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Opioid Prescribing for Dentists

This is a summary of recommendations drawn from United States national, Washington State, and Oregon guidelines regarding opioid prescribing practices by dental professionals.

Key Consensus Recommendations

  • Prioritize non-opioid analgesics such as NSAIDs and acetaminophen as first-line treatments for dental pain.
  • Reserve opioid prescriptions for cases where non-opioid treatments are insufficient or contraindicated.
  • Prescribe the lowest effective dose of immediate-release opioids for the shortest duration possible (typically 1–3 days, not exceeding 7 days).
  • Avoid prescribing extended-release or long-acting opioids for acute dental pain.
  • Avoid phone-based opioid prescribing when possible; require in-person evaluation for refills.
  • Use multimodal analgesia strategies when appropriate (e.g., combining NSAIDs with acetaminophen).
  • Before prescribing opioids, check the state’s Prescription Monitoring Program (PMP) to review the patient’s controlled substance history.
  • Discuss the risks and benefits of opioid therapy with patients, including risks of dependence, overdose, and diversion.
  • Educate patients on proper storage and disposal of unused opioids.
  • Use patient agreements or informed consent forms when prescribing opioids, especially beyond acute use.
  • Complete all required continuing education (CE) or training on opioid prescribing regulations in your jurisdiction.
  • Follow specific state-mandated rules (e.g., e-prescribing requirements in Washington; DEA training in Oregon).

CDC Clinical Practice Guidelines (2022)

American Dental Association (ADA)

Agency Medical Directors’ Group Guidelines (developed in collaboration with the Bree Collaborative)

Regulations

For Dentists:
For Dentists and Hygienists

Monitoring & Oversight

  • Washington requires dentists to comply with e‑prescribing mandates and integrate with the Prescription Monitoring Program (PMP) under SB 5380 doh.wa.gov.
  • The state’s Bree Collaborative has set opioid‑prescribing metrics and monitors trends to reduce unnecessary use dental.washington.edu+2qualityhealth.org+2doh.wa.gov+2.

Clinical Guidance

  • Encouragement to use NSAIDs first, monitor closely, and apply national best practices.
  • Sponsored CE like the “Art of Dental Therapeutics” course meets opioid CE requirements dental.washington.edu+1wsdha.com+1.
  • Oregon Health Authority (OHA) guidelines discourage phone prescribing, recommend 3‑day or ≤10‑tablet supply, and limit refills unless seen in person oregon.gov.
  • Combination opioids preferred over plain formulations; patient education on safe storage and disposal required oregon.gov.
  • Opioids should not be prescribed more than seven days post-appointment, and in most cases three days suffice.

Task Force Framework

  • OHA convened the 2016 and 2018 task forces to align acute dental pain care with CDC standards jada.ada.org+1cdc.gov+1.

Regulatory Oversight

  • The Oregon Medical Board enforces requirements: material‑risk notice, patient agreements, periodic use of PMP, and urine drug screening if used beyond acute pain
  • DEA requires 8 hours of controlled-substance training tied to DEA registration renewal oregondental.org.