Dental questions: emergency root canals and pain medication

In My Humble Opinion
1

As is my custom, I’ll break this into “backstory” and “actual questions.” Please feel free to skip my yammering if it suits you. I should also mention that I’ve never had any kind of significant dental work done, so these might well be stupid questions, but there you have it.

**Backstory: **

Last week, I discovered that the godawful toothache I’d been having for a few days was being caused by an enormous hole in one of my molars. I figured that was something I ought to have looked at, so I called a dentist, and they got me in a couple of days later for an emergency appointment. They told me I needed a root canal, which they could do in three to four weeks.

To combat the pain, they prescribed Vicoprofen 7.5/200, to be used every six hours as needed. I’d never taken opioids before, so I was wary of taking any, and managed to get through the first couple days with the help of Pierre Smirnoff, clove oil, hydrogen peroxide, and a whole lot of swearing.

On day three, it literally began bringing tears to my eyes, so I gave in and tried the pills. Long story short, I’m not sure why anyone would use this stuff recreationally — at the height of the drug’s effects, my tooth doesn’t hurt anymore (which I suppose is euphoric in a sense, but I don’t think it’s quite what junkies are after), but beyond that they just make me a bit sleepy.

I’ve still been trying to use them as little as possible, and I’m holding steady at two pills a day. They take two hours to kick in and provide 2-3 hours of relief, so I’m still in pain a little over half the time, but I can deal with that as long as there’s some respite.

I’m starting to get a bit worried, though, because they only gave me 16 pills for what will almost certainly be a three-week-minimum wait, and at this point, these things are the only way I can get to sleep. So, with that in mind…

Actual Questions:

  1. How much hassle am I likely to get when I ask the dentist for a refill on the Vicoprofen? As I said, I’ve never had opioids before, and am using them much less frequently than I could be per the directions, but I’m given to understand that many doctors are wary of pain med scripts these days.

And somewhat off the wall, but…

  1. Is there any way I could get the root canal done in anything resembling an immediate fashion? If so, how would I find a place to do it? I tried a few searches, but my Google-fu is failing me — I’m just finding ads for emergency dental exams and no-wait insurance policies. I don’t much care if my insurance covers it or not; I’ve got savings that were earmarked for a vacation that I’m more than willing to throw at this if it means I don’t have to sit around in agony for weeks. (I suppose I could just call every dentist in town to check schedules, but I’m hoping more for a search term I could use to find a premium wait-free dental clinic, if such a thing exists.)

As always, any advice is greatly appreciated. (I’d give you one of these :D, but it comes off as more of a grimace at the moment…)

2

Did they give you antibiotics? It’s not the hole that is hurting, it’s the infection. They can’t do the root canal until the infection is taken care of.

ETA: One the infection is under control , the pain should subside. This takes at most a couple of days. Second, I’ve always found doctors are much more likely to take tooth pain seriously than dentists. Dentists have become desensitized.

3

When I went to the dentist with a toothache, he sent me to a endodontist, who prescribed a root canal (surprise!) as the treatment, and scheduled me for two days later. I’m surprised that they are telling you that you must wait for weeks!

4

Yeah, I got amoxicillin. Meant to mention that they did say the infection was the reason for the wait, but also said it should clear up in 2-3 days — I got the strong impression, though they didn’t say it outright, that the rest of the wait was due to scheduling.

That said, I’ve been taking the antibiotics religiously since Tuesday, and the pain hasn’t decreased at all. Is that cause for a followup visit?

5

Absolutely. In fact, I’d go to an urgent care place right the fuck now. They can give you a different antibiotic, and, if they feel like you need it, a shot.

Are you running a fever?

6

Where the hell are you at that it took the dentist two days to see you on emergency notice, and 3-4 weeks for someone to get to you for a root canal?

I live in a city of 250k. Last October I got a next day (Monday) emergency exam for tooth/gum pain which discovered an abscess. A root canal was performed the next day after the exam. Other non-emergency work culminating with a crown was finished 42 days after the initial emergency exam.

I have a hydrocodone supply for gout, but luckily the pain, though significant, never got bad enough for me to have to take any real dope.

7

Huh. No, apart from the pickaxe that my nervous system is convinced is lodged in my right cheek, I’m just fine.

I’ll give it tonight, and if it hasn’t changed by morning, I’ll find an urgent care place with weekend hours.

8

I thought the timeframe was odd too, but I didn’t have anything to compare it to, so I just kind of went with it. (To answer your question, Roanoke has a population of about ~100k…Chicago it ain’t, but hardly BFE either, so I’m sure I can find another dentist or ten if I need to.)

9

Three weeks sounds excessive, given what’s going on inside the tooth! Sounds like you need a new dentist.

Story sharing time: It took my dentist about a month between my initial visit and the root canal appointment…I wasn’t in much pain at all though, aside from some throbbing when I would drink cold liquids. When the root canal was performed, it was found that the root was mostly necrotic…I wasn’t feeling very much pain because the root had pretty much died.

10

Dentist here, sorry Manda JO but you can have great pain without an abcess and we absolutly can do root canals before an infection is cleared up.

Roland, three weeks is way to long to wait for an emergency. At my office we will almost always get you in for the root canal the day you call. Call around, someone should be able to get you in much sooner, like Monday at the latest. Usually take about 24 hours for antibiotics to start working. Placing heat on the area will also help with an infection. Short of major swelling(that which can be seen looking at your face) I’d be inclined to think that with five days of antibiotics already, the pain is much more likely a result of the exposed nerve v. an infection.

11

I went to the dentist because I had pain when I bit down on one side. They started the root canal immediately (same day) and gave me antibiotics and pain pills. I had to go back twice once to complete the root canal then to have crown fit on. Actually twice more after that to a different dentist because the tooth never stopped hurting, so I had it operated one and then finally had it pulled, but that was more because of the bad dentistry in my opinion. After quite a few years I can actually chew on that side again.

I didn’t really need any more of the pain pills after the first few hours each time they worked on the tooth but it really did a number on me regardless. I wasn’t in a lot of pain but I felt like I had exercised to the point of exhaustion after having an awful day at work. weak, trembly, cranky etc.

I don’t know if the dentist will give you more pain pills but I don’t know why they wouldn’t as long as there is a decent amount of time since the original ones. shouldn’t hurt to ask them for more and for antibiotics to fight the infection.

12

Add another voice to everyone telling you that that is far too long to wait for a root canal when you’re in that much pain.

To go in a different direction, is it your furthest back molar? I’d suggest that with a big hole in it, you might be better off just having it yanked. Dentists (no offence, rsat3acr) tend to err on the side of trying to save every tooth, all the time. A couple of years ago I had a tooth pulled out that had been bothering me for years and years - crown, root canal, the whole shebang, and it never really stopped aching. It was a blessed relief to have that tooth pulled out - the hole barely hurt at all after it was pulled, and after a couple of days, it felt better than it had in years. Not all teeth make it to the end. :slight_smile:

13

You shouldn’t get hassled to get more, but if you got antibiotics, they might be expecting those to help knock down the pain as well. If you’re worried, you could always end your request with “or is there anyway I could get in sooner, I’m really dying here”…not that they haven’t heard that a thousand times.

WRT your comment of “I’m not sure why anyone would use this stuff recreationally”, it’s pretty common to not get much of a buzz off those kinds of pills if you’re in enough pain to need them to begin with, and most people (that aren’t in pain) would take at least 2-3 (7.5s) to get any kind of high from them. Also, I know you said you get sleepy, and that’s common, but, personally, I’m the opposite. If I take Vicodin, I can clean my entire house, hell, I could paint my entire house. That stuff makes me feel like I’m on Ritalin (and Vicodin). Even if I’m actually taking it for pain, I have to make sure I take it a good 6 hours or so before I go to bed and have some Benadryl on hand and I’m not going to be falling asleep anytime soon.

14

I had a Wisdom Tooth just about rot out of my head a few years ago. I was fine and then all of a sudden I had a horrible pain back there. Called the dentist, got in that day (maybe the next day) and at some point before I made it into his chair I noticed have the tooth was missing. He took one look at it and said it’s not even worth trying to fix and sent me to an Oral Surgeon. I was nervous as hell, but it was so easy that I wished after he was done I had the presence of mind to ask him to pull out the other top one (also erupted). I went from being on agony to being in no pain at all in a matter of hours.

15

none taken. You are absolutly correct not all teeth should be saved and not all teeth can be saved even if you want to. To fix or extract is a decision for the patient to make with my guidance. I can give the pros and cons of everything but they make the final decision.

Also Roland the vicoprofen has 7.5 mg of hydrocodone and 200 mg of Ibuprofen. you can take 600 mg of ibuprofen every 6 hours. I’d take two over the counter Advil about 4 hours after taking the vicoprofen. That spreads the dose out over time so keeps the level of drug from spiking as much.

16

I’ll be damned- I’m originally from Bedford.

I might understand such slow service for someone who had to rely on the presumably higher patient to dentist ratio in a place as small as Bedford (city ~6,000, county ~ 70,000), but I never would have guessed it for the much larger Roanoke.

17

Lots of great information in this thread, thanks very much! rsat3acr, I’ll take you up on that Advil advice.

As for pulling vs. saving, I originally thought it was a wisdom tooth — it’s the very back tooth, but apparently I only have wisdom teeth on the top — and asked to have it pulled. The dentist corrected me, and said “you don’t want to start pulling molars at 30.” (This bag of fun started on the 21st, which was my 30th birthday. The good news is that rest of the decade pretty much has to be looking up.)

But, based on the input in this thread and other information I’ve found, I may be going dentist shopping anyhow. I’ll call the original office first (I picked it based on convenient location) and see if they can get me in sooner, but if not, I’ll start making calls.

WheatCat — I’ve been through Bedford any number of times. Nice town, though you’re right that there’s not a heck of a lot to it. Have you been back to see the D-Day Memorial? It’s pretty impressive.

18

Roland sounds like a second molar not a wisdom tooth. There is no right or wrong as to pulling verses root canal. You have to weigh everything such as cost and length of time for treatment, changes in chewing and aesthetics. For second molars there is no aesthetic issue. A slight loss of chewing but not much(as opposed to first molars that give a great ammount of chewing). really it comes down to cost and time for this tooth and everyone has to make that determination for themselves. I my office a RCT, build up and crown would take an hour appointment for the RCT and hour appointment for the build up and crown prep and then a half hour appointment to seat the crown with a total cost of about $1800. A week to two weeks between the RCT and crown prep and two weeks between the crown prep and seat. All things being equal it is better to save the tooth then pull it but that doesn’t always work for everyone.

19

I moved away from Bedford in 1971, but my other lived there Bedford until 2003, and I may have visited 200 times 1971-2003. It is a very relaxing place and has some of the best mountain scenery in the world.

I was at the D-Day Memorial opening ceremony. I have not actually visited the memorial since then; I should, and hope I can get to it some day.

20

I was thinking that 30 is too young to lose a tooth permanently (I had my problem tooth out when I was around 45), but then I realized that the tooth had been bugging me since I was about 30. If I’d known then what I know now, I’d have had it yanked 15 years ago. As you say, though, you try the treatments, and if they succeed, great. If not, then you go for the Final Solution. :slight_smile: