I often give a block with Marcaine after endo or extractions
to extend the duration of anesthesia a few extra hours.

D

Important to take the NSAID's (or
- quote -

75 mg of ketoprofen works well with less frequent dosing, though it
does take a script.

D

Amatus Cremona wrote:

- quote -

Amatus Cremona wrote:
- quote -


Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

If I do a surgical third molar extraction with lots of osseous cutting,
sectioning, flap and (most importantly), it takes more than 15 minutes for
that one tooth, I will Rx narcotics -- assuming I will not be available the
next day or 2 to handle post-op calls. Otherwise, the patient is given VERY
strong instructions to take 2 Ibuprofen (assuming they are not restricted
from taking it) BEFORE the numbness wears off. Then, q 6h for two days.
That takes care of post-op pain for 99.5% of cases. Important to take the
NSAID's (or Tylenol) ***BEFORE*** numbness wears off.

--
/

Amatus

/
"Dartos" <tuthjockey[at]myturbonet.com> wrote in message
news:1222262946_30293[at]news.newsville.com...
- quote -

Amatus Cremona wrote:

- quote -


Quite true.

From personal experience, I haven't found vicodin, tylenol #3, or
darvocet to relieve pain any better than ibuprofen. For most patients
there is no clinical need for a script.

That doesn't mean that the placebo effect is not there with the patient
believing the prescription meds just have to be 'stronger'.

They are prescriptions because of the type of drug, not because they are
proven to be more effective.

Take the ibuprofen, save some money, and reduce side effects.

D

Is the pain really so bad that 3-4 OTC Ibuprofen are not enough? That
almost never happens.

Perhaps this dentist was recently hit by a drug seeker and is being extra
careful?

I personally do NOT prescribe narcotics for "routine extractions" unless
extenuating circumstances occur.

--
/

Amatus

/
"Bill" <billnomailnospamx[at]yahoo.com> wrote in message
news:6jv1idF59ulcU1[at]mid.individual.net...
- quote -

Bill wrote:
- quote -


Most dentists (me included) will offer pain medications if the
procedure can reasonably be expected to cause pain that cannot be
managed by OTC medication. However, there are good reasons a dentist
might not do this--perhaps the patient's medical history. It is also
possible that the dentist is not registered with the DEA to dispense
narcotic analgesics.
In any case, I do not write for the strongest (Schedule II) narcotics.
It should not be necessary for any procedure I do in my office (though
I'm sure this would not be the case for most oral surgeons). The
schedule III meds work well, but most studies show that 400 mg of
ibuprofen work as well as 1/2 gr. of codeine. So if your friend has no
prescription, he would probably be no better with Tylenol with codeine.
Moderate pain can usually be managed with up to 3 ibuprofen tabs/6hrs;
if the pain is returning before that he can take 600 mg of acetaminophen
3 hrs after the ibuprofen and stagger them. I wouldn't do that more
than a couple of days though, and he should not drink alcohol--bad for
the stomach (and liver!)

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

I have a friend who went to the dentist and had a tooth pulled. It was the
furthest back tooth on the top. After the tooth was pulled, the dentist
refused to give him a prescription for pain medicine - told him to take
Ibuprofen.

Then when my friend got home, he again called the dentist and asked for
prescription pain medicine as he was hurting. The dentist again refused. He
told my friend he did not need prescription pain medicine.

I have never heard of such a thing! Every time I have had a tooth pulled, my
dentist has given me prescription pain medicine. Same thing with my friend
(he just switched dentists due to insurance), he has been given a
prescription for pain medicine when having a tooth pulled in the past. And
same thing with other friends we have discussed this with including someone
who works in a dental clinic.

I am going to suggest to my friend that he report this dentist to the state
board of dentistry, but before doing so, I would like to ask if there is any
valid reason for a dentist to not prescribe pain medicine for a tooth
extraction?

Also my friend needs to have another tooth removed, but obviously has no
intention of ever returning to see this dentist. And he is now afraid of
this happening again in the future. Is it reasonable to ask the next dentist
if he will prescribe pain medicine BEFORE having a tooth pulled?