• Posted April 28, 2026

U.S. Dentists Still Overprescribing Opioids Compared To Other Nations, Puerto Rico

Folks getting a tooth pulled or a cavity drilled in the United States are still more likely to be prescribed powerful opioid painkillers, despite America’s ongoing opioid crisis, a new study says.

There was a 27% drop in dental patients filling opioid prescriptions between 2021 and 2024, researchers reported recently in JAMA Network Open.

But despite this decrease, U.S. dentists are still handing opioids out at rates far higher than other wealthy nations, researchers found.

For example, the Netherlands had a dental opioid prescription rate 24 times lower than that of the U.S. by 2024, the study found.

Even the U.S. territory of Puerto Rico is more tightly controlling dental opioids, with a rate half that found in the U.S., researchers found.

“Our study shows that the U.S. dental opioid dispensing rate is decreasing but remains high by international standards,” lead researcher Dr. Kao-Ping Chua, an associate professor of pediatrics at the University of Michigan, said in a news release.

Under newer dental guidelines, dentists are encouraged to advise patients to use other types of pain relief due to the addiction risk from opioids, researchers said in background notes.

For the new study, researchers analyzed opioid prescription data related to dental care in the U.S., the Netherlands, Belgium, France, Germany, Canada and Australia and Puerto Rico between 2021 and 2024.

Results showed that by 2024, U.S. dentists had closed the opioid prescribing gap between them and their neighbors in Canada — 2,022 prescriptions per 100,000 people in the U.S. compared to 1,773 per 100,000 in Canada.

However, the U.S. lagged Puerto Rico, a U.S. territory, as well as other developed nations:

• 1,259 per 100,000 in France (60% lower)

• 1,005 per 100,000 in Puerto Rico (twice as low)

• 1,038 per 100,000 in Australia (95% lower)

• 248 per 100,000 in Belgium (8 times lower)

• 98 per 100,000 in Germany (20 times lower)

• 83 per 100,000 in the Netherlands (24 times lower)

"This finding suggests that some U.S. dentists are still overprescribing opioids,” Chua said.

More information

The American Dental Association has more on oral medications for dental pain.

SOURCES: University of Michigan, news release, April 23, 2026; JAMA Network Open, April 17, 2026