In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency. Approximately 130 people die each day from opioid-related drug overdoses. Every day, more than 1,000 people are treated in hospital emergency rooms for misusing prescription opioids. 

We are not far removed from this epidemic in our comfortable coastal communities—California had the second highest number of drug overdose deaths in 2016. Additionally, the prevalence rate of opioid misuse/abuse is higher in Los Angeles County than the national average. 

Local oral maxillofacial surgeon, veteran and faculty at the UCLA School of Dentistry Dr. Max Moncayo shared what he and his team at Palisades Surgical Arts are doing to combat the crisis. 

“We try to take steps to minimize the need for opioid prescriptions,” says Dr. Max. “One issue, especially with surgery, is that patients assume they need an extremely strong pain medication like a narcotic, or if they’ve been prescribed it before, that’s what they want.”  

“We must educate our patients that the use of modern technology has reduced recovery time and pain from surgical procedures. Oral surgery 20 years ago is vastly different from surgery today, with different techniques and materials available.”

High Tech Healing

Dr. Max strives to be minimally invasive and utilize methods that accelerate healing, reducing the need for opioids. Most of his treatment includes wisdom teeth extractions, bone grafts, gum surgery, dental implant surgery, but he performs the full gamut of oral and maxillofacial surgery. Healing from this type of surgery can be uncomfortable, but here are some ways he and his team try to minimize pain and maximize healing. 

The Periolase MVP-7 is a dental laser that is essentially a “no cut, no sew” alternative to gum surgery. It helps initiate the healing/clotting process, resulting in faster recovery time.

Dr. Max uses patients’ own stem cells to aid in their healing. L-PRF, which stands for “leukocyte and platelet-rich fibrin,” is used to optimize wound healing and facilitate a smoother, more comfortable process.

Even a simple long-acting local anesthetic can eliminate the need for strong medications into the initial healing period. The longer a patient is comfortable after a procedure, less medication is needed to help manage post operative pain.

Dr. Max outlines recently mandated measures in California to help alleviate the crisis, including CURES, an online database with the Department of Justice, that requires prescribers to review a patient’s current and past use of controlled substances. Also, as of January 2019, prescribers must discuss specific information with a minor’s parent (and obtain consent) if issuing a prescription with an opioid-containing substance.

“These steps still aren’t enough,” Dr. Max explains. “Wisdom teeth removal is usually the first exposure to opiates for most adolescents—we need to do our best to limit that exposure since even the first use can lead to a lifetime of addiction.”

Dr. Max teaches his students, residents and fellow providers to embrace new advances to limit exposure of our youth to these addictive drugs.

Palisades Surgical Arts is located at 881 Alma Real Dr., Suite. T4,in Pacific Palisades. Contact them at 424.346.0955 or learn more at PaliSurgicalArts.com.