Dentists and dental healthcare providers are on the front lines of the opioid crisis. We see our patients suffering from substance abuse disorder and we also see our patients struggling with pain. It is critical, therefore, that we are fully aware of the risks and benefits associated with opioid and other analgesics and the best practices for pain control within the dental practice. Dentists currently rank #5 among healthcare providers in the number of opioid prescriptions written. Mitigation of risks association with opioid prescribing, including thorough screening, patient counseling, PDMP query, and limitation of the number and potency of medications prescribed. Furthermore, identification of particularly vulnerable groups of individuals, for example young people and individuals with a history of substance abuse and judicious use of opioid medications in these groups, can result in adequate pain control with less risk of adverse outcomes. It is critical that dentists are able to better manage pain for patients in ways that reduce individual and societal risk overall.