AI tools could make postoperative opioid prescribing more individualized

For patients undergoing wisdom teeth removal, determining the appropriate amount of pain medication is a critical decision. Over-the-counter options like acetaminophen and ibuprofen usually suffice, but some patients experience breakthrough pain that requires opioids. Currently, opioid prescribing during such procedures is largely standardized, despite the high variability in individual pain experiences.

Tim Wang, a senior author and chief resident at Harvard School of Dental Medicine, explains that two patients undergoing the same operation can have vastly different responses to postoperative pain and swelling. Oral and maxillofacial surgery accounts for over 60% of dental opioid prescriptions. Often, the prescribed opioids do not match the patient's actual needs, leading to challenges in prescribing just enough to manage pain without excessive use.

The researchers propose that artificial intelligence (AI) and machine learning could help predict a patient's postoperative opioid requirements more accurately. By analyzing large datasets of clinical, behavioral, and biological information, AI models can identify patterns associated with opioid use and misuse. One study analyzed over 560,000 Medicare beneficiaries and showed that machine learning outperformed traditional statistical methods in predicting opioid overdose risk.

The potential benefits of AI include providing individualized prescriptions, flagging patients who may need closer monitoring, and enhancing existing prescription drug monitoring programs. AI could also support care beyond the clinic by utilizing patient-reported data for more tailored pain management at home. However, the authors stress that AI should complement, not replace, clinical judgment.

While many studies are retrospective and models have limited external validation, the authors believe that AI holds significant promise for more precise and personalized pain control in dental surgeries.