Prescribing, controlled substances, and prescription monitoring
What the domain tests
This domain tests lawful prescribing by Montana dentists: state licensure, DEA registration, controlled-substance schedules, the prescription drug monitoring program (PDMP), and documentation. A dentist’s authority to prescribe flows from the dental license and the dentist-patient relationship; DEA registration alone does not authorize practice.
Core rules
- Prescribe only within the scope of dental practice, after an appropriate examination and with a documented treatment plan.
- Controlled substances require valid DEA registration and compliance with Montana Board of Pharmacy and federal rules; schedule II prescriptions have special requirements.
- Check the PDMP in the circumstances Montana law requires, including before certain opioid prescriptions, and document the review.
- Avoid self-prescribing and prescribing for family or friends except in a documented emergency; never prescribe without a legitimate dental indication.
- Use secure prescription practices, verify patient identity, and counsel on risks, storage, and disposal.
Worked example
A patient requests “the usual” opioid after a routine cleaning and says the pharmacist will fill it early. The dentist has not examined the patient for pain, finds no dental indication, and declines. The note records the request and the clinical findings. Prescribing would be outside scope and could support discipline.
Traps
Treating a DEA number as a state license; skipping PDMP review because the dose is small; failing to document rationale; assuming electronic prescribing rules do not apply to dentists.