title: Dental opioid prescribing practices and risk mitigation strategy implementation: Identification of potential targets for provider-level intervention.
abstract: BACKGROUND
  Given the regular use of immediate-release opioids for dental pain management, as well as documented opioid misuse among dental patients, the dental visit may provide a viable point of intervention to screen, identify, and educate patients regarding the risks associated with prescription opioid misuse and diversion. The aims of this statewide survey of dental practitioners were to assess (a) awareness of the scope of prescription opioid misuse and diversion; (b) current opioid prescribing practices; (c) use of and opinions regarding risk mitigation strategies; and (d) use and perceived utility of drug monitoring programs.
  
  
  METHODS
  This cross-sectional study surveyed dentists (N = 87) participating in statewide professional and alumni organizations. Dentists were invited via e-mail and listserv announcement to participate in a one-time, online, 59-item, self-administered survey.
  
  
  RESULTS
  A majority of respondents reported prescribing opioids (n = 66; 75.8%). A minority of respondents (n = 38; 44%) reported regularly screening for current prescription drug abuse. Dentists reported low rates of requesting prior medical records (n = 5; 5.8%). Only 38% (n = 33) of respondents had ever accessed a prescription drug monitoring program (PDMP), and only 4 (4.7%) consistently used a PDMP. Dentists reporting prior training in drug diversion were significantly more likely to have accessed their PDMP, P < .01. Interest in continuing education regarding assessment of prescription drug abuse/diversion and use of drug monitoring programs was high.
  
  
  CONCLUSIONS
  Although most dentists received training related to prescribing opioids, findings identified a gap in existing dental training in the assessment/identification of prescription opioid misuse and diversion. Findings also identified gaps in the implementation of recommended risk mitigation strategies, including screening for prescription drug abuse, consistent provision of patient education, and use of a PDMP prior to prescribing opioids.
authors.affiliation: a Department of Psychiatry and Behavioral Sciences , Medical University of South Carolina , Charleston , South Carolina , USA.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: McCauley
authors.affiliation: b College of Dental Medicine , Medical University of South Carolina , Charleston , South Carolina , USA.
authors.forename: Renata S
authors.initials: RS
authors.lastname: Leite
authors.affiliation: c Department of Public Health Sciences , Medical University of South Carolina , Charleston , South Carolina , USA.
authors.forename: Cathy L
authors.initials: CL
authors.lastname: Melvin
authors.affiliation: d College of Dentistry , University of Florida , Gainesville , Florida , USA.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.affiliation: a Department of Psychiatry and Behavioral Sciences , Medical University of South Carolina , Charleston , South Carolina , USA.
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003815:Dentists / Q000193:education / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D064226:Prescription Drug Diversion / Q000517:prevention & control*; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders / Q000517:prevention & control*
chemical_list: D000701:Analgesics, Opioid
keywords: Dentists; prescription drug monitoring program; prescription opioids