GA and pen meds Maine

[adriennecaldwell01]

Hi. I’m looking for an oral surgeon who uses general anesthesia for extractions in Maine who is intelligent enough to differentiate between drug seeking vs pain relieving behavior in the prescribing of pain killers. I also need to pay by Care Credit. I have been on antibiotics since 12/5 for a dental abscess. I have been to a total of 4 dentists and oral surgeons. One would charge $2100 for two extractions and refused to fill antibiotic and a script for two pain killers. One cancelled my appointment and said I was not the patient for them when I wanted the assurance of 1 or 2 pain meds post surgery. The dental office is annoyed with continually sending out the referrals.

 

[geos]

Why do you feel you need prescribed pain meds?

 

[adriennecaldwell01]

What is the intended use for prescribed pain meds?

 

[geos]

The intended use is to treat mild-to-moderate pain associated with conditions such as headache, dental pain, muscle pain, painful menstruation, pain following an accident, and pain following operations.

Those medical professionals don’t seem to think you need it. Have you asked them why? Have you asked what they suggest instead? Have you tried asking your doctor instead?

 

[comfortdentist]

In general the government of the United states has been on a crack down on prescribing opioids. This began a few years ago and I expect it will intensify. For example for me to write a prescription for a patient I need to first look up a patient in a database. The database will list all controlled drugs you have been prescribed in the last two years. It will tell me who wrote them and exactly how many, strength and dosing. I am then required to document that I looked you up before writing the Rx. I also have to go over an informed consent with you before I Rx. And finally I have to use a specialty prescription pad that duplicates and can't be altered.
If I do all of the above I can also only write you for a 3 day supply. Most chain pharmacies will also restrict the strength of the medication that they will fill to the equivalent of 50mg of morphine per day which is like 1 5mg pill of oxycodone every 4 hours.
The days of getting larger prescriptions for acute pain are over. This also indirectly adversely affects doctors who prescribe for chronic conditions as all of us have a license based from the DEA who we must keep happy. Pharmacies face the same scrutiny. This is not met to be an argument for or against use of opioids but rather an explanation of why those of you in the uSA will find obtaining a prescription for them will be much more difficult.

 

[krlovesherkids777]

Thank you for this explanation of the Drs side. It is scary from the vote side thinking you will be in immense pain and unable to get stronger meds. There are times nsaids just don't do the trick.

 

[comfortdentist]

Thank you for this explanation of the Drs side. It is scary from the vote side thinking you will be in immense pain and unable to get stronger meds. There are times nsaids just don't do the trick.

I agree the problem isn't for most people. The problem will be for the pain intolerant opioid resistant individual. Their stories won't be believed by the system.

 

[adriennecaldwell01]

I agree the problem isn't for most people. The problem will be for the pain intolerant opioid resistant individual. Their stories won't be believed by the system.

I am not opioid resistant. I developed an abscess on 12/5 that went up to my eye. It was a Sunday and luckily I was seen as a walk-in at the community health center (moved to Maine recently from NYC). They gave me antibiotics. I scheduled an appointment with dentist no 1. I just needed an X-ray to confirm that it was an abscess and to see if he was able to remove it. He wanted to poke around the tooth with metal instruments and I politely asked him for an x-ray first as poking around an abscess when he wasn’t even sure if he could remove it himself didn’t sound kosher. He told me he couldn’t treat me and that I was limiting his diagnostics. Went to dentist no 2. He took an x-ray and referred me to several oral surgeons. They were all booked till April. Found one he didn’t refer who gave me an over the phone estimate of approximately $500 plus $95 pre surgical consult. Get to appointment with Oral Sugeon no 1 and the estimate changed to $2100 for one tooth. Paid $95 to learn I couldn’t afford his services and he also refused to refill antibiotic script to last till appointment and told me I wouldn’t need pain killers and wouldn’t have any after pain. I told him I can’t take NSAIDS because of stomach reaction and I was treated as a drug addict for requesting one pill for after tooth removal in case there was pain. Waited till 1/30 for appointment with oral surgeon No 2. They day before surgery I confirmed appointment and that I would need one or two pain meds for after surgery and the end result was they told me I wasn’t the patient for them. I explained I have the genetic marker for decreased pain tolerance and local anesthesia resistance of natural redheads and they replied “we don’t care what color hair our patients have.” Guess they weren’t abreast of current medical literature on this topic. So here I am on 2/1 almost two months since the dental abscess still on antibiotics and looking at another three month wait for an appointment. I will not have the surgery without one or two pain pills. I remember one extraction I ended up calling an ambulance from the pain. This is looking very grim.

 

[cjswitch88]

I am not opioid resistant. I developed an abscess on 12/5 that went up to my eye. It was a Sunday and luckily I was seen as a walk-in at the community health center (moved to Maine recently from NYC). They gave me antibiotics. I scheduled an appointment with dentist no 1. I just needed an X-ray to confirm that it was an abscess and to see if he was able to remove it. He wanted to poke around the tooth with metal instruments and I politely asked him for an x-ray first as poking around an abscess when he wasn’t even sure if he could remove it himself didn’t sound kosher. He told me he couldn’t treat me and that I was limiting his diagnostics. Went to dentist no 2. He took an x-ray and referred me to several oral surgeons. They were all booked till April. Found one he didn’t refer who gave me an over the phone estimate of approximately $500 plus $95 pre surgical consult. Get to appointment with Oral Sugeon no 1 and the estimate changed to $2100 for one tooth. Paid $95 to learn I couldn’t afford his services and he also refused to refill antibiotic script to last till appointment and told me I wouldn’t need pain killers and wouldn’t have any after pain. I told him I can’t take NSAIDS because of stomach reaction and I was treated as a drug addict for requesting one pill for after tooth removal in case there was pain. Waited till 1/30 for appointment with oral surgeon No 2. They day before surgery I confirmed appointment and that I would need one or two pain meds for after surgery and the end result was they told me I wasn’t the patient for them. I explained I have the genetic marker for decreased pain tolerance and local anesthesia resistance of natural redheads and they replied “we don’t care what color hair our patients have.” Guess they weren’t abreast of current medical literature on this topic. So here I am on 2/1 almost two months since the dental abscess still on antibiotics and looking at another three month wait for an appointment. I will not have the surgery without one or two pain pills. I remember one extraction I ended up calling an ambulance from the pain. This is looking very grim.

Do you mind explaining more of the abscess issue? I am at fear of one developing in the infected gum area of my mouth at the moment, and same issue here, paid 225$ for a lousy dental visit that I was told would be 60$ over the phone, after talking about my post op root canal treatment they reccomended OTC stuff that hurts my stomach. I asked them if there was any liquid pain reliever or a stronger pill where I won't have to take 6 NSAID a day and further my stomach ulcers. He looked at me as if I'm a drug addict. I put a checkmark on drug use and smoker because I use cannabis legally for medical reasons, but was quickly seemed to be looked at as some drug abuser.

 

[adriennecaldwell01]

I think dental medicine is reverting to the dark ages. It should be really clear whether someone is an addict or not. If a patient has an abscess chances are very good that any request for pain meds is pain avoiding rather than drug seeking behavior. Who the hell can create an abscess in an attempt to get a few pills? Or would they take a chisel to their teeth to get a few pills. I did not experience this in the city and it’s leading me to believe that only metropolitan area rejects work here in Maine. It’s pathetic. I will now report any dentist who refuses one or two pain med pills for a traumatic surgery to the dental licensing board.

 

[krlovesherkids777]

It IS really sad that they are reverting to not giving meds for truly painful dental situations , I have ulcers too( thankfully not super bad right now) and can't take many nsaids. tylenol is better than ibuprofen, but.. none are good . Thankfully I haven't had an issue where I was in TOO much pain for some time. My last dentist did give me pain meds as needed but I didn't take them unless it was really bad. I"m wondering if the dentists see this. @comfortdentist are there certain procedures that deem them more legitimate or not for the pain and how can they really measure our level of pain? hard situation.

 

[comfortdentist]

Traditional periodontal surgery is painful, bone grafting that requires dissection and flap advancement results in considerable swelling, bruising and pain, extractions where the dentist uses a lot of force for a long time results in more pain.
Lower pain procedures:
quick extractions/ low force
implant placement in a well healed area without much manipulation
Variable Pain:
Root canal treatment both on access/instrument day and generally less on obturation when on a separate day.
Now my experiences:
My recent root canal- 1st night it hurt some I took nothing because I elected not to. I think 400mg ibuprofenor 1000mg acetaminophen would have been adequate.
I had a sinus lift and I took a opioid that night.
I had a three hour surgery on my finger I destroyed spear fishing so I took oxycodone 1 day and I really needed it.
So what to expect from doctors in this market:
They will be reluctant to prescribe to a patient they don't know. Any patient that asks about pain medication prior to procedure will be suspect. Any patient that has received multiple prescriptions for controlled drugs in the data base will be suspicious.
If you have a rather invasive procedure done then it is still reasonable to receive a prescription for a couple of days. Most people need for the first 24 hours then it eases off.
As to complaints to the board you are complaining to the wrong people as it is the DEA policy that is the issue. Complain to the board that your dentist told you to take ibuprofen and acetaminophen and put on ice for a couple of days while you want a controlled drug will go no where. Many dentists are dropping their DEA license because of all the problems and expense.

 

[krlovesherkids777]

Thank you Comfort dentist , very informative, helpful and easy to understand information .

 

[adriennecaldwell01]

I asked for one or two pills. It will be invasive as the roots separated and moved farther into the gums and there is an abscess. The tooth on the other side will involve cutting gum because it was a root canal that should never have performed so it cracked off beyond gum line. There is no way I’m doing this without one or two measles 5 mg oxy meds. They will see 0 scripts within last 2 years for pain meds. There are actual genetic markers for opioid addiction and I don’t have it. I experience no euphoria and don’t even like it as it interferes with getting things done but if pain is unbearable I will take it. If I don’t find an oral surgeon willing to give me a script for one or two I guess I will not survive this abscess as the fasciitis was up to my eye before starting meds. Ive been on antibiotics since 12/5. Eventually I will build a resistance.

 

[adriennecaldwell01]

Moreover recommending acetaminophen and ibuprofen is uncontraindicated for patients unable to tolerate them. As I said this entire issue brings dental medicine back to the dark ages and leaves me suspecting that the dental practioners enjoy inflicting pain.

 

[cjswitch88]

It IS really sad that they are reverting to not giving meds for truly painful dental situations , I have ulcers too( thankfully not super bad right now) and can't take many nsaids. tylenol is better than ibuprofen, but.. none are good . Thankfully I haven't had an issue where I was in TOO much pain for some time. My last dentist did give me pain meds as needed but I didn't take them unless it was really bad. I"m wondering if the dentists see this. @comfortdentist are there certain procedures that deem them more legitimate or not for the pain and how can they really measure our level of pain? hard situation.

yep I take ibu, 1-6 a day depending on my pain, and it has destroyed my ALREADY destroyed stomach lol... Yet I keep doing it because obviously I'm in pain and delaying the dental visit...