US dental opioid dispensing falls markedly 2021–2024 but remains highest among peers

Introduction / background

A multinational analysis published online 17 April 2026 in JAMA Network Open found that opioid prescriptions dispensed by dentists decreased substantially from 2021 to 2024 across a set of high‑income jurisdictions, but that the United States continued to have the highest dental opioid dispensing rate in 2024. The study was led by researchers at the University of Michigan (Ann Arbor) and the University of New South Wales (Sydney) and revisited earlier comparisons that showed elevated US dental opioid prescribing relative to the UK in 2016.

What was studied

The investigators evaluated dental opioid dispensing trends from 2021 through 2024 in eight jurisdictions: Australia, Belgium, Canada, France, Germany, the Netherlands, Puerto Rico and the United States. The primary aim was to assess whether the previously observed high US dental opioid rate remained elevated when compared with other countries and territories.

Key findings

• Dental opioid dispensing declined in every jurisdiction analysed between 2021 and 2024.
• The largest relative reductions occurred in Germany (a decline of almost one‑third) and in the United States (a drop of more than one‑quarter).
• Despite the declines, the US retained the highest dispensing rate in 2024: 2,022 opioid prescriptions dispensed per 100,000 people.
• Canada had the next highest rate; the US rate was approximately 14% higher than Canada’s in 2024.
• France, Puerto Rico and Australia recorded rates between about half and two‑thirds of the US rate.
• Belgium, Germany and the Netherlands had substantially lower dispensing rates; the Netherlands had the lowest rate, with the US rate exceeding it by more than a factor of 24.
• In the US cohort, about two‑thirds of dental opioid prescriptions were associated with tooth extraction procedures.

“Our study shows that the US dental opioid dispensing rate is decreasing, but remains high by international standards,” said lead author Dr Kao‑Ping Chua, associate professor of paediatrics at the University of Michigan Medical School. “This finding suggests that some US dentists are still overprescribing opioids.”

Relevance for dental practice

The results underscore continuing opportunities for opioid stewardship in dentistry, particularly around procedures that account for the majority of prescriptions such as extractions. The study aligns with a broader move away from routine opioid use for dental pain: professional guidance—cited in the study’s context—recommends acetaminophen and non‑steroidal anti‑inflammatory drugs as first‑line agents for short‑term dental pain in both adults and children under 12 instead of opioids such as codeine or tramadol. The authors’ findings may prompt clinicians and practices to review local prescribing patterns, analgesic protocols and patient education strategies to reduce unnecessary opioid exposure.

Limitations / context

The study compared dispensing rates across jurisdictions with differing health systems, regulatory frameworks and prescribing practices; these structural differences influence cross‑national comparisons. The authors positioned their analysis as an update to prior international comparisons and emphasised the observed downward trend while noting that the US rate remains elevated relative to the other jurisdictions included in the analysis. The report also referenced ongoing interest in non‑opioid alternatives, including investigational approaches such as cannabidiol, which has been discussed in the literature as a potential non‑opioid analgesic for dental pain.

SOURCE

https://www.dental-tribune.com/news/us-dental-opioid-dispensing-drops-sharply-but-remains-high-internationally/