Drug overdose and opioid-involved deaths continue to increase across the United States. An end-condition related to opioid abuse is neonatal abstinence syndrome (NAS). The implications for pregnant or post-partum women using an opioid, whether prescribed or illicit, can have significant effects on their infant. First described in the 1970s, NAS is defined as a postnatal drug withdrawal syndrome that primarily occurs in opioid-exposed infants. There are no nationally accepted, evidence-based treatment protocols for these infants. Pediatric dentists should be cognizant of potential dental development issues and developmental delays in children with NAS. Basic behavior guidance techniques, such as tell-show-do, may not be as effective. In addition, adherence to prescription drug monitoring programs can help identify patients who may have received multiple opioids, alerting the provider to possible misuse or abuse. The purpose of this paper was to provide background information on the incidences and potential dental implications for children with neonatal abstinence syndrome.