Ethics & Law · single question
A patient with severe caries presents requesting a codeine prescription, claiming it is the only medicine that has helped with past tooth pain. A DO resin restoration on tooth 4 was performed yesterday with no overhang, sealed margin, and is not approximating the pulp. Which action should be performed by the dentist?
Show answer and explanation
Correct answer: C. Prescribe the patient ibuprofen (Advil®) and follow up
The restoration is clinically adequate — no overhang, sealed margins, not near the pulp. Post-operative sensitivity is expected after composite restoration. The patient requesting a specific opioid (codeine) with claims it's the 'only' medication that helps is a classic drug-seeking behavior. The appropriate response is to prescribe an appropriate non-opioid analgesic (ibuprofen) and follow up — not to prescribe opioids unnecessarily.
- A. INCORRECT. There is no clinical indication to redo the restoration — it has no overhang, sealed margins, and is not near the pulp.
- B. INCORRECT. Prescribing oxycodone (a stronger opioid) when a well-placed composite is the only finding represents inappropriate opioid prescribing and potential facilitation of drug-seeking behavior.
- C. CORRECT. Ibuprofen (NSAIDs) is the first-line analgesic for post-operative dental pain. The restoration appears clinically acceptable. Prescribing ibuprofen with follow-up addresses the pain appropriately without enabling drug-seeking behavior.
- D. INCORRECT. Simply telling the patient to return in a few days without addressing the pain is not ideal patient care.