An evidence-based clinical practice guideline for dental pain (surgical and non-surgical)

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (known as the SUPPORT Act) was signed into law in October 2018. Section 3002 of the SUPPORT Act requires the Commissioner of Food and Drugs to develop evidence-based opioid analgesic prescribing guidelines for indication-specific treatment of acute pain where such guidelines do not exist. Consistent with the requirements of section 3002 of the SUPPORT Act, FDA launched an effort to develop a framework for evidence-based guidelines involving a contract with the National Academies of Science, Engineering, and Medicine (NASEM). In December 2019, NASEM provided a consensus report that identified the surgical procedures/medical conditions requiring research for the development of evidence-based guidelines to treat acute pain. FDA proposes to fund the development, dissemination, implementation, and evaluation of an evidence-based clinical practice guideline (CPG) for dental pain (surgical and non-surgical). The NASEM report identified dental surgeries (e.g., third molar extraction) and dental pain as priority areas for evidence-based guideline development because of the patient populations that are affected (e.g., adolescents and young adults), the high prevalence of the procedure, and the data that documents the efficacy of nonopioid pain management strategies for this procedure. Similarly, the most common diagnoses resulting in an opioid prescription in the emergency department were dental pain among adolescents and young adults. The NASEM report also recommends that organizations that develop evidence-based CPGs on opioid prescribing for acute pain establish a process for disseminating, implementing, and monitoring the uptake and impacts of the CPG on opioid prescribing practices.