Table 2.
Characteristics of dental encounters by opioid exposure, October 2008 – September 2017
| Encounter Characteristic | # of surgical encounters | % of surgical encounters (SE) | With opioid prescription (OP) | With total opioid dose > 100 MME | ||
|---|---|---|---|---|---|---|
| N | % of SE | N | % of OP | |||
| Total Surgical Encounters a | 743459 | 100.0 | 272718 | 36.7 | 138346 | 50.7 |
| Age group | ||||||
| 26+ | 471739 | 63.5 | 161323 | 34.2 | 76633 | 47.5 |
| <26 | 271720 | 36.6 | 111395 | 41.0 | 61713 | 55.4 |
| Sex | ||||||
| Female | 101651 | 13.7 | 35882 | 35.3 | 17445 | 48.6 |
| Male | 641808 | 86.3 | 236836 | 36.9 | 120901 | 51.0 |
| Rank | ||||||
| Enlisted | 653126 | 87.8 | 245096 | 37.5 | 125473 | 51.2 |
| Officer | 90333 | 12.2 | 27622 | 30.6 | 12873 | 46.6 |
| Race Ethnicity | ||||||
| Non-Hispanic, Asian or Pacific Islander | 79388 | 10.7 | 29915 | 37.7 | 15411 | 51.5 |
| Non-Hispanic, Black | 166843 | 22.4 | 62414 | 37.4 | 31642 | 50.7 |
| Hispanic | 80796 | 10.9 | 32176 | 39.8 | 16796 | 52.2 |
| Non-Hispanic, White | 401485 | 54.0 | 142986 | 35.6 | 71982 | 50.3 |
| American Indian, Alaskan Native or other | 14947 | 2.0 | 5227 | 35.0 | 2515 | 48.1 |
| Componentb | ||||||
| Active duty | 565551 | 90.5 | 216329 | 37.1 | 11,308 | 51.0 |
| National Guard | 38443 | 6.1 | 9749 | 25.3 | 4195 | 43.0 |
| Reserve | 20559 | 3.3 | 5686 | 27.6 | 2482 | 43.7 |
| Patient opioid status time of encounterc | ||||||
| Naïve | 502941 | 80.5 | 169157 | 33.6 | 86673 | 51.2 |
| Not naïve | 121735 | 19.5 | 62630 | 51.4 | 30323 | 48.4 |
| Type of surgical procedure (not mutually exclusive)d | ||||||
| Endodontic | 357189 | 48.0 | 38118 | 10.7 | 9812 | 25.7 |
| Periodontic | 56057 | 7.5 | 41485 | 74.0 | 19268 | 46.4 |
| Implant | 46550 | 6.3 | 18976 | 40.8 | 10533 | 55.5 |
| Oral & Maxillofacial (excl. extraction) | 46977 | 6.3 | 24860 | 52.9 | 13626 | 55.0 |
| Dental Extraction | 203559 | 27.4 | 165757 | 81.4 | 96192 | 58.0 |
| Palliative Emergency | 78019 | 10.5 | 14997 | 19.2 | 5148 | 34.3 |
| By Provider Type | ||||||
| Oral Surgeon | 50226 | 6.8 | 43270 | 86.2 | 30362 | 70.2 |
| Periodontist | 17839 | 2.4 | 13671 | 76.6 | 5362 | 39.2 |
| Prosthodontist | 11090 | 1.5 | 1033 | 9.3 | 393 | 38.0 |
| Orthodontist | 1066 | 0.1 | 143 | 13.4 | 65 | 45.5 |
| Oral Pathologist | 689 | 0.1 | 264 | 38.3 | 21 | 7.9 |
| Endodontist | 36738 | 4.9 | 7905 | 21.5 | 1310 | 16.6 |
| Dental Officer General | 624319 | 84.0 | 206034 | 33.0 | 100688 | 48.9 |
| Pedodontist | 1492 | 0.2 | 398 | 26.7 | 145 | 36.4 |
| By Opioid Subclass | ||||||
| Codeine | 17625 | 6.5 | 17625 | 100.0 | 73 | 0.04 |
| Hydrocodone | 68352 | 25.1 | 68352 | 100.0 | 12622 | 18.5 |
| Oxycodone | 183888 | 67.4 | 183888 | 100.0 | 123355 | 67.1 |
| Tramadol | 1912 | 1.0 | 1912 | 100.0 | 880 | 46.0 |
| Other | 941 | < 1.0 | 941 | 100.0 | 173 | 18.4 |
| Facility Service Branch | ||||||
| Army | 633913 | 85.3 | 248415 | 39.2 | 127014 | 51.1 |
| Other branch | 20815 | 2.8 | 7403 | 35.6 | 3759 | 50.8 |
| Facility Typeassociated with dental clinic | ||||||
| Medical Center (largest) | 185549 | 25.0 | 80050 | 43.1 | 47453 | 59.3 |
| Hospital (medium) | 368098 | 49.5 | 140449 | 38.2 | 74473 | 53.0 |
| Clinic and other (smallest) | 189812 | 25.5 | 52219 | 27.5 | 16420 | 31.4 |
| Facility Regione | ||||||
| TRICARE OCONUS | 42544 | 5.7 | 17878 | 42.0 | 5923 | 33.1 |
| TRICARE North | 155063 | 20.9 | 53137 | 34.3 | 21547 | 40.5 |
| TRICARE South | 255779 | 34.4 | 94401 | 36.9 | 49903 | 52.9 |
| TRICARE West | 215343 | 29.0 | 95120 | 44.2 | 54951 | 57.8 |
| Other / Unknown | 74730 | 10.1 | 12182 | 16.3 | 6022 | 49.4 |
Notes:
Note: number of encounters with opioids is less than total number of dental opioids (Table 1) because each encounter may be associated with more than one opioid prescription.
Total includes 123 encounters where component at time of the encounter was not recorded.
Opioid naïve defined as no opioid prescription fills for any purpose in the 90 days prior to the dental encounter.
Includes palliative emergency and invasive procedures that are not surgical but we hypothesized would account for some opioid prescriptions.
States included in TRICARE regions: North= Connecticut, Delaware, the District of Columbia, Illinois, Indiana, Kentucky, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, Wisconsin and portions of Iowa (Rock Island Arsenal area), Missouri (St. Louis area) and Tennessee (Ft. Campbell area); South = Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee (excluding the Ft. Campbell area) and Texas (excluding the El Paso area); West = Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa (excluding Rock Island Arsenal area), Kansas, Minnesota, Missouri (except the St. Louis area), Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Texas (the southwestern corner, including El Paso), Utah, Washington and Wyoming; OCONUS (outside continental US) = Hawaii, Guam, Puerto Rico, Europe, Asia, Pacific
All chi-square values for crosstabulations of each characteristic by opioid prescription and each characteristic by dose > 100 MME given an opioid prescription, are significant at p < .001