/0000-0002-1019-0413
                Article
                Publisher ID: 319373
                DOI: 10.2147/JPR.S319373
                PMC ID: 8164473
                PubMed ID: 34079355
                SO-VID: de5ba6df-4e9b-4522-bb57-c9a862db3f89
                Copyright © © 2021 Scrivani et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 09 May 2021
                Date accepted : 12 May 2021
                Page count
                Figures: 0, References: 100, Pages: 17
                Categories
                Subject: Meeting Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: pain management,dentistry,opioid analgesia,covid-19
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: pain management, dentistry, opioid analgesia, covid-19

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