Cost savings from averted prescription opioidattributable dental diseases in the United States between 2013 and 2019

Introduction Between 2013 and 2019, opioid prescriptions in the US declined by about 7% per year. However, little is known about the health and economic impacts of this decline on common dental diseases in adults (i.e. periodontitis, untreated dental caries and edentulism). We sought to assess relationships between prescription opioid use and indicated dental diseases, and to estimate associated epidemiologic and economic impacts of the decline in opioid prescriptions. Methods We evaluated NHANES data (2009, 2011, 2013 and 2015 cycles) to measure associations between recent prescription opioid use and indicated dental diseases. We then used an empirical modeling approach to estimate: a) the number of patients directly affected by withheld opioid prescriptions, b) associated changes in the number of patients with indicated dental diseases, and c) associated changes in direct and indirect costs of care. Results Estimated one-year risks of untreated caries and edentulism were 1.5% (95% CI: 0.2–2.8, p<0.05) and 2.6% (95% CI: 1.2–4.1, p<0.05) higher in NHANES participants with recent prescription opioid use compared to those without. About 102 million opioid prescriptions were withheld from about 91 million individuals between 2013 and 2019; this may have averted over 1.3 million cases of untreated caries and 2.3 million cases of edentulism, and may have saved up to $1.4 billion in direct and indirect costs. Conclusions The decline in opioid prescriptions between 2013 and 2019 may have averted over 3.6 million combined cases of untreated caries and edentulism, and may have saved the US economy over $1.4 billion.