Opioid Prescribing Patterns Among Oral and Maxillofacial Surgeons: A Regional Survey-Based Study.

PURPOSE: We sought to obtain baseline statistics regarding the amount of opioid tablets prescribed by oral and maxillofacial surgeons (OMSs) in the New England area after office-based procedures and to identify factors that might be predictors of their prescription patterns. MATERIALS AND METHODS: An anonymous online survey was e-mailed to practicing OMSs in the New England area. The survey explored the quantity of opioid medications prescribed for various procedures, how opioid precautions were given, practitioners' attitude toward opioid dependency, and whether certain surgeon- or patient-related factors influenced prescription behavior. Statistical analyses were used to categorize the OMSs according to their prescription patterns and to identify the most common factors affecting their decision to prescribe opioids. RESULTS: Of 315 OMSs, 151 (43%) responded to the survey. Our analyses were of complete data obtained from 118 respondents. For procedures, such as extraction of 7 or more teeth, the placement of 4 or more implants, office-based sinus surgery, cortical block grafts, and removal of third molar teeth, respondents indicated they typically prescribed 8 to 12 opioid tablets. For all other procedures, they typically never or rarely prescribed opioid tablets. The respondents were grouped into low-, medium-, and high-quantity opioid prescribers. Regardless of their grouping status, the respondents showed general agreement regarding their roles in reducing opioid prescription-related issues. No group differences were found in terms of the demographic variables. Relative to the factors predicting increased prescribing habits, the results suggested that OMSs working either exclusively or primarily in academic settings tended to prescribe fewer opioid tablets than those working primarily in the private setting (ß = -2.73; P < .001). Additionally, 109 respondents (92.4%) reported that OMSs could play a role in decreasing opioid dependency. CONCLUSIONS: Most practicing OMSs in the New England area prescribed opioids after office-based surgery and are cognizant of the risks of opioid medications.

Thyroid abnormalities in pediatric patients with vitiligo in New York City.

The link between vitiligo and thyroid disease has been well-established. However, the types of patients at risk for thyroid disease and the strength of this connection in childhood are debatable. We retrospectively reviewed 67 charts of pediatric dermatology patients with vitiligo vulgaris (53 with nonsegmental vitiligo) who were tested for thyroid disease. In our cohort of 28 patients with available thyroid test results, we identified 7 patients (25%) with active thyroid disease. None of the 7 patients with thyroid disease had segmental vitiligo. If we had included the broader number of patients (N=67), the rate may have been as low as 10.4% overall (7/67), which is still a substantial rate of thyroid disease. These results are comparable to the European literature and highlight the need for thyroid screening in children with vitiligo vulgaris of a generalized nonsegmental type.