Statement on the use of Narcotic Analgesic Drugs in Dentistry

South River Periodontics is firmly committed to reducing exposure to Narcotic Analgesics in our practice.  Our country currently faces a crisis of addiction to Narcotic (Opoid) Pain medications.  Addiction most commonly begins with drug exposure for a legitimate purpose, and progresses to use of illicit substances to feed a resulting addiction.

Opoid medications are commonly used in dentistry for two reasons, for pain control and for sedation.  We seek to reduce prescription of narcotic medications in two ways:  The need for sedation to control intra-operative anxiety and pain is well founded.  There is scale of invasiveness of procedures, and anxiety of patients which determines the level of sedation necessary to allow periodontal treatment to be rendered.  It is an art to determine which level of sedation which is appropriate for each individual patient.

Most if not all pain associated with Periodontal Surgical Procedures can be eliminated by the use of effective local anesthetic medications, which render tissue numb.  The combination of local anesthetic medication and strong, short acting anxiolytic medications is generally effective to eliminate anxiety and pain for periodontal surgical, dental implant surgery and extraction of teeth, including third molar teeth.  There are, of course, patients and treatments for which general anesthesia with strong opioid pain medications is indicated.  We partner with several practitioners who maintain proficiency in these procedures, and whom we trust with the care of patients such as these.

We perform surgical procedures in a minimally invasive and gentle manner.  This is the single most important factor which influences postoperative discomfort.  In addition to gentle surgical technique, effective preoperative medication with muscle relaxing medications, and locally applied anti-inflammatory medications result in significantly less trauma and post-operative inflammation.  Appropriate post-operative anti-inflammatory medications, non-narcotic pain medications and antibiotics produce a predictably comfortable post-operative course.  Narcotic pain medications are prescribed for use in the rare instances that they become necessary to control discomfort, and may be used at the patient’s discretion.

Proper rest, nourishment and hydration are extremely important to achieving a satisfactory surgical outcome.  Whether periodontal surgery, third molar extraction or dental implant surgery, it is important to have a good night’s sleep both prior to and after surgery.  Your sedative regimen specifically directs medications to be taken the night prior to and the night after your surgical treatment.  This is to ensure good, sound sleep, as our body repairs itself while we sleep.

Intraveneous narcotic analgesia and sedation protocols strictly forbid eating or drinking anything for twelve hours prior to surgery.  This produces a state of hypoglycemia and dehydration in patients.  Proper nutrition and hydration are essential to good healing, therefore we are able to encourage our patients to drink plenty of fluids and eat a small, nourishing meal prior to dental surgery.  Our oral sedation regimen has no prohibition on food or drink prior to surgery.

Following surgery, nourishment and hydration is just as important.  While we discourage eating solid foods until such time as the local anesthesia wears off, a nourishing cold smoothie is encouraged.  We have found that if our patients attempt to eat solid food, they tend to injure themselves by biting soft tissue, such as the tongue, cheek or lip.  Post-operative antibiotics and non-narcotic pain medications should be taken soon after the smoothie has been consumed and allowed to work while the surgically treated area is still numb.

It has been estimated that over seventy percent of cases of narcotic addiction in our country begin with an exposure to prescription pain medications.  We cherish every one of our patients, and care about their overall well-being.  While committed to rendering periodontal treatment in a kind, caring and comfortable manner, we are also committed to doing our part to battle this terrible health care crisis.

Four Convenient Locations for Periodontal Therapy, Dental Implant Surgery and Third Molar Extraction

South River Periodontics
Annapolis Location

104 Forbes St, Suite 204,
Annapolis, MD 21401
(410) 295-1000

Providing Care
For the Communities of:

Annapolis, Admiral Heights, Naval Academy,
West Annapolis, Eastport, Severna Park, Maryland's Eastern Shore, and surrounding communities.

Meet Our Team

South River Periodontics
Barrington Location

310 Maple Ave, Suite 107,
Barrington, RI 02806
(401) 247-2200

Barrington Rhode Island (Maple Avenue Family Dentistry)

Proudly Serving patients in Barrington, Warren, Bristol, East Providence and Southeastern Massachusetts.

Meet Our Team

South River Periodontics
Marriottsville Location

2600 Longstone Ln, Suite 101,
Marriottsville, MD 21104
(410) 442-0103

Marriottsville (Revive Dental)

Proudly serving patients in Ellicott City, Frederick Sykesville and Western Maryland

Meet Our Team

South River Periodontics
Rockville Location

9850 Key West Ave,
Rockville, MD 20850
(301) 838-9300

Rockville (Rockville Smile Design)

Convenient to the I-70 corridor from Washington DC, and Northern Virginia through the Washington DC Suburbs in Maryland and Frederick

Meet Our Team
  • American Board of Periodontology
  • Academy of Osseointegration
  • The Capital


See What Our Patients Are Saying

I have been going to South River Periodontics for years. I can't say enough about Dr. Robert Bouffard, DDS. His expertise and chair-side manner are positively beyond compare. I actually enjoy going to the dentist! If you're searching for a fabulous dentist who takes the time to actually get to know his patients and provides the best in dental treatment, one who will also explain procedures to you and treat you with the utmost respect and care, look no further than Dr. Robert Bouffard!

Linda Lee Annapolis, MD Dental Patient

Dr. Bouffard extracted my son's wisdom teeth when my son was only 13 and did such a fabulous job. He took his time to explain the procedure and put my son at great ease. Now my son needs an implant to replace a tooth lost when he was 9 and there is little anxiety since he trusts Dr. Bouffard so much. We are so happy to have met him at Maple Ave Family Dentistry in Barrington.

Eileen Brady Annapolis, MD Dental Patient

I was referred to Dr. Bouffard six months after hitting my face on the steering wheel in a car accident. Although I had been seen several times for face pain since the accident, it was still unclear about what was going on. Dr. Bouffard listened closely to all my continued troubles and within 5 minutes of meeting me figured out that my upper jaw had actually been dislocated and should’ve been wired shut to heal properly. I was upset but relieved to finally have some answers and a solid plan for treating my pain. Dr. Bouffard worked with one of "his guys" to construct a splint that I wore for several months to provide support and structure for my healing jaw. He has continued to be involved in my healing process, performing two implant surgeries and sending me on to an orthodontist for braces to further strengthen the integrity of my jaw. Two years later, he continues to check in with me and show genuine concern about how I am feeling. I am truly grateful to have been referred to him.

Laura Petersen Annapolis, MD Dental Patient

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104 Forbes St, Suite 204, Annapolis, MD 21401
310 Maple Ave, Suite 107, Barrington, RI 02806
9850 Key West Ave, Rockville, MD 20850
2600 Longstone Ln, Suite 101, Marriottsville, MD 21104