What would you do if a dentist prescribed...

strange people....

Is the wife hot? ...and does she have a sister?

Dental08?09 said:

birth control for his wife? Would you fill it or give him a call and say "no way"? From my understanding legally they can but ethically they can't since its out of the scope of practice.

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In my state (WA) prescribing outside of the scope of practice is prohibited. I would have to decline to fill the prescriptiona nd gently inform the prescriber that no pharmacy can fill a prescription for a mediation outside of the scope of his practice.

bananaface said:

In my state (WA) prescribing outside of the scope of practice is prohibited. I would have to decline to fill the prescriptiona nd gently inform the prescriber that no pharmacy can fill a prescription for a mediation outside of the scope of his practice.

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Or report him to his professional board and get the dentist's prescribing privelages revoked.

In AZ, a pharmacist can lose his/her license over dispensing illegal prescriptions.

aaron31981 said:

Or report him to his professional board and get the dentist's prescribing privelages revoked.

In AZ, a pharmacist can lose his/her license over dispensing illegal prescriptions.

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No need to make enemies. A gentle reminder will suffice. Many prescribers don't realize the limits of their priviledges.

Wouldn't a 9 month pregnant woman be a higher risk for a full root canal? Maybe he has her scheduled a few months down the road and doesn't want that to interfere with the procedure.

A pharmacist would also be full within their right to confiscate a written prescription in this case as well (assuming a scope of practice provision exists for the state)

ask why it was prescribed and then tell them to find another MD to write it

On a similar note, I have a dental appointment coming up, you think I could get the DDS to write me an omeprazole 20mg script so I don't have to pay to see my PCP? Maybe I could say the acid reflux is hurting my molars, therefore a PPI is needed to stop the decaying? Too much of a stretch?

imperial frog said:

Wouldn't a 9 month pregnant woman be a higher risk for a full root canal? Maybe he has her scheduled a few months down the road and doesn't want that to interfere with the procedure.

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No go. Sorry. He can collaborate with her other healthcare providers if this is a concern.

WVUPharm2007 said:

On a similar note, I have a dental appointment coming up, you think I could get the DDS to write me an omeprazole 20mg script so I don't have to pay to see my PCP? Maybe I could say the acid reflux is hurting my molars, therefore a PPI is needed to stop the decaying? Too much of a stretch?

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You can but Prilosec OTC.

In some states prescribing priviledges are more generous. Maybe your state has lax laws.

Dental08?09 said:

birth control for his wife? Would you fill it or give him a call and say "no way"? From my understanding legally they can but ethically they can't since its out of the scope of practice.

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Straightforwardly illegal for the dentist. This case gets tried every now and then by the dental boards and generally is a long suspension/revocation offense for the dentist. Pharmacists who are stupid enough to fill a prescription for such and is caught generally has their license on probation or suspended.

However, that's if you get caught. The only way these things are found out are during routine system or med. file records. That's unlikely to happen so long as someone doesn't tell.

The one time it happened to me, I did call the dentist, asked for the diagnosis to confirm (hey, they are wierd indications for some drugs), and if it wasn't a dental concern, politely inform him that this prescription is going to the dental board with a complaint. I have no sympathy for someone who screws with my license. Even if by stupidity, they should be repremanded for it as an unacceptable breach of practice.

WVUPharm2007 said:

On a similar note, I have a dental appointment coming up, you think I could get the DDS to write me an omeprazole 20mg script so I don't have to pay to see my PCP? Maybe I could say the acid reflux is hurting my molars, therefore a PPI is needed to stop the decaying? Too much of a stretch?

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No, not at all. Acid reflux can cause erosion of your teeth and halitosis. If you put it that way then a DDS can Rx the omeprazole. But this case would be better cared for by an internal medicine doc. DDS can Rx anything as long as it relates to dentistry. Viagra and birth controll pills are not in DDS's scope of practice.

bananaface said:

You can but Prilosec OTC.

In some states prescribing priviledges are more generous. Maybe your state has lax laws.

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Prilosec OTC 40mg dose = $30
Omeprazole Rx ran through my insurance (which I got as of 8/1/05, w00t!) as 20mg, II qDay, disp 60 = $5

lnn2 said:

No, not at all. Acid reflux can cause erosion of your teeth and halitosis. If you put it that way then a DDS can Rx the omeprazole. But this case would be better cared for by an internal medicine doc. DDS can Rx anything as long as it relates to dentistry. Viagra and birth controll pills are not in DDS's scope of practice.

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Actually a DDS/DMD can Rx anything (according to the DEA) whether or not it is "deemed" dental related or not. Dentists have the same range of drugs the can prescribe as physicians.

KingChris said:

Dentists have the same range of drugs the can prescribe as physicians.

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They might be able to choose among the same drugs, but all doctors are limited to their own scope of practice. Unless a dentist can justify his RXs, he has to write within his professional scope. Would you do a vaginal exam and pap smear before writing a prescription for birth control? The gynecologist will.

PharmDstudent said:

They might be able to choose among the same drugs, but all doctors are limited to their own scope of practice. Unless a dentist can justify his RXs, he has to write within his professional scope. Would you do a vaginal exam and pap smear before writing a prescription for birth control? The gynecologist will.

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Many men perform vaginal exam...gynecologist or not...

ZpackSux said:

Many men perform vaginal exam...gynecologist or not...

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Wait, what's that new movie out? Oh, that's right, SICKO!

KingChris said:

Actually a DDS/DMD can Rx anything (according to the DEA) whether or not it is "deemed" dental related or not. Dentists have the same range of drugs the can prescribe as physicians.

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In my state prescribers are limited by their profession. So dentists may prescribe for conditions that affect the oral cavity, podiatrists for the foot and ankle, MD/DO's for the entire body.

KingChris said:

Actually a DDS/DMD can Rx anything (according to the DEA) whether or not it is "deemed" dental related or not.

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Can you provide a link to back up this claim?

my store wouldn't allow that rx to be filled based on the fact that they were writing the script for his wife, regardless of what the med was. We will only fill scripts within the same family if it is something with a sense of urgency, and even then we give a friendly reminder to the doc writing the perscription.

KingChris said:

Actually a DDS/DMD can Rx anything (according to the DEA) whether or not it is "deemed" dental related or not. Dentists have the same range of drugs the can prescribe as physicians.

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I hope you won't go out and perscribe medications as you see "fit" since this will be rude awakening for you. Dentists can write any rx if it is dentally related. Viargra? No. DP

Whoever told you it's legal is lying to you. Whoever says the DEA allows dentists to prescribe is confused. The DEA just enforces CONTROLLED substances. They have no control over birth control or any script whose possession isn't a first degree felony.

All drugs must be prescribed for legitimate medical purposes from a licensed practitioner. A dentist isn't licensed to properly give a physical examination to determine the appropriateness of therapy. Also, if it was submitted to insurance, not only is it fraud, but if they audited you, they would note that a dentist wrote it and they would not pay for the claim.

So that's three reasons not to right there.

I definitely would not, sorry. PA school is only a few more years. I've actually thought about doing it myself.

Is this dentist an oral and max surgeon? ...DDS with MD. If he is, I don't see why he can't do it. I've been told that GP can prescribe any medicine that is related to teeth. If I'm a GP, I don't think I would prescribe birth control because I can't prove that it's related to teeth.

If the dude is licensed by the medical board, then he can write for anything except like accutane, clozapine, and otehr drugs that require specialization and training prior to dispensing.

Hi
I have seen mention of threads here on the dental forum... best way is to communicate as health care FRIENDS. Each state has their own laws. And each dentist is different. I am full time hospital based treating medically compromised and patients with oral diseases/problems and pain (mostly atypical). I receive many phone calls from local pharm. re the RXs... We communicate... work as a team. I have often given them copies of our clinical therapeutic books to help with xerostomia, etc... Many of which are simple OTC meds.

We have rules for our residents at the hospital on what they can RX and not.
We have formal reviews (case based, problem orientated, and evidence based). We often review with the pharm residents at the hospital.

In the Oral Medicine/Oral Path books, we have evidence studies which are not widely know to general dentists.

I have often reviewed RXs directly with the pharm to explain why and see if in his/her knowledge something might be better.

I agree who must have the ability to treat the disease... but also the knowledge... and again COMMUNICATE. The FIVE letters I tell by residents....
A - Ask/answer questions
B - Best patient care - keep up to date
C- COMMUNICATE - to all as allowed by HIPPA... pt, family, other docs,
pharm, other health care works, etc
D- Document - be sure to record facts/communications
E - Electronic Records - dictate so all on the system (hosp powerchart) can
see the records/consults.

Often several local pharm would call me for questions... most have my cell #

To deviate to another closed thread... I am sorry... especially in Dental School.... students only can do what the faculty says... may dentists do not want a DEA # so RXs will be limited. A root canal (if it was completed) should have no pain... but of pain is present... the pt should be re-eval to see why... needs new Root canal, is it a fractured/cracked tooth syndrome, is it secondary MPDS (muscle spasm) from unilateral eating, is it referred pain from another problem... so many differential diagnosis to bring up...

I am always ready to communicate/exchange ideas when not traveling (limited computer time overseas)... just email me.... [email protected]

This was meant as a discussion amongst friends... and i am sorry if anything does not sound that way.... was not meant to

Bob arm

Dr. Arm,
When I had my root canal done, the procedure itself wasnt that painful but after the local wore off it was so painful. The pain was so unbearable that I would rather have someone just knock me out. I received no pain meds and the pain was just pulsating... Anyway, Motrin didn't do anything and I just sat there...A 20 yr old adult just agonizing like a little boy.... Thanks for the input Dr. Arm in the post above.


I just noticed this is way off topic, seeing as though the other thread is closed. I was just responding to the doc above.

All4MyDaughter said:

In my state prescribers are limited by their profession. So dentists may prescribe for conditions that affect the oral cavity, podiatrists for the foot and ankle, MD/DO's for the entire body.

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A sildenafil rx certainly could fall within a dentist's scope of practice based upon this particular description

JerryPharmD said:

A sildenafil rx certainly could fall within a dentist's scope of practice based upon this particular description

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Of course. Because pulmonary hypertension is within their scope of practice.

Smack Em Upside The Head!!!

Just kidding, folks. JUST KIDDING!!

well.. maybe by your thinking<g>... if anything it would be to ask it be stopped.... it may cause the "lindalovelace" syndrome of lesions on the palate.

But with the major reported problems in some of muscle pain and headaches(over 10 %) in may have to be stopped.

My experience with prescribers prescribing outside their scope of practice was they knew they were doing it & were asking a favor of me. I've done it for all kinds of prescribers - though not midlevels at all. Most don't want to take advantage of me & are willing to see a proper prescriber since they know the "right" thing to do.

Only one - a dentist, who I knew...well...because he's a colleague of my husbands - tried to ok a refill of an acne medication for his son, which had previously been denied due to not continuing his appts. This guy was just too cheap to send his son to the dr & said he didn't want to keep paying for appts when he could just prescribe it - he actually admitted this to me. I told him no!

Others I've done - antibiotics for their kids, once a bcp for a wife who had left her last refill in a hotel, an anthihypertensive for a parent whose luggage had been misrouted, last year...lost of Katrina stuff - I've done them all once. Its legal, I use my judgement but I let them know I'm doing them a VERY BIG favor & not to take advantage of me - sorry....viagra is taking advantage.

A colleague of my husband though did get stung by the State Board of Dentists & the DEA both because of prescribing demerol for his wife (who in the heck uses demerol??? - thats a red flag right there!). Lost his CII prescribing permanently, had his CIII's put on hold for 1 year & his license was rescinded for 6 mo & put on probation for 1 year - OUCH! That hurt him financially!

Yes, Dental do have a wide range of prescriptions. They can prescribe just as physcians, but that doesnt mean they CAN prescribe it. It has to be related to their scope of practice just as physcians have to also. The DEA (besides what WU said about them enforcing only controls) is only on the Federal level and one agency. You also have to deal with other agencies and of different levels such as your state board of professions, you know. . . the one who can suspend or revoke your license and your ability to practice.

Depends on the state, but most limit the scope of practice. I do not report people who prescribe what they shouldn't, but I call them and tell them they cannot write that. It's more of an issue with MDs writing a non-emergency supply of controls for their immediate family...