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consumed postoperatively is unclear, substantial amounts are leftover to be later reused, shared among friends and family, or abused non‐medically.4,5 Among prescribers of opioids for adolescents, dentists are proportionately the most prevalent prescribers (Fig 1).6 This is consistent with the Department of Health’s assessment of acute opioid prescriptions in youth using the Prescription Monitoring Program data between July and December 2015.7 Dentists write approximately 31% of opioid prescriptions for patients between 10 to 19 years.8An estimated 56 million tablets of 5 mg hydrocodone are prescribed after third molar extractions each year in the United States.8High schoolers who receive an opioid prescription are 33% more likely than those who do not receive a prescription to misuse opioids between the ages of 18 and 23 years.9 Data shows an upsurge in heroin‐related deaths among 18 to 25 year olds. 1,2 Therefore, dental providers could play a critical role in minimizing opioid exposure for vulnerable young people by reducing the number of opioid tablets prescribed for common procedures such as extractions. In response to the release of the 2016 CDC opioid guidelines, which recommended limiting the duration of opioid prescriptions for acute pain, Dr. Paul Moore, speaking for the American Dental Association Figure 1: Percentage of Prescriptions Dispensed for Opioid Analgesics from Outpatient US Retail Pharmacies by Age and Physician Specialty, 2009 Dental Guideline on Prescribing Opioids for Acute Pain Management Adopted by the Bree Collaborative, September 27th, 2017 Page 2 of 12 Council on Scientific Affairs, said, "For dental practitioners, the importance of these recommendations should be carefully considered . . . Every year, millions of adolescents receive their first introduction to opioids following the extraction of their third molars. Many of these young adults may have never received these centrally‐acting analgesics before in their lives. We have a special responsibility to counsel them about their dangers and educate them about their safe use of opioids when taken for acute postoperative pain.”10 Approximately 37% of nonmedical opioid use by high school seniors came from their leftover opioid prescription.1‐ 4 Clinical Recommendations Acute pain management poses many challenges to providers regarding treatment decisions, improving quality of recovery, and identifying patients at risk for poor pain management or uncontrolled pain. Assessing patients and proposing pain management plans that minimize risk while optimizing benefits is incumbent on providers. Good practice involves skilled initial patient assessment, individualized pain management strategies, effective intervention, and re‐assessment as necessary. In those rare instances when opioids are prescribed for chronic orofacial pain, providers should follow the best practices in the AMDG Interagency Guideline on Prescribing Opioids for Pain. Preoperative Period 1. Conduct a thorough evaluation including a patient interview with dental and medical history. Screen for past or current use of opioids and benzodiazepines, sedative‐hypnotics, or anxiolytics. See Appendix A for list of benzodiazepines, sedative‐hypnotics, and anxiolytics. a. Check the Prescription Monitoring Program (PMP) for every patient for whom you write a prescription for opioids to be aware of prior or concurrent prescriptions of opioids or sedatives. This is especially critical for patients who report a history