The American Dental Association (ADA) has entered the ring in the fight against opioid abuse. Recent mandates outlined in a new ADA policy urge dentists to limit, if not discontinue opioid prescriptions for dental pain and educate themselves on opioid abuse and the use of alternative pain medications. The Use of Opioids for Dental Pain Dentists with either a doctoral degree in dental surgery or dental medicine can write painkiller prescriptions to treat acute pain. Typically these dental prescriptions come in the form of narcotics like Vicodin or Percocet. Some conditions dentists have historically prescribed opioids for include: \tTooth extractions \tRoot canals \tDental implants \tSevere tooth decay and gum surgery \tRemoval of impacted teeth Dentists were the top specialty prescribers of opioids in 1998, but have since passed that torch to medical professionals prescribing opioids for chronic pain management. The percentage of all opioids prescribed by dentists tapered from 15.5% in the late 1990\u2019s to 6.4% by 2012 according to the ADA. Still, ADA leadership believe these numbers should be less. On the new policy to combat the opioid epidemic, ADA Spokesperson Paul Moore, DMD, MS, PhD, MPH said: \u201cAs dentists, patients are our first priority. We have long been committed to multidisciplinary efforts to end the opioid epidemic, and this is a great step that the dental community is embracing to help combat the epidemic.\u201d Trends in Opioid Dental Prescriptions Recent research published in the Journal of the American Dental Association serves as ammunition for immediate change in the way opioids are prescribed for dental pain: \t Opioid alternatives are more effective. A systematic review of pain management data found that a dosage of 1000 mg acetaminophen and 400 mg ibuprofen worked better for acute pain relief in adults and had less adverse effects than painkillers that contained opioids. Dr. Moore says they\u2019re still learning more and evaluating the opioid-free drug combination to determine the most effective doses and proper dosing strategies for procedures. \u201cThis approach could maximize patient comfort, while limiting the need to use opioids analgesics such as Vicodin for treating acute postoperative dental pain,\u201d he said. \t Gender and racial differences in opioid prescriptions. A review of 890,000 Medicaid claims between 2013 and 2015 revealed dentists were 50% more likely to prescribe opioids for dental pain to women and twice as likely to prescribe them to African Americans and non-Hispanic Caucasians. The same study found people seen in ER departments for dental pain were almost five times more likely to obtain an opioid dental prescription than if treated in a dentist\u2019s office. \t Opioid dental prescriptions have increased in some age groups. According to data from prescription databases, among healthcare providers, dentists most frequently prescribe opioids to teenagers. Dentists saw the greatest spike in opioid prescriptions for 11 to 18 year olds from 2010 to 2015 -- an increase of 100 to 165 prescriptions per 1,000 teens. Overall, opioid prescriptions for dental pain jumped from 131 to 147 per 1,000 people. This last study is particularly concerning given that research shows teens are 33% more likely to develop an opioid addiction when exposed to opioids, even if legally prescribed. Dr. Moore told the Associated Press: \u201cThe fact that we\u2019re still prescribing opioids when we\u2019ve demonstrated that nonsteroidals are as effective most of the time is a little disturbing. this is going to be their first experience with opioids. Maybe it is our opportunity to stop and counsel patients about the dangers.\u201d New Policy for Dentists Prescribing Painkillers To this point, the ADA released a new policy for dental prescriptions and practices on March 26, 2018.\u00a0 The policy has been called one of the first of its kind among healthcare professional organizations and follows on the heels of the American Medical Association's (AMA) Opioid Task Force. The new policy supports: \t Prescription limits Dentists are encouraged to confine the dosage and quantity of opioid dental prescriptions to seven days or less for acute pain treatment. \t Painkiller abuse education The policy calls for mandatory addiction education on prescribing opioids and other controlled substances for dental pain. Dr. Moore says the ADA will offer courses at meetings, including \u201cSafe and Responsible Prescribing of Opioid Analgesics\u201d at ADA 2018 this October as well as host four opioids-related webinars this year. \t Registration and use of Prescription Drug Monitoring Programs (PDMPs) These databases track prescriptions for controlled substances. Moore says these efforts will promote the appropriate use of opioids and deter misuse and abuse. \u201cI\u2019m pleased to see dentistry working to fully implement PDMPs,\u201d he said. \u201cKnowing what our patients are taking can only improve safety.\u201d The ADA\u2019s new policy is a good start, but doesn't translate into the law of the land yet. Dentists and lawmakers can choose whether or not to adopt these mandates. Encouragingly, many states have done so. Some are also putting into practice other restrictions around opioid dental prescriptions such as written consent from parents for patients under the age of 18. \u201cAs president of the ADA, I call upon dentists everywhere to double down on their efforts to prevent opioids from harming our patients and their families,\u201d said ADA President Joseph P. Crowley, D.D.S. in an ADA press release. \u201cThis new policy demonstrates ADA\u2019s firm commitment to help fight the country\u2019s opioid epidemic while continuing to help patients manage dental pain.\u201d Time will tell if ADA\u2019s new policy helps reduce opioid dental prescriptions and makes a dent in a public health crisis that claims hundreds of lives daily. Researchers and addiction experts will surely be watching the numbers in the years to come.