To evaluate trends of severe oral pain management between endodontists and obstetricians during pregnancy.
A web-based survey was sent to 217 Department of Defense Obstetricians and 2,777 members of American Association of Endodontists to obtain data regarding oral pain management during pregnancy. Answers were compared between the two groups. Comparison was done by chi square, Pearson correlation coefficient, and multiple logistic regression.
Sixty-eight obstetricians (31.3%) and two hundred ninety-three endodontists (10.6%) completed web-based surveys. Pain management trends were evaluated. NSAIDs were used by 50.8% of obstetricians versus 22.5% of endodontists (P<.01). Acetaminophen/opioid combinations were used by 100% of obstetricians versus 79.4% of endodontists (P<.01). Obstetricians used Percocet or Vicodin 81.9% or Tylenol with codeine 16.7% of the time versus endodontists who used Percocet or Vicodin 40.20% of the time and Tylenol with codeine 38.5% of the time (P<.01). When treatments were compared among providers in each trimester, obstetricians were more likely to prescribe opioids in all trimesters and NSAIDS in the first and second trimesters when compared to endodontists.
Obstetricians were more likely to prescribe a variety of pain medications and narcotics for severe oral pain in pregnancy compared to endodontists. Inter-professional collaboration regarding dental treatment and safety of different pain medications in pregnancy could lead to an improvement of managing severe oral pain during pregnancy.
Womack Army Medical Center, Ft Bragg, NC
Financial Disclosure: The authors did not report any potential conflicts of interest.