Pain meds and the Dentist

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shaw31
Regular Member


Date Joined Mar 2007
Total Posts : 155
   Posted 5/14/2009 3:00 PM (GMT -6)   
I have a question that I hope someone can help me with.  I have to get dental work done.  I am in pain from some tooth problems.  My question is this.  How do I deal with my dental pain.  I am in pain management and my PM doc prescibes me my pain meds.  I know that a PM patient is only supposed to get pain medicine from his PM doc.  What happens when I am in bad pain from dental work?  Do I just use the meds my PM doc prescribes me for my back?  If so, wont I run out of my meds because I will be using them for terrible dental pain?  Also I am on oxycontin 3 times a day and not just any medicine will help me for tooth pain because my body is used to the meds I am on (my tolerance is high).  I just dont know how this works.  Do I need to call my PM doc and tell him I am having dental work so I need to use the meds he gives me for tooth pain as he (my PM) doc is the only doc that can prescribe any pain meds to me?  I am in a bit of a pickle and really dont know how to approach it.  Any help would be greatly appreciated. 
THanks and wish me luck.

Chutz
Veteran Member


Date Joined Jan 2005
Total Posts : 9090
   Posted 5/14/2009 3:27 PM (GMT -6)   
Hi shaw!

If I were in your place I would call both my dentist and my PM doc and ask them to talk to each other. As you've discovered...if you are on pain control 24/7 a regular dose of pain meds added to what you already take doesn't do much. Often it has to be upped considerable to get the pain under control. I would think they could prescribe something for a few days after the dental work, then go back to your regular routine.

That's a very good question and I'm interested to find out what your doctors do. Don't be shy about asking. It will confirm to your PM doc that you take your obligation seriously in reference to your meds.

Keep us posted,
Chutz
Co-Moderator Fibromyalgia & Chronic Pain Forums
~~~
Fibromyalgia, Ulcerative Colitis, Insulin dependent diabetic, PTSD, dermatitis herpetiformus, osteoarthritis and a few other side dishes.
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mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1116
   Posted 5/14/2009 3:28 PM (GMT -6)   
Shaw,
Whenever I have had to have dental work done and needed pain meds, all I had to do was call my PM and let him know what the dentist was prescribing and for how long. He would just okay it and make a note of it in my chart....and that was the end of it.
Call your PM's office and ask them how they want you to handle it. Do they want your dentist to call, or have you call before you fill the script or do they want you to bring it in to show them? Each office usually has it's own protocals, but normally, it's just notifying them of the script, who gave it and why....
sandi
PLIF/TLIF Fusion w/Instrumentation L4-5 Spondololysthesis L4-5.Laminectomies L4-5, foraminal stenosis L3-4, L4-5, L5-S1, herniations L3-4, L4-5, L5-S1, central canal stenosis L3-4, L4-5 and L5-S1
POST OP CES 3/30-06
Neurogenic Bladder and Bowel, bilateral numbness legs and feet
Revision for failed Back surgery, pseudoarthrosis L4-5, hemilaminectomies L3-4, L4-5, L5-S1, bmp added to revision fusion, replaced two bent screws that were reversing out of vertebrae - August 2, 2007
On going back pain and neuropathic pain, failed back surgery, consult for scs, decided not to do that at this point.
Adhesive Arachnoiditis also......just what I didn't need..9/08- adding bilateral ulnar neuropathy with severe compression to the mix. They want me to see a surgeon for ulnar nerve surgery, but I'm not biting.
I've seen enough surgeons over the last few years.


Boxerlover
Regular Member


Date Joined Dec 2006
Total Posts : 267
   Posted 5/14/2009 4:33 PM (GMT -6)   

The way my PM doc does it is I let him know when I am going to be having something done, denist or surgery and then I tell him what the other doc prescribed so he can make note of it.  If whatever the surgeon prescibes isn't strong enough then I am to call my PM doc and he will prescibe something for me. 

Melissa


Hello~Kitty
Veteran Member


Date Joined Jun 2005
Total Posts : 610
   Posted 5/15/2009 12:00 AM (GMT -6)   
I had to have my wisdom teeth removed a few years ago, but they had to cut into my gums to get them out, so it was considered surgery, and it hurt like crazy after the numbing stuff wore off. They gave me pain meds that of course didnt work, probably partially due to my high tolerence but we tried a few diffrent with diffrent doses and none of them worked. But after talking to my pain doctor and oral surgeaon we decided that I would come in every few days to the oral surgeon to get this numbing goo put into the holes where my teeth where pulled from and it worked. But I found that ibprofen worked wonderfully for teeth/oral pain, I dont know why it worked way better then the narcotics, but it just does, probably due the the ainti-inflammatory part of the ibprofen did something to the swelling there and released the pain. And I cant do NSAIDs often cause they upset my stomach, but just for a few days I'm ok, and just with ibprofen cause the other NSAIDs makes my stomach hurt with just one dose. But if I where you, I would have some NSAIDs on hand just in case, and I would give them a try if you find that narcotics are not working, cause they worked for me. And the goo, I dont know what the name of it was, it was some pink stuff that tasted really nasty but worked wonderfully. But I swear by the ibprofen for any teeth pain now, I dont even mess with te narcotics anymore for teeth pain, cause they dnt do anything for that kind of pain on me, and I just happened to be tlaking about this on another pain forum, and we all agreed that NSAIDs for teeth work was the best choice. So thats just my experience, I hope it helps some.

-hellokitty


 

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angel8
Regular Member


Date Joined Apr 2009
Total Posts : 109
   Posted 5/15/2009 5:19 AM (GMT -6)   
Do you have a pain contract? This usually changes things to some point and usually covers the area's of other Docs prescribing and how your PM Doc wishes this to be handled. If not give them a call and ask them to explain or cover their policy regarding dental work as you do not want to find out after you fill something from the Dentist that your PM or contract states they will cover any and all pain meds for whatever your having done.
 
I have to say that usually the dentists prescribes what he would normally prescribe for the procedure and evidently it wont cover those of us tolerant to opiates already but sometimes it along with our regular meds is enough to take the edge off.
 
If the dentist prescribes anything at all make sure that your PM Doc gets a copy of that script it is the only way to insure it doesnt come back to bite you. Things and especially messages have a way of getting lost in the office and who will remember you calling? I just ask the pharmacy to fax the copy of the script to my PM office and that way they know and the RPH knows I did everything I could to insure it was noted in my chart.
 
I have seen far too many folks out there lose their PM due to someone not getting the message that another med was prescribed by another Doc for a procedure or whatever and it showing up in a drug test later.

LLPLUV
Veteran Member


Date Joined Mar 2009
Total Posts : 1158
   Posted 5/15/2009 7:44 AM (GMT -6)   
Wow! I was just thinking about this before I went to bed lastnight. I have to have three root canals and 2 extractions done sometime in the near future. I was also wondering about the PM contract. I thank everyone for the advice more then one of us on here needed the information....

Laurie
Chronic Kidney Stones, PKD (Polycystic Kidney Disease), Chronic Kidney Failure, Severe Hypertension, Urological RSD


BionicWoman
Regular Member


Date Joined Jul 2008
Total Posts : 243
   Posted 5/16/2009 2:16 AM (GMT -6)   
My pain doctor is extremely strict about the rule of no other doctors prescribing pain medications. When I have any dental work done, my dentist has to call my pain doctor for a little pow-wow, then my pain doctor calls in the prescription.

Definitely check with your pain doc first, to make sure you're not violating your contract. It'd really stink to get the boot from the pain doc while in pursuit of healthy teeth. smhair

PAlady
Veteran Member


Date Joined Nov 2007
Total Posts : 6795
   Posted 6/2/2009 1:47 PM (GMT -6)   
Shaw,
I'm bumping this up so you can reread some of the advice already given.

Good luck tomorrow!

PaLady
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