The Canadian Dental Association affirms the responsibility of dentists to provide safe, effective, and patient-centred acute pain management while minimizing the risk of misuse and diversion of prescribed medications. Dentists should identify and manage the source of pain directly whenever possible. Pharmacological management should prioritize non-opioid therapies and use a stepwise approach that escalates to immediate-release opioids only when necessary. As supported by relevant clinical guidelines, if opioids are required, they should be prescribed at the lowest effective dose and for a short duration.
Dentists are expected to conduct risk assessments prior to prescribing analgesics. Risk assessments should consider age-related vulnerabilities, polypharmacy, mental health conditions, prior substance use, and barriers to timely follow-up. Using their clinical judgment, dentists should tailor pain management to both the procedure and the individual patient, proactively engage patients in shared decision-making, and discuss risks, benefits, alternatives, expected postoperative pain trajectories, functional goals, and recovery timelines. Importantly, dentists should communicate that analgesics support pain reduction and functional recovery but are unlikely to fully eliminate pain, and care plans should reflect these expectations.
Dentists should consider social determinants of health and structural factors that may influence access to effective pain management, including geography, insurance status, cost, cultural considerations. Where relevant and based on available information, these factors should inform pain management planning, patient education, and follow-up.
Dentists should provide patients with clear information on the intended use of prescribed analgesics and work collaboratively with pharmacists and other healthcare professionals to support safe medication use, storage, and disposal. Prescriptions should be prepared clearly and accurately to reduce the risk of errors or alterations. If pain persists, dentists should re-evaluate the pain source and management plan.
This position emphasizes equitable access to safe and effective pain management, recognizing that all patients should benefit from evidence-informed prescribing practices. Balancing effective acute pain relief with safe prescribing and reducing opioid-related harms is essential. Adequate treatment of acute pain is crucial not only for immediate recovery but also for preventing potential progression to chronic pain and other sequelae that impose personal, social, and economic burdens.
Working Committee:
Drs. Ivonne Hernandez, Chris Lee, Bruce Freeman, Daniel Haas, Susan Sutherland, James Brady, Anjali Bhagirath, Michelle Wong, Iacopo Cioffi, Kevin Mccann, Rachael Bosma, Yaad Shergill
Production of this document has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada.
CDA Board of Directors
Approved: July 2026
