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Policy Changes Lead to Significant Drop in Dental Opioid Prescriptions

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In January 2018, Tennessee’s Medicaid program, TennCare, changed its reimbursement policy regarding dental opioid prescriptions for patients age 20 and younger with significant results. New data demonstrate a 45% decrease in opioid prescriptions written by TennCare dentists in 2019 compared to 2017. The policy change caps opioid prescriptions at a maximum of 60 morphine milligram equivalence (a measurement of potency) per day, and limits the supply to three days. Once the initial prescription is up, 10 more days may be requested — but this requires authorization from the state.

TennCare partnered with its dental claims administrator, DentaQuest Partnership for Oral Health, to determine the outcomes of the policy change. In addition to 11,000 fewer opioid prescriptions being written in 2019, the research revealed a significant decrease in the percentage of opioids prescribed for nonsurgical oral care. Such prescriptions dropped from 21% in 2017 to 9% in 2019. The new policy also resulted in the elimination of codeine-containing medications prescribed to children, as well as a reduction in the number of high-dose opioid prescriptions, which fell from 9% in 2017 to 1.5% in 2019.

Sean G. Boynes, DMD, MS, vice president of health improvement at DentaQuest Partnership for Oral Health Advancement, notes, “The work of TennCare and subsequently this analysis showed a significant impact on the health of children by decreasing the number of those receiving high daily doses of opioids that lead to addiction and overdose risk. Additionally, the fact the state now reports zero prescriptions for opioids containing codeine for children between the ages of 0 and 11 provides a great model that all states can utilize.”

These results correspond to a decrease in the number of overdose deaths due to opioid use in Tennessee between 2017 and 2018, according to the research brief. The full report is available here.

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