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Analgesics, OpioidADOPTNCT06275191

Alternatives to Dental Opioid Prescribing After Tooth Extraction

A study testing Multicomponent intervention in people with Analgesics, Opioid and Acute Pain, run by Douglas Oyler at 1 site in United States.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to test a three-item intervention in oral surgeons who remove teeth. The main questions it aims to answer are: Can the intervention reduce opioid prescriptions to adolescents and young adults after tooth removal? Do oral surgeons' beliefs about the intervention and opioid prescribing… Read more about this study

Who is it for?
Ages 12 to 25 years
Conditions the study is for
Analgesics, Opioid, Acute Pain, Tooth Extraction
What is being tested?
Multicomponent intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
38,159 participants
Where
1 siteUnited States
Study dates
16 Apr 2024to Dec 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 25 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Actively U.S. licensed dentist or oral surgeon practicing at a participating cluster. Participating clinics were finalized prior to the beginning of the study based on the following criteria: (1) perform tooth extractions on at least 70 AYA patients during a 5-month screening period from July 1, 2022 through November 30, 2022 and (2) electronically prescribe opioids to at least 30% of AYA patients who underwent extraction during the screening period. Additionally, each participating cluster signed a data use agreement (DUA) for sharing electronic health record data, can provide the necessary electronic health record data, and agreed to comply with study procedures and be available for the duration of the study.
  • Provide a signed and dated informed consent form.
  • Willing to comply with all study procedures and be available for the duration of the study.
  • Undergoes any tooth extraction at a participating cluster during the study (intervention condition, transition period, or control condition) between 6-10 days earlier.
  • Age 12-25 at the time of tooth extraction.
  • Reads and acknowledges survey cover letter in lieu of a full consent/assent process.
  • Can access the electronic survey using an internet-capable device.

Who cannot join

  • There are no other exclusion criteria for clusters or provider/patient participants that meet all inclusion criteria.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site
  • University of Kentucky

    Lexington, Kentucky, 40536

Other trials in United States

About this study

The goal of this clinical trial is to test a three-item intervention in oral surgeons who remove teeth. The main questions it aims to answer are:

  • Can the intervention reduce opioid prescriptions to adolescents and young adults after tooth removal?
  • Do oral surgeons' beliefs about the intervention and opioid prescribing change?
  • Do patients that report using opioids after tooth removal have different experiences than patients that do not?
Read more

Oral surgeon participants will:

  • Attend a 1-hour education session with a trained pharmacist
  • Receive patient instructions and blister packs of pain medicine to give to patients
  • Complete 2 surveys about feasibility and appropriateness

Patient participants will complete a survey about pain and medication use after having a tooth removed.

Researchers will compare the intervention to usual care to see if it reduces opioid prescribing.

Read the detailed description

Although use of nonsteroidal antiinflammatory drugs and acetaminophen is recommended first-line by the American Dental Association and American Association of Oral and Maxillofacial Surgeons, dentists and oral surgeons are leading prescribers of opioids to adolescents and young adults (AYA), who are at high risk for developing problematic opioid use after an initial exposure. This multi-site, stepped wedge cluster-randomized trial will assess whether a multicomponent behavioral intervention can influence opioid prescribing behavior among dentists and oral surgeons compared to usual practice. Across up to 12 clinical practices (clusters), up to 33 dentists and oral surgeons (provider participants) who perform tooth extractions for individuals 12-25 years old will be enrolled. After enrollment, all provider participants will receive the intervention at a time based on the sequence to which their cluster is randomized. The intervention consists of academic detailing plus provision of standardized patient post-extraction instructions and blister packs of acetaminophen (APAP) and ibuprofen for dispensing. Provider participants will dispense the blister packs and distribute the patient instructions at their discretion to AYA undergoing tooth extraction, with or without additional analgesics (e.g., opioids). The primary outcome is a binary, patient-level indicator of electronic post-extraction opioid prescription. Data for the primary outcome will be collected from the provider participant's electronic health records quarterly throughout the study. Provider participants will complete a survey before and approximately 3 months after transitioning into the intervention condition to assess implementation outcomes. AYA patients undergoing tooth extraction will be offered a survey to assess pain control and satisfaction with pain management in the week after their extraction. Primary analyses will use generalized estimating equations to compare the binary patient-level indicator of being prescribed a post-extraction opioid in the intervention condition compared to the control condition (i.e., usual practice). Analyses will adjust for patient-level factors (e.g., sex, number of teeth extracted, etc.). Secondary analyses will assess provider participants' perceptions of feasibility and appropriateness of the intervention, and patient-reported pain control and satisfaction with pain management.

Being tested
Multicomponent intervention, Usual care
Medical subject headings
Acute Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Multicomponent interventionBehavioural

    The multicomponent intervention consists of (1) a single 45-60-minute academic detailing session with provider participants, plus (2) provision of patient post-extraction instruction materials and (3) provision of blister-packaged acetaminophen and ibuprofen for distribution to adolescent/young adult patients after tooth extraction in the course of clinical practice

  • Usual careOther

    No intervention.

Study groups in NCT06275191
Study groupRoleWhat they receive
Intervention conditionExperimental1. Academic detailing (45 to 60-minute session), plus 2. Provision of standardized patient post-extraction instructions for distribution, plus 3. Provision of blister-packaged acetaminophen and ibuprofen at recommended standard doses for distribution to to adolescent/young adult patients after tooth extraction in the course of clinical practice
Receives: Behavioral: Multicomponent intervention
Control conditionActive comparatorUsual practice
Receives: Other: Usual care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Odds of post-extraction opioid prescription to adolescent/young adults after tooth extraction

    The primary outcome is a patient-level binary indicator for being prescribed an opioid. The value for this outcome variable is equal to 1 if the patient is prescribed an opioid, whereas this variable takes on a value of 0 if this patient is not prescribed an opioid. Opioid prescription will be defined as an electronic order (from the electronic health record) for an opioid analgesic (e.g., hydrocodone, oxycodone, tramadol, morphine, fentanyl, etc.) on the same calendar date as the tooth extraction appointment.

    Measured: Same calendar date as dental extraction. Electronic health records will be extracted for the duration of the 4-year study period.

Secondary outcomes (7)
  1. (Change in) intervention feasibility

    Survey response. 5-point Likert-type questions (from 1-completely disagree to 5-completely agree) regarding feasibility of distributing blister packs and patient post-extraction materials. Selection of the top 2 choices (completely agree or agree) from the scale is considered as agreement with the statement.

    Measured: Pre-surveys will be conducted during the calendar month preceding the transition to the intervention condition (i.e., within 60 days). Post-surveys will be conducted during the 3rd month of the intervention condition (i.e., within 120 days).

  2. (Change in) intervention appropriateness

    Survey response. 5-point Likert-type questions (from 1-completely disagree to 5-completely agree) regarding appropriateness of distributing blister packs and patient post-extraction materials. Selection of the top 2 choices (completely agree or agree) from the scale is considered as agreement with the statement.

    Measured: Pre-surveys will be conducted during the calendar month preceding the transition to the intervention condition (i.e., within 60 days). Post-surveys will be conducted during the 3rd month of the intervention condition (i.e., within 120 days).

  3. (Change in) opioid prescribing feasibility

    Survey response. 5-point Likert-type questions (from 1-completely disagree to 5-completely agree) regarding feasibility of reducing opioid prescription. Selection of the top 2 choices (completely agree or agree) from the scale is considered as agreement with the statement.

    Measured: Pre-surveys will be conducted during the calendar month preceding the transition to the intervention condition (i.e., within 60 days). Post-surveys will be conducted during the 3rd month of the intervention condition (i.e., within 120 days).

  4. (Change in) opioid prescribing appropriateness

    Survey response. 5-point Likert-type questions (from 1-completely disagree to 5-completely agree) regarding appropriateness of reducing opioid prescription. Selection of the top 2 choices (completely agree or agree) from the scale is considered as agreement with the statement.

    Measured: Pre-surveys will be conducted during the calendar month preceding the transition to the intervention condition (i.e., within 60 days). Post-surveys will be conducted during the 3rd month of the intervention condition (i.e., within 120 days).

  5. Self-reported pain

    Patient survey, 3 items from Brief Pain Inventory (worst, least, average pain) based on self-reported opioid use. Each item uses an 11-point Visual Rating Scale from 0-no pain to 10-worst possible pain.

    Measured: within 10 days of tooth extraction

  6. Self-reported pain interference

    Patient survey, NIH PROMIS Pediatric Short Form v1.0-Pain Interference 8a (age < 18) or NIH PROMIS Adult Short Form v1.0-Pain Interference 6b (18+) based on self-reported opioid use. NIH PROMIS Pediatric Short Form t-scores range from 34.0 to 78.0, with higher scores indicating greater interference. NIH PROMIS Adult Short Form t scores range from 41.0 to 78.3, with higher scores indicating greater interference.

    Measured: within 10 days of tooth extraction

  7. Self-reported pain satisfaction

    Patient survey, 5-point Likert-type question (from 1-very unhappy to 5-very happy) regarding overall satisfaction with pain management based on self-reported opioid use. Selection of the top 2 choices (very happy or happy) from the scale is considered as satisfaction with overall pain management.

    Measured: within 10 days of tooth extraction

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Feb 2024
  2. Study start16 Apr 2024
  3. Primary completionJan 2028 (estimated)
  4. Study completionDec 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Sequential
Model description
Stepped wedge cluster randomized trial
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
38,159 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06275191
Sponsor's protocol ID
80758
Other IDs
1UG3DE032621-01, 4UH3DE032621-02
Acronym
ADOPT
Status last verified
Sep 2026
First submitted
3 Feb 2024
Last updated
10 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Oyler DR, Edgecombe SJ, Babusci EA, Dolly Prothro J, Begley AL, Rojas-Ramirez MV. Practical Fraud Detection and Prevention in Incentivized Online Surveys: Secondary Analysis of the ADOPT Study. J Med Internet Res. 2026 Jul 31;28:e90159. doi: 10.2196/90159.

    PubMed 42536768
  • Oyler DR, Rojas-Ramirez MV, Nakamura A, Quesinberry D, Miller CS. Dental opioid prescription patterns in academic and community settings. J Public Health Dent. 2023 Jun;83(2):200-206. doi: 10.1111/jphd.12568. Epub 2023 Mar 11.

    PubMed 36905202
  • Oyler DR, Rojas-Ramirez MV, Nakamura A, Quesinberry D, Bernard P, Surratt H, Miller CS. Factors influencing opioid prescribing after tooth extraction. J Am Dent Assoc. 2022 Sep;153(9):868-877. doi: 10.1016/j.adaj.2022.05.001. Epub 2022 Jun 9.

    PubMed 35691709
  • Oyler DR, Miller CS. Patterns of opioid prescribing in an Appalachian college of dentistry. J Am Dent Assoc. 2021 Mar;152(3):209-214. doi: 10.1016/j.adaj.2020.12.002.

    PubMed 33632410
  • Oyler DR, Westgate PM, Walsh SL, Dolly Prothro J, Miller CS, Roberts MF, Freeman PR, Knudsen HK, Lang M, Dominguez-Fernandez E, Rojas-Ramirez MV. Alternatives to dental opioid prescribing after tooth extraction (ADOPT): protocol for a stepped wedge cluster randomized trial. BMC Oral Health. 2024 Apr 4;24(1):414. doi: 10.1186/s12903-024-04201-0.

    PubMed 38575929

Questions about this trial

What is this clinical trial studying?

A study testing Multicomponent intervention in people with Analgesics, Opioid and Acute Pain, run by Douglas Oyler at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 10 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Odds of post-extraction opioid prescription to adolescent/young adults after tooth extraction (time frame: Same calendar date as dental extraction. Electronic health records will be extracted for the duration of the 4-year study period.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06275191, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2026.

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