Opioid prescribing by US dentists has fallen sharply in recent years but remains substantially higher than in other high-income countries, according to a study published in JAMA Network Open on 17 April 2026. Researchers from the University of Michigan and University of New South Wales analysed data from 2021 to 2024 across eight jurisdictions: Australia, Belgium, Canada, France, Germany, the Netherlands, Puerto Rico and the US.

Disparities in opioid dispensing rates

All jurisdictions studied showed declining dental opioid dispensing between 2021 and 2024. Germany recorded the largest relative decrease at nearly one-third, while the US fell by more than a quarter. However, the US maintained the highest rate in 2024 at 2,022 prescriptions per 100,000 people, followed by Canada at approximately 1,779 per 100,000. The gap between the US and other countries narrowed over time but remained substantial. France, Puerto Rico and Australia dispensed at rates between half and two-thirds of the US level. Belgium, Germany and the Netherlands had much lower rates. The US rate was about 14 per cent higher than Canada's and more than 24 times higher than the Netherlands, which had the lowest rate.

Shift toward non-opioid alternatives

The findings reflect a broader movement away from routine opioid use for dental pain management. The American Dental Association has endorsed guidelines recommending acetaminophen and non-steroidal anti-inflammatory drugs as first-line treatment for short-term dental pain in children under 12 and adults, rather than opioids such as codeine or tramadol. Research has also shown that cannabidiol, a non-opioid analgesic, offers considerable promise for pain reduction. Two-thirds of US dental opioid prescriptions are for tooth extraction, indicating substantial room for further reduction in opioid use.