Apicoectomy concerns

[collin]

Hello, I'm having an apicoectomy done on #9 and #10, two crowns with no nerves in them. Since an accident at 11, I've had root canals, crowns, and re-treatment of the root canals. Because of all that, usually I'm not scared to go to the dentist generally because it can't be worse than four root canals, but this feels different.

Right now I'm scared about two things:

1. The oral surgeon told me he wasn't going to prescribe pain medication after the surgery, but he will prescribe steroids to help with the swelling. Since they are cutting my gums, I'm very scared it will be awful afterward. I understand the opiate crisis, but damn. Does anyone have experience with this? Does ibuprofen and steroids generally work?
2. The abscess in my tooth has been causing migraines (or making them worse), and I have an odd feeling in my face where the trigeminal nerve is right now. I'm scared they will mess up the surgery somehow and hit a nerve and I'll have permanent pain. I recognize this fear as a little bit irrational, but it's still messing me up. If there's someone out there that knows where nerves are (??), it would be great to get some reassurance on this.

This surgery needs to happen because I can't live with the abscess, but the anxiety attacks aren't helping. Thank you!

 

[Gordon]

1) He's right. Despite what you might think, it's been pretty well documented that opioids are of little to no use for dental pain. NSAID drugs have done much better in pretty much every scientific test that's been done. If your stomach can handle it, good old aspirin is probably the best of the lot. The pain is mostly from inflammation, so the anti inflammatory effect of the drugs (the AI bit in their name) is the most useful, the steroids are good too for the same reason.
2) They won't be anywhere near the main nerves in your face. Just FYI nerve damage usually results in loss of sensation rather than increase in sensation i.e. pain.

 

[collin]

Thank you, I feel a lot better about both of these questions.