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paintref
Look, I see stars
join:2003-02-21
Houston, TX

paintref

Member

Over the counter painkiller stronger than advil?

I had 3 fillings done last Friday and I have pain from tooth sensitivity from said fillings.

On most days, my pain is tolerable and I take advil gel caps. But for 2 days in a row, I have been having unbearable pain and advil does not cut it (Although it will subside eventually).

I am hesitant to go ask my dentist for a prescription painkiller, since this pain is supposed to be temporary (2-4 weeks is what I have read and I am in my first week as of today).

Is there anything I can buy OTC that is stronger than advil?

John Galt6
Forward, March
Premium Member
join:2004-09-30
Happy Camp

John Galt6

Premium Member

This might answer your question:

»www.safemedication.com/s ··· ers.aspx

There shouldn't be any issue asking your dentist for a prescription. Simply tell them you OTC meds are not working at the recommended dosages.

paintref
Look, I see stars
join:2003-02-21
Houston, TX

paintref

Member

said by John Galt6:

This might answer your question:

»www.safemedication.com/s ··· ers.aspx

There shouldn't be any issue asking your dentist for a prescription. Simply tell them you OTC meds are not working at the recommended dosages.

The article was a bit confusing to follow, but I get the general idea.

I am going to wait and see how this week goes and continue taking advil. If it gets worse again, I will go see my dentist.
BlitzenZeus
Burnt Out Cynic
Premium Member
join:2000-01-13

BlitzenZeus

Premium Member

Without knowing what you're exactly going through I will say I've been on oxy-something for my back for months before I was finally approved for surgery, and that didn't even begin to take away the majority of pain I temporarily had in a tooth. I did built up a tolerance for having to take them for months when they tried to see if physical therapy would actually help, it didn't as my disc was actually crushed, which then was pinching a nerve also causing other lovely problems, and vicodin would have been like children's tylenol.

I know there stuff you can buy otc to put on your gums to numb them.

paintref
Look, I see stars
join:2003-02-21
Houston, TX

paintref

Member

said by BlitzenZeus:

I know there stuff you can buy otc to put on your gums to numb them.

Orajel is the one I was thinking of, may have to go out and try that...would be good to have on the go.

dandelion
MVM
join:2003-04-29
Germantown, TN

1 recommendation

dandelion to paintref

MVM

to paintref
I am assuming you are doing the usual like brushing with sensidine toothpaste.. no very cold/very hot liquids.. careful of chewing hard things. Mix an advil with a 12 hour aleve might help taking on a regular basis i.e. every 12 hour whether you hurt or not. Also tylenol for arthritis might help. A lot of pain however can be a symptom of other problems so I would advise to call your dentist. He/she may wish to see you again.

John Galt6
Forward, March
Premium Member
join:2004-09-30
Happy Camp

2 edits

1 recommendation

John Galt6 to paintref

Premium Member

to paintref
Here's an answer directly relevant to your issue:

»www.medscape.com/viewart ··· e/809415

Summarizing...
quote:
The combination of ibuprofen and acetaminophen works better than the combination of an opioid drug and acetaminophen for the relief of pain from dental operations, according to results from a new analysis of published data. The analysis also showed that the ibuprofen and acetaminophen combination was safer than combinations that include opioids.

.....

Previous research has shown that combining analgesics that work differently provides more pain relief than a single analgesic can provide on its own.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, work by blocking the synthesis of prostaglandins, suppressing both inflammation and pain, the researchers note. In contrast, acetaminophen does not suppress inflammation and appears to suppress pain through multiple other mechanisms. Increasing doses of these drugs can increase their effectiveness only up to a point, and high doses can be toxic, but the 2 together can suppress pain better than either alone, the authors write.

.....

They found consistent evidence for the effectiveness of the combination. As a measurement for comparing the various treatments, they used number needed to treat (NNT), defined as "the number of patients needed to be treated to obtain one additional patient achieving at least 50 percent maximum pain relief over four to six hours compared with placebo." The lower the NNT, the more potent the pain relief.

Zeroing in on studies for controlling the pain of third molar extractions, they found that 200 mg ibuprofen combined with 500 mg acetaminophen had the lowest NNT of the treatments tested in the studies they analyzed. The NNT for this combination was of 1.6 (95% confidence interval [CI], 1.4 - 1.8) compared with a 2.2 NNT (95% CI, 1.8 - 2.9) for 60 mg codeine with 1000 mg acetaminophen.

.....

For mild pain, the guidelines call for clinicians to prescribe 200 to 400 mg ibuprofen to be taken every 4 to 6 hours as needed. For mild to moderate pain, the guidelines call for 400 to 600 mg ibuprofen every 6 hours for 24 hours, followed by 400 mg ibuprofen every 4 to 6 hours as needed.

For moderate to severe pain, the guidelines call for 400 to 600 mg ibuprofen with 500 mg acetaminophen every 6 hours for 24 hours, and then 400 mg ibuprofen with 500 mg acetaminophen every 6 hours as needed.

Finally, for severe pain, the guidelines call for 400 to 600 mg ibuprofen with 650 mg acetaminophen and 10 mg hydrocodone every 6 hours for 24 to 48 hours, followed by 400 to 600 mg ibuprofen with 500 mg acetaminophen every 6 hours as needed.

It is important to avoid daily doses of more than 3000 mg acetaminophen or 2400 mg ibuprofen, the guidelines state. Therefore, clinicians should be aware of what other medications patients might be using that contain these drugs and should warn patients about the maximum safe daily dose.

In addition, NSAIDS may work best when administered preemptively. The guidelines add that a perioperative corticosteroid such as dexamethasone may limit swelling and decrease postoperative discomfort after third molar extractions.


There is much more to the article, but this hits the highlights most relevant to the discussion. Note that the statement about acting preemptively. Don't wait for the pain to start before taking the medications. Establish a schedule and stick to it. Make sure you are drinking sufficient water both when you take the medication, and during the interval between. As always, give due consideration to other medications that you might be taking, and consult your doctor or dentist if you have any questions about possible drug interactions, or if you have medical issues that might require professional guidence.

kevinds
Premium Member
join:2003-05-01
Calgary, AB

kevinds

Premium Member

500mg acetaminophen and 400mg ibuprofen
or
500 acetaminophen and 500 naproxen

are good combinations

Boooost
@76.65.143.x

Boooost to paintref

Anon

to paintref
Careful with the Advil. I know someone who ended up in the hospital with internal bleeding from taking Advil (ibuprofen). Don't take it long-term.

paintref
Look, I see stars
join:2003-02-21
Houston, TX

1 recommendation

paintref to dandelion

Member

to dandelion
said by dandelion:

I am assuming you are doing the usual like brushing with sensidine toothpaste.. no very cold/very hot liquids.. careful of chewing hard things. Mix an advil with a 12 hour aleve might help taking on a regular basis i.e. every 12 hour whether you hurt or not. Also tylenol for arthritis might help.


Yes, doing all the things you mentioned. I will try what you suggested the next time pain is bad.
said by dandelion:

A lot of pain however can be a symptom of other problems so I would advise to call your dentist. He/she may wish to see you again.

Today the pain is slight, nothing like the pain I experienced for 2 days straight. If it does get bad again, I will follow up with my dentist.

Thanks everyone for the help.
PX Eliezer1
Premium Member
join:2013-03-10
Zubrowka USA

1 recommendation

PX Eliezer1

Premium Member

Absolutely do not overdose on any of the meds mentioned, no matter how tempting. Risk of ulcers as noted, and liver toxicity.

Also when taking acetaminophen (called paracetamol in many countries) do NOT consume any alcohol. Combining acetaminophen and alcohol can severely damage both the liver and kidney.
moes
Premium Member
join:2009-11-15
Cedar City, UT

moes to Boooost

Premium Member

to Boooost
taking it for years with bad teeth, you have to watch how you take it. typically I'm at 800mg when working 12 hour shifts and on my feet and then typically 200 or so when home for my teeth and related pains. sometimes that can jump to 1000mg or higher depening on the pain level.

but I will only take it once a day at max. I've learned my limits.