Why aren't adults given advanced painkillers?

[cavomington]

I can understand why kids aren't given opiate or narcotic pain killers, but not responsible adults. I had to have 4 different root canal sessions done to finally fix one of my molars, and after each one I was asked if I wanted an advanced pain killer. I was only given 10 or 15 each time by my dentist and endodontist, but it was great for managing the pain. The first 2.5 days of braces at age 25 were pretty painful. I would classify the pain as much worse than the aftermath of a root canal. I don't see why orthodontists are so adamant about not giving out advanced pain killers. People have made the argument that one must get used to the pain. Though that statement seems completely illogical to me because after medicating myself with some Hydrocodone leftover from a back injury for days 1 and 2, I'm completely fine and just using Ibuprofen to keep the swelling in my mouth at a minimum on days 3 and 4.

[BracedSurgeryStudent]

You know, when I first got my braces they were horrible on pain nearly as bad as a kidney stone and i've had both. I called and asked for a script of either 600 or 800 ibuprofens and was told no by the orthodontist. Let alone asking for advanced medicine for it. But I too use hydrocodones when it's horrible (I have some left over from the kidney thingy). I never understood why the freaked. Maybe because most of them never had braces. Maybe they don't even have an Rx lisence as orthodontists. That's probably why because they tell people over the counter tylenol.

[bbsadmin]

Most orthodontic pain is not bad enough to warrant narcotic pain killers. They are not commonly prescribed. You can "make" your own prescription-strength Ibuprofen by taking 3 or 4 Ibuprofen with food every 6 to 8 hours for a few days, as long as it doesn't bother your stomach (and as long as you aren't taking other blood thinning drugs).

If your pain is not helped enough just with the Ibuprofen, you can alternate it with 2 Tylenol, taken 4 hours after that Ibuprofen (again, take it with food).

But most of the really bad pain goes away in a few days to one week.

I'm very sensitive to pain and never felt the need for anything stronger than a few Advil in those first weeks.

The product GumEase, available at http://www.dentakit.com , will also help deaden the pain with cold therapy (and no drugs).

[BracedSurgeryStudent]

Sadly I am immune to advil, aleeve, ibuprophen and tylenol. But now I'm just used to the pain. Btw its dangerous for the liver to take more than 2-3 advils and such in a day you can go into liver failure.

[sirwired]

Btw its dangerous for the liver to take more than 2-3 advils and such in a day you can go into liver failure.

This is simply not true. While some people may be intolerant/allergic to NSAIDs (the class of drugs including Aspirin, Advil, and Aleve), at below OTC doses (2-3 a day are well below the max OTC dose) they are amongst the safest medications on the market. They are routinely prescribed by doctors at doses well over OTC limits for inflammation.

Taken over an extremely long period of time (years upon years) they will eventually rot the stomach, but short term NSAID use is about as harmless as any drug can be, unless there is a specific reason you should not take them.

BTW, if you think Advil is so dangerous and/or useless, why did you ask your ortho for a Rx for pills equivalent to 3-4 OTC pills? (And, on another note, why get a scrip for such pills? Why not just take 3-4 OTC pills, which you can pick up on your own at any drugstore?)

[klobird]

I am intolerant of NSAIDS also. I don't see any reason to have to suffer. I really don't. I have read that for older adults (56 here), moving teeth is like trying to get them to move through concrete. Sometimes it is really, really painful.

My regular doctor understands, and gives me Percocet (I'm terribly allergic to Vicodin), enough (like 12) to last for several months. I take about 2 (1/2 at at time) when it's bad and that's it.
My doctor knows my behavior and trusts me.

I work in an upscale medical facility where drug abuse is rampant. It's really bad, and it affects all levels of society. Among them are people who go to several different doctors and several different pharmacies. (By the way, all of that information is now available electronically to physicians. It's getting harder to pull that kind of thing). We have had one person whose friend distracted staff while he stole a prescription pad. He ended up in jail. Doctors aren't stupid...

On the other hand, real pain is not necessary and I don't see a problem with a very small amount of pain control to be available. I do see a problem with the ortho giving it out. Everyone would be asking for it, and the ortho would be responsible for the actions of ALL of their patients, and potential serious consequences with giving out the pain meds.

Absolutely take the Ibuprofen only if you are tolerant. It works, it really does. Go to your doctor as a last resort. Even then you may not be able to get a prescription for pain meds...and the reasons for that are very legitimate....it's a fine line...

That's the way I see it anyway...I think we all feel differently regarding this issue....

[cavomington]

I don't see the "it only hurts for a week" statement as a valid argument. If it hurts for a week, then a weeks worth of applicable pain meds can be prescribed. Responsible adults should not be punished because of others than abuse meds.

[SandySam]

Eek! This sounds scary. Is this something that's orthodontist dependent or across the board?

Is it appropriate to ask the orthodontist this when in your first consultation?

"Will you give me opiates?"

[nikkibabie19]

Wow! I didnt kno people require advance pain meds to deal wid braces...

I tort OTC painkillers work just fine...I only took one on day 2 of having braces...And after that NO painkillers at all...

I dont think my pain tolerance is extraordinarily high or anything. I consider i t to be normal...But i guess some people cant cope.

But really tho isnt it usual for OTC pain meds to NOT work on the pain of braces?
So i dont c why prescription meds are necessary esp when there is a chance people can get addicted to them easily...So i see why orthos dont give them out...

Have u tried using a different strength or type of OTC pain med?
Many that one doesnt work for u....Just a suggestion

Hope the pain eases up for u soon...

[bbsadmin]

If you can't tolerate OTC painkillers or NSAIDs, then speak up and tell your orthodontist. It's as simple as that. If you orthodontist can't give you a prescription for something stronger, perhaps your regular medical doctor can.

Generally the pain from braces is not bad enough to require something as strong as an opiate or a narcotic. That is why they are not routinely supplied or offered.

Personally I got by just fine with Advil during the first two weeks. After that, I didn't need to take anything. And I have a very low pain threshold.

[braceface46]

BECAUSE they are physiologically addictive. Meaning, you get hooked on them and go into withdrawals when you don't have them. Then, you're a JUNKIE, yes, YOU who think it could never happen to you. You will quickly get used to taking them and need more and more to get the desired effect. You're problems will become much worse than crooked teeth. You'll sell your soul to get more, lose your job, your family, your dog, your IRA EVERYTHING. Trust me, I work in the field and have seen people who never did drugs at all start with pain pills and end up junkies. Ibuprofen, aleve, acetominophen, neurontin (a prescription n0n-narcotic pain killer) even. But NOT opiates.
I don't have an especially high pain tolerance and have gotten by with aspirin and ibuprofen. If I'm really hurting I'll take a tylenol PM and go to bed.
But stay away from any narcotic...bad news and unnecessary.

[cavomington]

Thank you for your non-professional opinion.

[starfish88]

If your ortho isn't able to provide painkillers speak to your GP. My problam is slightly different in that I need anti-anxiety pills for dental appointments but have to get them from a GP. But usually the GP just calls the dentist/ortho to check your being honest and is quite happy to prescribe a SMALL ammount.

[OldBikerBag]

Holy mackerel! Some of the responses here are absolutely stunning to me! I have been in the medical field in both pharmacy and as an emergency responder. To make a blanket statement indicating people who resort to narcotic analgesics will become drug addicts or to suggest those who request them are somehow weak, well, that is simple misinformation. I can understand where the addiction commentary stems from. When a person deals with addicts all day long, pretty soon, that person begins to believe everybody who takes a specific medication is automatically an addict. That is just not true.

It has been proven that people who use narcotics for pain, when the pain warrants it, do not become addicted. Those who use the medication for its unintended, but pleasant, side effects generally do become addicted. Use of a narcotic for a few days will not automatically create an addict. We're not talking about morphine or oxycontin here. We're talking about Vicodin (hydrocodone/acetaminophen) or Tylenol 3 (codeine/acetaminophen). There is no shame in asking for it. Whether the ortho will grant the request is another story altogether.

I am a bit confused with the statement that someone (forget who) is allergic to Vicodin (hydrocodone) yet can tolerate Percocet (oxycodone/acetaminophen) well. The two drugs are so similar, they are almost twins. If I remember correctly (been a very long time) there is one additional carbon molecule on one or the other's atom. I suppose it's possible to be allergic to one but not the other...but that is extremely unlikely. I would be curious as to what the symptoms of the allergy are...out of pure nosiness, I assure you.


In the mean time, those who feel like wagging a finger at someone who believes a narcotic will help, it's time to put your hand in your pocket and mind your own business. The question asked had nothing to do with this addiction theory.

[klobird]

Hey Biker,

I am the one who is allergic to Vicodin and not Percocet. Believe me, I don't understand it either.

Symptoms with Vicodin are: SEVERE itching, sweating, headache, chest pressure etc.. In the past, when I have had Vicodin, those symptoms got worse each time. I am totally afraid to touch another one.

Percocet does none of that. None. I don't know why or how to explain it--it just is....

I have had 3 major surgeries--a lot of chances to figure it out....