Study led by faculty member Elizabeth Hatfield is JADA cover story4 min read

Ann Arbor, Mich., Jan. 6, 2021 – The cover story of the December issue of the Journal of the American Dental Association features a study led by School of Dentistry faculty member Dr. Elizabeth Hatfield.

Hatfield is a clinical lecturer focused on Temporomandibular Disorders and Orofacial Pain in the Department of Oral and Maxillofacial Surgery/Hospital Dentistry. She is the lead author of a study reviewing medical literature related to the efficacy of low doses of naltrexone in the management of chronic pain conditions, particularly orofacial pain. Naltrexone is a semisynthetic opioid antagonist first discovered in the 1960s and later adapted as a novel anti-inflammatory agent in chronic pain.

The research shows that low doses of naltrexone show significant promise in pain reduction and improvement in quality of life in patients with conditions associated with chronic widespread pain, such as fibromyalgia, complex regional pain syndrome, chronic pelvic pain and orofacial pain. To determine further applications, the study concludes, more large-scale studies are needed to investigate the efficacy of the treatment for orofacial pain, including an evaluation of reduction in reported pain and quality of life measures.

“(Low-dose naltrexone) offers an additional treatment modality for dental care providers to use for chronic pain that is difficult to manage,” the study says. “In addition, novel treatments are needed to reduce opioid prescriptions, address the burden on the health care system, and improve patient quality of life.”

Co-authors of the study are Dr. Kristine Phillips, a resident in the OMS/Hospital Dentistry Department’s Orofacial Pain Residency Program; Dr. Sahar Swidan, an Ann Arbor pharmacist and former faculty member at the U-M College of Pharmacy; and Dr. Lawrence Ashman, Clinical Assistant Professor in the Department of Oral and Maxillofacial Surgery/Hospital Dentistry.

Hatfield earned her DDS from the U-M School of Dentistry in 2017, followed by a Hospital General Practice Residency at U-M. She was then admitted as the first resident and first graduate, in 2020, of U-M’s newly accredited two-year Orofacial Pain Residency program in the OMS/Hospital Dentistry department, with the naltrexone paper as her research project. She is expected to finish accreditation requirements and become a board-certified Orofacial Pain Specialist later this year. In her role as a clinical lecturer, her time is divided between providing care for patients in the Orofacial Pain Clinic and providing dental care for patients with special needs and high medical complexity.

Ashman said it is a major accomplishment for any dental professional to be published in the Journal of the American Dental Association. “To have an article published in a major journal is a wonderful achievement and an honor, but to have your peers also select it as a cover story while being a recent graduating resident of the first graduating class of our orofacial program is even a greater achievement and honor,” said Ashman, who is Director of the Temporomandibular Disorders and Orofacial Pain Clinic, as well as Director of Advanced General Dentistry Education Programs in Orofacial Pain. “Dr. Hatfield shines as an individual who takes pride in her patient care, spends time mentoring her peers and other trainees, and continues to participate in other evidence-based research projects.”

More information on the study, “Use of Low Dose Naltrexone in the Management of Chronic Pain Conditions: A Systematic Review,” can be found on the JADA website here.

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The University of Michigan School of Dentistry is one of the nation’s leading dental schools engaged in oral health care education, research, patient care and community service.  General dental care clinics and specialty clinics providing advanced treatment enable the school to offer dental services and programs to patients throughout Michigan.  Classroom and clinic instruction prepare future dentists, dental specialists and dental hygienists for practice in private offices, hospitals, academia and public agencies.  Research seeks to discover and apply new knowledge that can help patients worldwide.  For more information about the School of Dentistry, visit us on the Web at: www.dent.umich.edu.  Contact: Lynn Monson, associate director of communications, at [email protected], or (734) 615-1971.