CDE: Evidence Based Analgesia and Alternatives to Opioids

Mar, 2021
06:00 PM-08:00 PM

Presented virtually via Zoom webinar

Time: 6:00-8:00 pm; This virtual lecture will begin promptly at 6:00 pm via Zoom Webinar.
Registration: FREE to view (does not include continuing education credits); Registration is still required.

CE Credits:
2.0 lecture credits
To receive continuing education credits:
Dentist, $50.00
Penn Dental Medicine Alumni, $37.50
Military, $37.50
**Payment is made following the program.**

Course Description

This presentation will first review the biochemical and physiological mechanisms behind post-surgical dental pain and then discuss various double-blind randomized controlled trials on the efficacy of various analgesic agents following the surgical removal of impacted third molar teeth. A discussion of the “drug seeking patient” and the prescription opioid abuse problem will be highlighted. The final portion of this discussion will focus on meta-analysis data for various analgesics in both dental pain and other post-surgical pain models. “IN OTHER WORDS WHICH ANALGESICS CONSISTENTLY LEAD THE PACK AND WHICH ARE CONSISTENTLY DOGS”. An updated flexible analgesic schedule which was originally published in JADA in August of 2013 will also be introduced.

Educational Objectives
  • Discuss the utility of the oral surgery pain model.
  • List various peripheral chemical mediators which contribute to post-surgical dental pain.
  • Compare the analgesic efficacy of NSAIDs to single entity oral opioids in randomized placebo controlled double-blind oral surgery pain studies.
  • Describe the rationale for combining opioid with non-opioid analgesic agents.
  • Compare the short-term side effect profile of NSAIDs versus opioids.
  • Discuss the potential opioid-sparing effect of combining an NSAID with acetaminophen
  • Discuss meta-analysis data on the numbers needed treat (NNT) to obtain one additional patient with at least 50% maximum pain relief beyond the placebo treatment.

Dr. Hersh is currently a Professor of Pharmacology/Oral Surgery at the University of Pennsylvania School of Dental Medicine. He received his DMD degree from UMDNJ-NJDS in 1981 and his MS and PhD degrees from UMDNJ – Graduate School of Biomedical Sciences in 1983 and 1988 respectively. Since arriving at the PENN in 1988 Dr Hersh has won the Dental School’s Excellence in the Teaching of Basic Science Award 20 different times and was also presented with a University Lindback Award in 1993, the highest teaching honor in the entire University. He has published more than 150 scientific articles, abstracts and book chapters in the areas of dental pharmacology, drug interactions, analgesics and local anesthetics. His clinical research studies in the areas of acute postsurgical pain control and local anesthesia played an important role in the eventual FDA approval and marketing claims for such diverse products as 4% articaine plus 1:200,000 epinephrine (Septocaine 1:200,000), phentolamine mesylate (Oraverse), the lidocaine transmucosal patch (Dentipatch), diclofenac Prosorb (Zipsor), and ibuprofen Liquigel (Advil Liquigels). His is currently collaborating with faculty from the PENN Institute of Translational Medicine and Applied Therapeutics in identifying biomarkers that may predict individual analgesic response to NSAIDs. He remains passionate about providing students and practitioners with evidence-based data to reduce the unnecessary use of, and when needed the prescribing of excessive amounts of immediate-release opioid formulations. His scholarly and research contributions in the areas of local anesthesia and pain control were recognized by the International Association of Dental Research in 2007 when he was presented with the Distinguished Scientist Award in Pharmacology, Therapeutics and Toxicology. Dr Hersh states “that while the research accolades are nice, the most important thing I do is sharing this knowledge with my students and other dental professionals”.

Disclosure: Dr Hersh has received grant funding from Pfizer Consumer Healthcare the maker of Advil® products, NIH/NIDA, and the PENN Medicine Center of Precision Medicine. He has also received consulting moneys from Bayer Pharmaceuticals, the maker of Aleve®. This presentation will contain data showing flurbiprofen use in acute postsurgical dental pain. Currently approved for inflammatory pain of osteoarthritis and rheumatoid arthritis. Has though been used for lots of other pain syndromes off-label.

University of Pennsylvania School of Dental Medicine is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

University of Pennsylvania School of Dental Medicine designates this activity for 2.0 continuing education credits.

Penn Dental Medicine – Continuing Education Policies