7: Principles of writing a prescription
Raewyn Huang; Wei Chen; and Wei Qi Zhang
Learning outcomes
- Explain the types of medications that a dentist can prescribe.
- Describe all specific information that must be included for the prescription to be valid.
- Explain any special conditions that are related to dentists writing a prescription in Australia.
Prescriptions in the dental office
Dentists may prescribe medications including analgesics, antibiotics and anxiolytics for the purpose of oral healthcare (ADA, 2023).
A thorough understanding is required of standard dosages, duration of use, and, in prophylactic scenarios, the required duration for efficacy before treatment is advantageous.
Medications should be administered only after careful assessment of the balance between biological risk and benefit, or when they are absolutely necessary. This is particularly true in the case of antibiotics prescribed to prevent life threatening infection with a risk of systemic involvement.
The Electronic Therapeutic Guidelines can be accessed via The University of Queensland’s Library (UQ students and staff) or via Therapeutic Guidelines with a subscription. This is a resource in Australia which is disease-oriented with guidelines for prescribing and recommendations for therapy. The Oral and Dental section is oriented towards providing information for dental practitioners in Australia and should be referred to when prescribing medications.
The patient factor
The type of patient can determine the dose, frequency and type of medication prescribed. Some examples of variations could be between children, elderly patients, pregnant or postnatal women, patients with systemic disease, immunocompromised, adverse drug reactions or allergic reactions.
The document
Examples in Australia that can be ordered via Services Australia website:
- Personalised prescription pad for dentists.
- Pharmaceutical Benefits Scheme (PBS) and Repatriation Schedule of Pharmaceutical Benefits (RPBS) computer generated prescription for health care practitioners.
- Interim PBS and RPBS prescription pad for dentists.
A prescription is a legal document and requires complete information is filled in for both the prescriber and the patient.
Ensure the prescription details are recorded in clinical notes for follow up appointments, confirming if the dispensing pharmacy needs further clarification and for future instances of a legal challenge,
A key aspect is that the date should indicate the date of prescribing, and to remember that forward or backdating is not permitted. Whilst up to three Pharmaceutical Benefit Scheme (PBS) items may be included on a single PBS prescription, dental practitioners can not write repeats on the scheme.
Specific information provided to patients should include:
- the generic or approved name of the drug
- expected effects of the drug and what its used for
- instructions on how to take the drug including dose, form, route and frequency
- potential adverse effects and what to do if they occur.
Before commencing script writing for a prescription, ensure the following steps are followed:
- Utilise the correct prescription pad, containing the prescriber’s name, address, contact number, and, importantly, the prescriber number.
- Fill in the patient’s complete name, address, and date of birth. For pediatric patients, include their age and weight.
- Specify the medication name to be dispensed, along with its dosage form (e.g. tablets, capsules, liquid suspension) and drug strength, on the first line.
- Provide clear instructions for use on the second line, including dosage, route of administration, frequency, and duration of medication prescribed.
- Indicate the total quantity of the medication prescribed on the third line.
- In the dental setting, it is essential to state “for dental use only” on the last two lines, as dentists may not order repeat prescriptions.
- Include the manual signature of the prescriber and the date of issue at the bottom of the script.
The entire prescription should be completed legibly, using indelible ink, and signed by the prescriber, ensuring it is a valid document in accordance with professional standards.
Prescriber’s details required
- Name
- Address
- Telephone number
- Prescriber number
Patient details required
- Full name
- Address
- Date of birth
- If a child, include age and weight
Drug information required
- Drug name
- Drug form (e.g. tablet, capsule, suspension)
- Drug strength (e.g. 250mg, 500mg)
- Drug dose, manner of administration, frequency, and duration of treatment.
Other information required
- Quantity of drug
- Signature of prescriber
- “For dental treatment only” designation.
To ensure you are following guidelines, Services Australia has multiple Education Modules you can complete.
Key modules include:
- Provider and Prescriber Number Eligibility
- Prescription Requirements
- Prescribing in Public Hospitals
Ensure you use standard language for instructions, avoiding abbreviations or Latin terms.
Additional considerations for children
- Every medication has its therapeutic and maximum dose, this is comparatively significant when prescribing it to children.
- Children response to medications and the drug dose differs from the adult population and thus should be calculated carefully.
- Drug doses are calculated according to the body weight of the children multiplied by the weight standardised dose.
References
Australian Dental Association. (2023). Policy statement 6.23 – Prescribing medications in dentistry. https://ada.org.au/policy-statement-6-23-prescribing-and-dispensing-medications-in-dentistry
Australian Institute of Health and Welfare. (2023). Oral health and dental care in Australia: Prescribing. https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/prescribing
Therapeutic Guidelines. (2023). Therapeutic guidelines (Australia). https://tgldcdp.tg.org.au/index
