As healthcare providers licensed to provide prescription medications, dentists must educate themselves about safe and responsible prescribing as well as identify potential abuse by their patients. Opioids are commonly prescribed by the medical and dental professions to relieve pain. There is a widely publicized opioid epidemic. According to the Center for Disease Control and Prevention (CDC), out of the 52.404 lethal drug overdoses in 2015, opioids accounted for 20,101 deaths, over 38 percent. The CDC also advises that overdose is not the only risk related to prescription opioids. Misuse, abuse, and opioid use disorder (addiction) are also potential dangers. As prescribers of opioids, dentists and the dental profession, have a role in preventing their misuse. As the nation’s leading dental benefits provider, covering more than 73 million Americans, and offering the country’s largest dental network with roughly 152,000 participating dentists, Delta Dental recommends the following industry norms to better manage the prescribing of opioids. 

• When considering prescribing opioids, dentists should conduct a thorough medical and dental history, including documentation of current medications taken.
• Dentists should consider treatment options that utilize best practices to prevent exacerbation of, or relapse of, opioid misuse.
• Dentists should consider using alternative treatments such as non-steroidal anti-inflammatory drugs (NSAIDS) which are effective in relieving postoperative dental pain, have fewer side effects and less potential for abuse compared to opioids.

If opioids are prescribed, the dose and duration should be for as short a period as possible. Dentists should follow CDC guidelines, such as the lowest possible effective dosage and start with immediate-release opioids instead of extended-release/long-acting opioids. Dentists should have a discussion with patients regarding the risks and complications of any medications they prescribe, including opioids. The patient should also be instructed on responsible storage and disposal of prescription opioids and the potential for misuse and abuse. Safe disposal instructions should be given to patients to ensure unused medications are not misused or improperly disposed of.

Dentists should follow and continually review CDC guidelines as well as their State Licensing Board recommendations for safe opioid prescribing.