Prescribing, controlled substances, and recordkeeping for medications
What the exam tests
This domain tests lawful prescribing, controlled-substance handling, the New Jersey Prescription Monitoring Program (NJPMP), and medication recordkeeping. The focus is both patient safety and diversion control.
Core rules
- A dentist may prescribe within the scope of dental practice and must hold the required New Jersey controlled-substance registration and, for controlled substances, federal DEA registration. Hospital or office policy may be stricter.
- Prescriptions must be issued for a legitimate dental purpose, with the drug, strength, quantity, directions, refills, patient, prescriber, and date. The chart should show the indication, relevant history, and monitoring.
- New Jersey limits initial opioid prescriptions for acute pain to a short supply, generally five days, with exceptions for documented conditions; larger quantities require justification. Query the NJPMP as required before prescribing controlled substances and document the review.
- Store controlled substances securely, keep inventory and dispensing records, report loss or theft, and never use pre-signed blanks or let staff sign for the dentist.
Worked example
After a routine extraction, a dentist prescribes 30 oxycodone tablets with two refills and writes “pain” in the chart. The quantity exceeds the acute-pain limit and the record lacks justification, PMP review, and a non-opioid plan. The prescription is both a patient-safety and recordkeeping violation.
Traps that cost marks
Do not prescribe for self, family, or friends outside a documented patient relationship. Do not delegate prescribing decisions. An incomplete prescription can be a legal violation even if the pharmacy catches it. “The patient asked for it” is not a clinical indication.