2025 Dental Opioid Update with Dr. William Claytor-2025 Dental Opioid Update with Dr. William Claytor

Video Transcription

Video Summary

Dr. J. William “Bill” Claytor briefs Georgia Dental Association members on dentists’ roles in patient safety amid the evolving opioid crisis. He traces U.S. opioid history from morphine and heroin through the rise of hydrocodone/oxycodone, highlighting how messaging like “pain as the fifth vital sign” and claims of low addiction risk fueled prescribing. While opioid prescriptions have fallen sharply since peaks around 2010–2012, overdose deaths rose due to shifts from prescription opioids to heroin and then illicit fentanyl—now often combined with stimulants. Most fentanyl deaths are unintentional, driven by counterfeit pills and inconsistent mixing (“clumping”), prompting the “one pill can kill” public health message, especially for youth. He notes current Georgia trends, including teen overdose increases and the spread of xylazine (“tranq dope”).<br /><br />Claytor emphasizes screening: routinely ask about alcohol, opioids, and cannabis, including name, frequency, and consequences. He reviews evidence on cannabis: strongest support is limited to a few indications (e.g., chronic pain, chemo-related nausea, MS spasticity, certain pediatric seizures via Epidiolex). For dentistry, he warns cannabis—especially recent use, vaping, and edibles—may increase cardiovascular risk, citing new data suggesting elevated MI and stroke risk in younger users.<br /><br />For dental pain, he reinforces NSAIDs and acetaminophen as first-line and often superior to opioids, citing evidence that ibuprofen/acetaminophen combinations provide the best relief for common dental pain. He also highlights emerging concerns like kratom (potent opioid-receptor activity) and notes sedatives like dexmedetomidine and xylazine appearing in illicit supplies. Finally, he introduces a new FDA-approved non-opioid analgesic, suzetrigine (Journavx), acting peripherally on sodium channels and studied in third-molar pain, as another option to reduce opioid reliance.

Keywords

Georgia Dental Association

dentists patient safety

opioid crisis history

hydrocodone oxycodone prescribing

pain as fifth vital sign

illicit fentanyl counterfeit pills

one pill can kill

xylazine tranq dope

substance use screening alcohol opioids cannabis

cannabis cardiovascular risk MI stroke

NSAIDs acetaminophen dental pain first line

suzetrigine Journavx non-opioid analgesic