The national and local prescription opioid crisis will be defined with current data. The role of the dental community in preventing prescription opioid misuse will be discussed. The various causes of orofacial pain and headache and the appropriate treatment modalities for each diagnosis will be discussed. The use of opioids, non-opioid medications, and non-pharmacologic strategies will be compared. Best practice guidelines for the use of opioid medications including risks, benefits, alternatives, safe storage and disposal will be recommended. The identification and management of patients at risk of prescription drug abuse will be discussed and the use and interpretation of the Prescription Awareness Tool will explained with clinical case histories.